First, there have been six cases of monkeypox in the UK. Then other European countries also recorded infections, including Germany, Spain, Portugal, France and Italy. Cases of monkeypox have also been detected in North America, Latin America and Australia. Experts are on high alert, but warn of panic.
A risk assessment by the European Center for Disease Prevention and Control (ECDC), released on May 23, advised EU/EEA countries to “focus on prompt identification, treatment, contact tracing and reporting of new monkeypox cases”.
Another recommendation from the agency is to review the availability of smallpox vaccines, antiviral drugs and personal protective equipment for health professionals. Despite these dangerous indications, experts say there is no need to panic.
Parties in Spain possible super prose?
Andrea Amon, director of the Centers for Disease Control and Prevention, said: “Most of the current cases have had mild symptoms of illness, and for the broader population, the potential for spread is very low. However, the potential for the virus to spread further through close contact, for example during Sexual activities among people with multiple sexual partners, is considered high.”
In this context, Spanish authorities are investigating whether gay pride parties on the holiday island of Gran Canaria could be another source of monkeypox infection. This was reported by the Spanish newspaper El País, citing health sector sources.
From May 5-15, a total of about 80,000 people, mostly from Spain, joined in the pride parties. So far, 30 cases of monkeypox have been confirmed in Spain and there are 23 more suspected cases.
Smallpox vaccine may help
According to the World Health Organization (WHO), the human smallpox vaccination is also effective against monkeypox. Both types are related but human smallpox is more dangerous.
Because of the acute course of human smallpox, the high mortality rate and the high risk of infection, the World Health Organization launched a global vaccination campaign in 1966. In 1980, the World Health Organization declared smallpox to be eradicated worldwide. Since then, only people working with vaccine viruses have been vaccinated in laboratories.
Skin lesions are an obvious symptom of monkeypox
Most have not been vaccinated
Because smallpox has been considered eradicated in humans for more than 40 years, people no longer get vaccinated. A British study published in the July 2020 issue of the journal Vaccine indicates that 70% of the world’s population is not effectively vaccinated.
The European Center for Disease Control (ECDC) has already issued recommendations for the so-called ring vaccinations. This includes immunizing all close contacts of infected people to form an immune loop. Ring vaccinations are already being carried out in the UK.
The World Health Organization stockpiled smallpox vaccines. Many countries, such as the United States, Germany, Austria and Switzerland, keep their own stocks. However, experts consider that an outbreak of human smallpox is highly unlikely.
How is monkeypox transmitted?
MPV monkeypox virus has been known since 1958 and occurs mainly in West and Central Africa. Monkeypox belongs to the group of zoonotic diseases, that is, diseases that are transmitted from animals to humans, mainly by monkeys and various types of rodents.
Infection is caused by infected animals, their secretions, blood, secretions, or contact with body tissues. Infection can also occur through handling the meat of infected animals.
“If human-to-animal transmission occurs, and the virus spreads in a group of animals, there is a risk that the disease will become endemic in Europe. As such, there must be close intersectoral collaboration between human and veterinary public health authorities to manage exposed pets and prevent transmission of exposed pets. disease to wildlife,” says the rapid risk assessment.
What are the symptoms?
The first symptoms of monkeypox infection are fever, headache, muscle aches, and back pain. Lymph nodes swell. There are noticeable changes in the skin, the so-called skin bloom. Depending on the stage of the disease, these skin changes are similar to those of chickenpox or syphilis.
Nodules, blisters, or pustules may form. It usually begins in the face and then spreads to other parts of the body, such as the legs and arms. Some of the cases reported in May also included skin lesions in the urogenital tract. Men who had sex with men were particularly affected. According to the German Robert Koch Institute (RKI), they should “seek medical attention immediately” if they experience unusual skin lesions.
Small blisters filled with secretion form
While smallpox in humans is usually a very serious and often fatal disease, monkeypox infection is milder and patients usually recover within a few weeks. However, there are exceptions. If children under 16 are infected with the Central African variant, a lethality rate of up to 11% can be observed, according to the RKI. On the other hand, the variant currently registered in West Africa leads to the death of about 1% of those infected.
Are there treatments?
Most treatment approaches focus on treating symptoms and relieving discomfort. In the European Union, Tecovirimat was recently approved by the European Medicines Agency (EMA). It was developed to treat infections with orthopoxviruses, a group that includes not only human smallpox but also cowpox and monkeypox.
A recent vaccine approved in the European Union is Imvanex which is based on the so-called MVA, the modified vaccinia virus in Ankara. This live vaccine was originally only approved for smallpox in humans, but it is also used off-label against monkeypox, ie as a vaccine without official approval.
In the United States and Canada, Imvanex is licensed for human smallpox and monkeys. The German Paul Ehrlich Institute recommends its use starting from the age of 18. Imvanex protects against the virus through what is known as cross-immunity.
The modern vaccine cannot reproduce in humans and cannot cause disease, which is a big difference in the vaccines used before smallpox was eradicated. Older vaccines contain viruses that can multiply and carry the risk of spreading the virus to other parts of the body.
The vaccination is given under the skin in the upper arm and is recommended by the EMA for people who do not have any immunization. In these individuals, the preparation is taken twice, month by month. For individuals who have already been vaccinated, a single dose of the vaccine of 0.5 milliliters is sufficient. The effectiveness of vaccination is about 85%.
Edited by: Andreas Elmer