London, May 4, 2022 – A man admitted with a rash and fever becomes the first confirmed case with symptoms of monkeypox outside of Africa in six months. Since 2018, there have been isolated casesall imported from countries like Nigeria, where the virus was considered endemic Monkeypox. But, three months later, we are faced with the largest international outbreak of monkeypox in its entire history.
The first Spanish case of monkeypox started symptoms on April 26, that is to say on dates similar to the appearance of the symptoms of the British patient, who came from Nigeria. The last The Carlos III Health Institute report collects 4,298 cases reported since then in Spain.
The epidemic curve indicates there was no exponential explosionI. In other words, it’s not comparable to the start of the coronavirus pandemic and a good part of its waves. Infections continue, indicates from London the Paul Hunter Professor of Medicine (UEA). In countries where the spread has started (UK, Spain and Portugal), “the number of new cases reported each week now appears to be decreasing. But there is still a long way to go before we can relax, because the risk persists another increase.
‘New’ symptoms and signs in this monkeypox outbreak
Last week, the World Health Organization (WHO) called on anyone with symptoms consistent with monkeypox to self-isolate immediately and not travel, as we have learned from the coronavirus crisis. The problem is that the list of symptoms and signs is common to other ailments, including covid, in its initial stages. This chart shows the classic characteristics of monkeypox symptoms, according to the WHO. However, in Spain or the United Kingdom, the prevalence of lesion type and location has changed.
General malaise and fever are usually accompanied by something very characteristic: inflammation of the lymph nodes in the neck. Having “swollen glands” is a most typical symptom of monkeypox that of eradicated smallpox. A rash then develops (first welts, then pustules) that can sometimes be mistaken for chickenpox.
However, this epidemic seems to have very characteristic clinical manifestations. Thus, according to the ISCIII-SIVIES report, lesions limited to the genital and anal area (60.3%), when the lesions were usually seen especially on the face, hands and feet. These specific signs and symptoms of monkeypox prompted WHO Director-General Tedros Adhanom to call for abstaining from risky sexual practices and limiting the number of partners for intimate encounters.
the doctors Anne Rimoin and Raina Maclntyre have a hypothesis: the high incidence is from a coincidental introduction into Europe during one or more superspreader events. Sex is circumstantial, the key was (and would be) close contact.
It’s not an STD but sex is involved in 82% of cases
Dr. Teadros made specific mention of the group of men who have sex with men (95% of cases), which did not please the LGTBI associations who denounce the stigma that falls on a group that does not is not the only one affected.
It is true that he also insisted on particularly protecting pregnant women, children and the immunocompromised, since “anyone exposed can contract it”. In Spain, according to the report, the 16.7% of cases cannot be linked to sex between men. 82.1% of infections of known origin involved a sexual encounter, with men or women.
This leads to the question whether we should now regard monkeypox as a sexually transmitted disease (MST). Epidemics produced up to 2022 did not suggest this at all. The typical contagion occurred by coming into contact with animals carrying the virus. Its natural reservoirs are some African forest rodents. Their bites or scratches or undercooked consumption have led to infections in humans.
Human-to-human transmission was possible, but not as common, until 2022. Usually through skin-to-skin contact or small droplets of saliva. Also, touching towels, clothes, or linens that are highly exposed to an infected person’s rash. But he was found virus in semen, although it is not known if it is infectious in this state.
Genetic sequencing of the variant circulating in some seventy countries indicates that no longer a rodent virusotherwise what it adapts to humans, who would be a new favorable host. Hence perhaps its contagiousness (R0=1.6 to 1.8 or more) and new symptoms or signs specific to monkeypox in 2022.
Why two people died in Spain from monkeypox
The disease, traditionally considered no graveis linked to the death of two people in our country. Two young men from Valencia and Cordoba, who ended up with a encephalitis. An inflammatory reaction of brain tissue, as occurs with other uncontrolled infections.
According to the same report, the 2.8% of cases required hospitalization. In most cases, to treat the rash, which was accompanied by pain and a risk of skin infection. According to the WHO, these untreated pustular infections are often the cause of death in infected people in countries where it is endemic in central or western Africa.
The United Kingdom has updated its recommendations and its list of signs and symptoms, in an attempt to promote the quarantine of contacts but also the clinical management of cases who may end up in hospital.
“Monkeypox Symptoms Experienced [por hombres con sexo con hombres] they can be different from symptoms seen in other outbreakssays Jonathan Ball, professor of molecular virology at the University of Nottingham in the SMC United Kingdom. “Therefore, expanding the list of potential symptoms to reflect this will ensure that as many cases as possible can be identified and isolated and their contacts traced,” he explains.