Spanish researchers show what is the main route of transmission of monkeypox

The Spanish group of sexually transmitted diseases and AIDS of the Spanish Academy of Dermatology and Venereology considers that contact with the skin is the key to contagion


A study conducted by the Spanish Group for Sexually Transmitted Diseases and AIDS of the Spanish Academy of Dermatology and Venereology (AEDV) showed new clinical and epidemiological findings on monkeypox.

The survey, coordinated by the AEDV research unit and published in the scientific journal “British Journal of Dermatology”, confirms that the main transmission route of this epidemic is basically skin contact. This prospective cross-sectional study analyzed 185 cases collected by a large number of Spanish dermatologists.

General symptoms of monkeypox include fever and swollen lymph nodes, followed by a generalized rash that progresses through four distinct stages. While fever and swollen lymph nodes remain common in this outbreak, research has found that cases tend to have few skin lesions.

“The usual thing is for the skin symptoms to show up in the contact areas during sex. This can include lesions of the pharynx, anal canal, face and fingers,” explained Dr. Alba Catalá, dermatologist in the Dermatology Department of Hospital Clínic de Barcelona and lead author of the study.

On the other hand, and contrary to what has been described previously, this study shows that any dermatological lesions that may appear as a result of the disease are not pustules, but hard papules that look like pustules (pseudopustules).

“This finding is important because it makes it much easier to recognize the disease, since very few diseases produce this type of lesion,” said Petunia Clavo, a dermatologist at the Sandoval Center in Madrid and another of the research authors.

However, the doctor also assured that some of these papules become necrotic and can lead to genital ulcers, “making diagnosis difficult due to their similarity with other diseases”.

Other findings from this work reflect, although with less certainty, that neither well-controlled HIV disease nor prior smallpox vaccination (before 1972) affected the severity of lesions in the study patients.

Moreover, according to the authors, the fact that a patient has another sexually transmitted infection (STI) does not exclude him from suffering from monkeypox, in the same way that patients with smallpox must be studied to rule out others. sexually transmitted diseases.

Regarding the patient profile, the cases studied were mostly composed of men who have sex with men and were associated with frequent risk behaviors of contracting sexually transmitted diseases, although Dr. Catalá considers the likelihood that it changes over time.

“Outbreaks often start in a specific group and then spread, but currently disease protection efforts should focus on that group,” he says.

The authors of this work concluded that further research is needed to better understand when patients become most infectious and the preventive advice is clear: “Although we do not know when patients begin to be infectious, avoid close contact with people who have monkeypox lesions, and having them checked before having sex can help reduce the risk of getting the disease.

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