Since May 13, 92 confirmed and 28 suspected cases have been reported in 12 countries that are not endemic for monkeypox virus at three World Health Organization (WHO) regional offices Among them, confirmed and suspected cases are mainly from the United Kingdom, Spain and Portugal, and the rest are distributed in Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Sweden and the United States [1].
Number of monkeypox cases reported to WHO in non-endemic countries from 13 to 21 May 2022 at 13:00
(Reference source: WHO official website)
These cases have no clear history of travel to areas endemic for monkeypox and are primarily, but not limited to, found in men who have sex with men.
Given the fact that monkeypox infection has been detected in several countries where the monkeypox virus is not endemic, the WHO says that more cases are likely to be detected in these and other countries in the future, The monkeypox virus will spread further.
What is monkeypox?
Monkeypox is a zoonotic disease (virus spread from animals to people). In 1958, European scientists isolated monkeypox virus from monkeys in the laboratory for the first time.
Centers for Disease Control and Prevention’s 2003 electron microscope image showing an egg-like mature monkeypox virus
The main sources of monkeypox infection are rodents and primates. Before the current outbreak, monkeypox cases were scattered in tropical rainforests in central and western Africa.
(Image source: Reference [3])
How did monkeypox spread from animals to humans?
Monkeypox can spread to people when people have physical contact with infected animals. Avoiding unprotected contact with wild animals, especially those that are sick or dead (including their flesh and blood), can reduce the risk of contracting monkeypox from animals. In countries and regions where monkeypox is endemic to animals, any food containing animal meat or offal should be thoroughly cooked before consumption.
(Image source: Reference [4])
How does monkeypox spread from person to person?
Monkeypox patients are contagious when they develop symptoms (usually lasting 2-4 weeks).
Human-to-human transmission may be due to close physical contact with a symptomatic patient, especially contact with an infected person’s broken skin< /strong> of pus, blood or exudate. Contact with items such as clothing, bedding, towels or utensils contaminated with the virus can also lead to infection.
Also, mouth ulcers, mucosal lesions are contagious, meaning the virus can be spread through saliva. Therefore, people who are in close contact with an infectious patient, including medical staff, family members and sexual partners, are at greater risk of infection.
Monkeypox virus can also be transmitted through the placenta, from mother to fetus, and from an infected parent to child through skin-to-skin contact during or after birth.
Human-to-human transmission, does it mean the monkeypox virus has mutated?
Rosamund Lewis, head of the WHO Emergency Programme Smallpox Group Secretariat, said at a briefing that monkeypox viruses are generally low variability, but Genetic sequencing of cases will help us understand the current outbreak
Will monkeypox cause a larger outbreak like the new coronavirus?
Monkeypox virus is significantly different from 2019-nCoV in biological characteristics, morphology, structure, antigenicity, etc. Monkeypox is generally not considered highly contagious because it requires close physical contact (such as skin-to-skin) with a contagious patient to spread from person to personspread. It is also because of the limited routes of transmission that most outbreaks are small, and the risk to the general public is low because infected people mainly transmit the disease to family members or health care workers.
The World Health Organization’s Covid-19 technical lead, Dr. Maria Van Kerkhove, said in a live online Q&A on the 23rd that monkeypox is not a new virus, and its transmission is different from that of the coronavirus, so Virology experts are needed to better understand the pathogen and how the disease it causes is different from Covid-19.
Is monkeypox a sexually transmitted infection?
Monkeypox can spread from one person to another through close physical contact, including sexual contact. It is not known whether monkeypox can be transmitted sexually (eg, through semen or vaginal fluid), but direct skin-to-skin contact with lesions during sexual activity can transmit the virus [5].
Monkeypox rashes are sometimes found on the genitals and mouth, which can lead to transmission during sexual contact. Therefore, oral-skin contact may cause transmission where skin or oral lesions are present [5].
Monkeypox rash, which may resemble some sexually transmitted diseases, including herpes and syphilis. This may explain why a large proportion of several cases in the current outbreak have occurred in men who have sex with men.
Who is at risk for monkeypox?
Anyone who has had close physical contact with a person with monkeypox symptoms or an animal infected with monkeypox virus is at the highest risk of infection. People who have been vaccinated against smallpox may have some protection against monkeypox infection, with an 85% efficacy rate, but the smallpox vaccine is no longer available to the general public after the global eradication of smallpox.
In addition, newborns, children and people with underlying immune deficiencies may be at greater risk for severe monkeypox symptoms and death.
What can be done about monkeypox?
External defense input is the key
Up to now, my country has not reported the discovery of monkeypox cases, nor the discovery of monkeypox virus in animal hosts. Since my country strictly prohibits entry of all animals except cats and dogs, it is unlikely to be introduced through animals, but it is still necessary to strengthen animal inspection and quarantine and the monitoring of entry personnel.
Everyday protection is key[6]
1. Do not come into contact with animals of unknown origin, especially wild animals.
2. Maintain good hand hygiene and do not touch the delicate parts of the human body, such as the mouth and nose, with your hands.
3. The “four early” principles of early detection, early diagnosis, early isolation, and early treatment are the “golden rules” for dealing with emerging infectious diseases.
Reviewer: Wang Zhong
Chief Physician of Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University
References
[1]https:https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON385
[2]https:https://www.cdc.gov/poxvirus/monkeypox/veterinarian/transmission.html
[3]https:https://www.cdc.gov/poxvirus/monkeypox/veterinarian/transmission.html
[4]https:https://www.ioes.ucla.edu/news/using-remote-sensing-map-principal-carrier-monkeypox-virus-congo-basin/< /p>
[5]https:https://www.who.int/philippines/news/q-a-detail/monkeypox
[6]https:https://www.cdc.gov/poxvirus/monkeypox/prevention.html
Author: Yu Jia
Editors: Ye Yichu, Wu Jiaxiang, Ye Zhengxing
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Ye Yichu
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