Monkeypox: reasons for concern

A researcher in the Indian laboratory studying monkeypox. / ECE

WHO monitors a disease with more than 18,000 cases and which records the first two deaths in Europe in Spain

Alvaro Soto

In mid-May, a health alert shook epidemiologists. The UK had just detected two cases of monkeypox, a disease that had never been transmitted outside of Africa. Overcome with the initial scare, the early news was relatively good. In young people, his symptoms were uncomfortable but not dangerous; and by avoiding contact between risk groups (especially men who have sex with men), chains of transmission could be brought under control within weeks.

However, everything got complicated, to the point that the World Health Organization (WHO) – yes, with its divided experts – a week ago declared monkeypox an international public health emergency of a “disturbing nature”. . can define for a disease. How did we get there ?

What happened in London?

Scientists continue to study how monkeypox, previously confined to central or western Africa, was able to spread to the heart of Europe. “The most likely theory is that before the first two cases (unrelated to each other) were reported in the UK capital, the virus was already circulating in the UK or on the continent,” explains the professor of microbiology at the University of Salamanca. Raúl Rivas, who has followed the spread of the epidemic from the start.

What does the declaration of emergency “concerning” mean?

“This is the seventh time that a statement of this type has been made in thirteen years,” said Rivas. In 2009 because of the H1N1 virus pandemic (swine flu), in 2014 because of poliomyelitis, in the period 2013-2016 because of the Ebola epidemic in West Africa, in 2015 and 2016 in cause of the Zika virus epidemic, from 2018 to 2020 due to the Ebola epidemic in Kivu and the penultimate, due to the covid-19 pandemic. With this statement, the WHO warns that a disease has become “a public health risk to other states through the international spread of the disease and potentially requires a coordinated international response,” says Rivas.

How is monkeypox spread?

She does this through very close physical contact, mostly through risky sex. According to a report from La Paz University Hospital in Madrid published this week in ‘The New England Journal of Medicine’, 95% of infections have occurred during sexual activity between men. But health authorities warn: if the transmission is not controlled, there is a good chance that it will spread to other groups and, if this happens, vulnerable people (immunosuppressed, transplant recipients, babies or elderly people). ) may be at risk.

new symptoms

The most common symptoms in patients are rash, fever, fatigue, muscle aches, vomiting, diarrhea, chills, sore throat or headache. But experts have also detected anogenital lesions or mucosal lesions.

What does the WHO do?

When it issued the alert a week ago, the organization asked infected people, suspected cases and their relatives not to travel to avoid spreading the virus. The health agency has also asked countries to establish protocols for carrying out diagnostic tests. But this Wednesday the WHO went further. With 18,000 confirmed cases worldwide, he called on gay people to reduce their sexual contact and “exchange information” about the possibility of being infected with people they have sex with.

Treatments and vaccines

In Europe, the medicine Tecovirimat SIGA, authorized for the treatment of smallpox, monkeypox and cowpox, and the vaccine Imvanex, authorized to protect adults against smallpox and monkeypox, can be used.

Situation in Spain

Spain is the second country in the world with the most cases (4,298) only surpassed by the United States (4,907). In Europe, the other states with the most patients are Germany (2,540), the United Kingdom (2,367) and France (1,837). Spain was one of the first European countries to detect cases and an event, Maspalomas Pride, and a venue, Sauna Paraíso in Madrid, became hotbeds of the disease in May. He was also the first to confirm two deaths – the first on the Old Continent – in the Valencian Community and Cordoba. With a patient in Brazil, these are the only deaths outside Africa.

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