Epidemiology and public health reactions of monkeypox

Monkeypox is a zoonotic disease. That is, it can be transmitted between animals and humans through direct or indirect contact. Following the eradication of smallpox and the end of smallpox vaccination, monkeypox is now the most common orthopoxvirus infection in humans.

Since May 2022, monkeypox outbreaks have been reported in several countries around the world, primarily affecting young men who self-identify as men having sex with men.4 quick communications published in Euro surveillance Today we will discuss cases diagnosed in Italy, Portugal, the United Kingdom (UK) and Australia.

UK: 1 outbreak, 3 individual incidents

Vivanco setal. Describes the epidemiological and public health reactions of monkeypox outbreaks in the United Kingdom, where 86 cases of monkeypox virus infection were identified between May 7 and 25, 2022.

The authors classified the currently known cases into three different cases: a case confirmed in an isolated laboratory after a trip to Nigeria, the infection has already been clinically resolved (in the laboratory). (No confirmation) Two confirmed monkeypox cases from another home cluster containing one case, and a third case, a monkeypox case confirmed in 82 laboratories, are associated with the other two cases. The patient did not report a trip to an area where monkeypox was endemic.

Investigations are still underway to determine if Incident 3 cases may have been transmitted outside the UK, but due to the history of sexual health, the UK and foreign countries. In the group associated with the third case, gender information was available in 79 cases, all of which were male. Of these, the majority, 66, were identified as gay or bisexual or other men having sex with men.

So far, no single factor or exposure associated with the case has been identified.

Vivanco et al. “Current outbreaks represent a change in the basic assumptions about the epidemiology of MPXV in Europe and have significant implications for monitoring and control,” he said. -Human transmission through close contact, including sexual networks.

Possible previously undetected spread of monkeypox suspected in Portugal

Portugal confirmed the first case of smallpox in the country on May 17, 2022. Describes the detection of 96 cases of monkeypox identified so far from the Lisbon and Tejo Valley areas. The onset of the first case in Portugal was reported as early as April 29, 2022.

Most patients were not part of the identified transmission chain and were unable to establish links to travel or contact with symptomatic humans or animals. According to the author, this suggests the possibility of a previously undetected epidemic of monkeypox.

Among the 23 confirmed cases, Duque etc. 14 were HIV positive and the most common symptoms were rash (n = 14), inguinal lymphadenopathy (n = 14), fever (n = 13), and genital ulcer (n = 6). The authors question that “MPX circulates below the detection of surveillance systems. In some cases there is a clear epidemiological association, but in others the lack of identified exposure is unanswered. I have raised it. “

Samples from monkeypox-positive Italian semen

Vita et al. Provides a clinical description of the four monkeypox cases reported in Italy. In adult males, the skin lesions are asynchronous, showing a different clinical picture from the existing literature, from single or clustered spots to papules with progressive central ulcers and finally to scabs. increase. .. The lesions were mainly in the genitals and perineum.

Biological samples from semen were positive for monkeypox virus DNA in all four patients, with a range of quantification cycles of 27-30. Based on this, the authors “These findings are not considered conclusive evidence of infectivity, but do indicate viral shedding. Efficiency in transmission cannot be ruled out.”

Risk of superinfection of bacteria

In the description of their case, Hammerschlagetal. After visiting Europe in May 2022, who was later hospitalized, we will share data on virus-suppressed HIV-positive patients with genital rashes in Australia.

The clinical manifestations in this case were atypical because the rash was present only at the site of sexual contact 3 days before fever, and the centrally distributed lesions with the fewest lesions on the face and limbs after the rash were predominant. Was considered. Popularized.

The authors said, “Our patient hospitalization was not for the serious symptoms of monkey sputum virus infection, but to enable diagnostic evaluation, pain management and treatment of bacterial superinfection.” Treatments that emphasized the patient’s normal CD4 + T cell count and suppression of the HIV virus load against antiretroviruses were “potentially important factors in preventing more serious consequences from his monkey infection. “.

sauce:

European Center for Disease Control and Prevention (ECDC)

Journal reference:

Duque, MP, et al. (2022) Ongoing monkeypox virus outbreak, Portugal, April 29-May 23, 2022. Euro surveillance. doi.org/10.2807/1560-7917.ES.2022.27.22.2200424.

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