what is the profile of infected people and how can it change as the disease progresses

Monkeypox seen under an electron microscope.



Monkeypox seen under an electron microscope.

Men under the age of 40 who have sex with men are most affected by the monkeypox virus in the first months since cases began to spread around the world.

Experts warn that this does not mean that other people are safe from the threat: as the virus spreads around the world, it tends to infect more and more people than do not correspond to this initial profile.

In the United States, for example, the first two cases of this infection in babies have already been detected.

“It’s a matter of weeks before we start seeing more cases in other groups, like heterosexuals or children,” predicts Dr Nésio Fernandes, president of Brazil’s National Council of Health Secretaries.

“This is the expected natural history of the disease,” he adds.

Current profile of those most affected by monkeypox

One of the major studies assessing this question was recently published in The New England Journal of Medicine.

In it, experts from Queen Mary University of London, together with several other UK institutions, assessed 528 cases of monkeypox that occurred between April and June in 16 different countries.

Figures show that 98% of patients identify as gay, bisexual or men who have sex with men. Three-quarters of them say they are white and 41% are HIV-positive.

The average age of the individuals assessed was 38 years old and 95% had sex as the primary suspicion of contact with monkeypox.

As for symptoms, the study found that 95% had skin irritation (two-thirds had less than ten lesions).

In 73% of the participants, the location of the sores was in the area of ​​the anus and genitals, while 41% had irritations in the oral mucosa.

Among general symptoms, 62% of patients presented with fever. Other common signs were swollen lymph nodes or “lumps” (occurring in 56% of participants), lethargy (41%), muscle pain (31%) and headache (27%).

The average incubation period, or the time between contact with the virus and the onset of symptoms, was seven days. But some people have taken three to 20 days to feel the first signs of monkeypox.

Inform without stigmatizing

Specialists consulted by BBC Brazil point out that it makes no sense to see only men who have sex with men as a risk group for this virus.

“The concentration of cases in these individuals is a thing of the moment and each disease has its own dynamics”, underlines Doctor Alexandre Naime Barbosa, vice-president of the Brazilian Society of Infectious Diseases.

“We already have at least 70 or 80 children in the world diagnosed with monkeypox and half of them are under four years old”, calculates the specialist, who is also a teacher at the school. State Universityyouin Paulista.

The main mode of transmission of monkeypox is direct contact with the wounds of an infected person. This is why sexual intercourse, where there is skin-to-skin friction, has been shown to be one of the most common sources of infection.

But this virus can also be transmitted by droplets of saliva or by contaminated objects such as dishes, towels and sheets.

Health worker vaccinating a man against monkeypox.



Vaccination against monkeypox is already practiced in some countries of the northern hemisphere.

A fourth way to contract monkeypox is by being close to animals that carry the pathogen; it is also one of the main forms of transmission in parts of Africa where the virus has been endemic for decades, especially in wild areas.

The World Health Organization (WHO) describes that this mode of infection can occur through direct contact with the blood, body fluids and skin lesions of infected animals, such as rodents and primates.

In the opinion of infectiologist Mirian Dal Ben, from the Sirio-Lebanese Hospital in São Paulo, all these forms of transmission (in particular sex, saliva and contaminated objects, which spread the disease in several countries) mean that “Sooner or later, monkeypox will create chains of transmission in other subgroups.”

“It is not a disease restricted to one profile or another”, he specifies.

“And it seems we’re so afraid of stigmatizing certain groups that we’re not able to offer adequate advice to those who are most at risk right now,” the doctor says.

How to protect yourself and others

The first step is to be aware of the symptoms and seek medical attention if they appear.

“Any lesion that starts out as edema or a little redness and progresses to a spot, has fluid, forms a sore and scabs, it could be monkeypox,” Barbosa describes.

These manifestations can appear in the anus, genitals, face and hands.

“That lesion could also be acne, herpes, shingles or a host of other things. But if in doubt, it’s important to see a doctor and get tested,” he adds. he.

Examples of lesions caused by monkeypox.



Examples of lesions caused by monkeypox.

If the examination confirms the presence of this infectious agent, health professionals recommend isolation and avoid close contact with other people until the wounds are completely healed (even their scabs are still carrying the virus) .

By limiting interactions, the patient reduces the risk of transmission of the virus and avoids the creation of new chains of contagion in the community.

In most cases, the disease progresses well and the person recovers after a few weeks. The UK study found that 13% of patients followed required hospitalization, with the main reasons for admission being severe anal and rectal pain, opportunistic infections and, more rarely, pharyngitis, eye trauma, acute renal failure and myocarditis (a type of inflammation in the heart).

Some countries, such as the United Kingdom, Spain and the United States, have already launched a vaccination campaign against monkeypox.

At this time, it is unclear whether condoms help protect against this virus, although their use remains essential to prevent the transmission of various sexually transmitted diseases (STDs), such as HIV, syphilis, gonorrhea and some hepatitis.

At a recent press conference, WHO Director-General Tedros Adhanom Ghebreyesus also advised groups where the disease is currently most prevalent to temporarily limit the number of sexual partners.

“For men who have sex with men, it means making safer decisions for themselves and others,” he said.

Andy Seale, WHO adviser on HIV, hepatitis and STDs, said he hoped the advice would only be valid for a short time. “Our hope is that this epidemic will not last long.”

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