Three questions about monkeypox and its forms of contagion

First modification:

With more than 19,000 cases in 76 countries, the World Health Organization (WHO) on July 23 declared monkeypox a public health emergency of international concern, its highest level of alert. RFI spoke with Dr Javier Membrillo, spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).

For Patricia Paez.

RFI: What are people recommended to avoid contagion?

Dr. Javier Membrillo: While it is true that it can be spread through respiratory droplets, this contagion is very difficult and unlikely. It requires a very intimate contact and even then it is difficult. It’s not about covid, it’s not a disease that can be contracted while walking down the street, in a mall, at a public event.

Infection mainly occurs through skin-to-skin contact with people with these skin lesions. What you should do is avoid contact with people who have compatible symptoms. Mainly what we see is that almost all cases are due to intimate skin-to-skin contact during sex.

Avoid having sex with people who have symptoms or skin lesions compatible with the disease. The condom would not completely protect us, although smallpox behaves like a sexually transmitted disease. Contagion is not proven to occur through fluids, such as semen, vaginal discharge, etc. For this reason, the condom alone would not protect against infection in a person who, for example, has the characteristic lesions of the disease in the pelvis.

RFI: Knowing that this is a endemic diseasetypical of the African tropical zones, Why is Europe the most affected region?

Dr. Javier Membrillo: Because the environment in which the chains of contagion are established is difficult to control. Once the disease has begun to circulate in the environment of people, especially men who have sex with men, or who attend parties with sporadic sex with unknown partners, and who do not respect the hygienic measures, it is very difficult to break the chain. transmission. We are left with the additional difficulty that the condom does not completely protect against disease.

It has been interpreted that the disease is transmitted fundamentally in groups of men who have sex with men and, therefore, that it is an exclusive disease of the homosexual group. For this reason, there are heterosexual patients who become infected because they do not take precautions. For example, I think of a case we witnessed a month ago of a straight man who had sex with a prostitute without a condom and got infected.

RFI: Following WHO’s high alert, what measures should countries put in place? March?

Dr. Javier Membrillo: First, information to the population, to understand how the disease is transmitted and how to prevent it. Second, this alert should promote cooperation between countries for access to vaccines and antiviral treatments.

If we have problems accessing these treatments in Spain, what else will we not have in other countries with a lower socio-economic level? In Africa, this disease has always been with us, we have deaths every year and no one has bothered to help these countries vaccinate or treat seriously ill patients.

Eventually, sooner or later, in a world with more than a billion international trips every year, the diseases that we neglect in developing countries end up affecting us.

Finally, since I am talking about Spain, it is essential to have professionals trained and prepared specifically to detect and treat these cases. Surprisingly, Spain, in the year 2022, remains the only country in the European Union that does not have a recognized specialty in infectious diseases. This may have influenced the fact that we do not detect cases with symptoms that are out of the ordinary and that we do not treat them properly.

► Listen to our full interview.

Interview with Javier Membrillo, spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology

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