Some infection details worth noting
Writing | Yan Xiaoliu
Source | “Medical Community” Public Account
On May 20, local time, the World Health Organization (WHO) held an expert meeting and said that as of that time, 11 countries around the world had reported about 80 cases of human infection with monkeypox virus, and another 50 The case is suspected to be under investigation.
This is a significant increase from the more than 50 cases in the four countries two days ago. (For more details, please click “The “Human Monkeypox Epidemic” is spreading, there seem to be multiple chains of transmission, will it affect China?”)
Europe is more affected, including Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the United Kingdom. Confirmed cases have also been found in the United States, Canada, and Australia.
WHO says more cases may be detected as surveillance expands.
“This is not another new crown-like outbreak. But it is an unusual and unprecedented outbreak of monkeypox.” The BBC pointed out that scientists specializing in the study of the disease found that monkeys The way poxviruses spread appears to have changed.
Image caption: A child infected with monkeypox virus. /CDC
The source of the infection is still unknown,
Multi-country reminder to identify special groups
The current case of monkeypox is described by WHO as an “atypical outbreak”.
On the one hand, the incidence area has changed, and “non-monkeypox virus-endemic countries” such as Europe and the United States are reporting cases one after another.
On the other hand, the route of infection is a mystery. Except for the first confirmed case in the UK who had travel history to Nigeria, most cases in various countries are more like “local transmission”, and the source of infection is unknown.
The BBC quoted experts as commenting that many infected people looked “unrelated” and lacked a chain of transmission linking cases across the country. The cases are scattered across Europe and the United States, meaning the virus may have been spreading covertly for some time.
“There are some details of the infection that seem to be coming to light,” noted the British “Daily Telegraph”.
Information from the Madrid Public Health Agency in Spain showed that the source of monkeypox infection was traced locally and found that among the 30 infected people, many were related to a sauna. The word “sauna” in Spanish, not only means “bathhouse”, but is also used to refer to a place where men and boys seek pleasure. The sauna is closed.
The UK Health Safety Agency (UKHSA) earlier stated that the majority of cases detected in the country are concentrated in people who have sex with men.
Belgium traces back 3 confirmed cases, all linked to an LGBTQ campaign. The event was held on May 4 this year in Antwerp, Belgium for a period of 4 days. The campaign describes itself as “encouraging people to explore sexuality and learn about gay fetishes.”
The Daily Telegraph, citing sources, said an international gay party in Spain was also included in the investigation, or the cause of a global monkeypox outbreak.
Maria Van Kerkhove, head of WHO’s Emerging and Zoonotic Infectious Diseases Unit, confirmed the findings. But she said that sexual orientation characteristics are only a phenomenon observed in the current round of infection cases, “because most of the infected people are found in medical institutions that treat sexually transmitted diseases. It is not appropriate to over-interpret.”
Combining reports from Reuters and The Guardian, it is not discrimination to point out the characteristics of sexual minorities, let alone that the virus will only spread among this group. Its more important significance is to let medical institutions in various countries, especially the departments that receive sexually transmitted diseases, pay attention to similar symptoms and remind people to pay attention to the possible transmission channel of sexual behavior.
US VOX news network reported that the first symptoms of most infected people begin in the genital area.
UKHSA Chief Medical Adviser Susan Hopkins said: “These men are particularly encouraged to be aware of any unusual rashes or lesions. If there is a problem, get in touch immediately relevant agencies.”
Photo caption: On May 20, local time, the National Institute of Infectious Diseases in Rome, Italy, held a press conference to announce two confirmed cases of monkeypox. /AP
Monkeypox virus ‘mutates to be more transmissible’?
“It’s a whole new situation.” Talking about the status quo, Peter Horby, director of the Institute for Epidemiological Sciences at Oxford University, told the BBC that for epidemiological research , which is full of “surprise and worry”.
The surprise was that the classic theory of monkeypox virus transmission was “challenged”.
“Before this, human infection with monkeypox virus was foreseeable.” The BBC said that monkeypox virus is more common in wild animals in Central and West Africa. Cross-species transmission of the virus is possible when locals are in close contact with infected organisms.
Unlike the airborne SARS-CoV-2 virus that plagues the world, monkeypox virus relies on close contact with bodily fluids, or spreads through close-range, long-term, and poisonous flies. Thus, even in major African endemic areas, its spread is often limited and generally does not result in large outbreaks.
In countries and regions other than Africa, there have been a small number of cases of infection, but all have a clear history of overseas travel or close contact with the source of infection.
It’s unclear why gay and bisexual men are showing up, says Adam Kucharski, co-director of the Centre for Epidemic Preparedness and Response at the London School of Hygiene and Tropical Medicine Disproportionate infection. “Does this mean that sexuality is more spreadable? Is it a coincidence? Or is it just because the people involved are more concerned about sexual health and get regular checkups, so they are more likely to be detected? These are all worth studying.”
Worry is “we don’t know why, and we don’t know what happened.”
The BBC quoted experts as saying that there may be two explanations. One, the monkeypox virus mutates to make it more spreadable, and two, the virus doesn’t mutate, it just infects specific people at the right time, and then the spread begins.
Peter Hobby pointed out that unlike the new coronavirus, monkeypox virus is a DNA virus, and its genetic material is more complex than that of RNA viruses such as the new coronavirus, so its mutation ability and speed are lower than those of the new coronavirus. .
Early genetic analysis in the United Kingdom and the United States shows that the monkeypox virus emerging in the country is a “West African strain”, which is closely related to the virus detected in 2018 and 2019. Even in Congo (DRC), where thousands of infections have been reported, no signs of virus mutation have been found.
Virologists from Nigeria disagree. In 2019, epidemiologist Adesola F. Yinka-Ogunleye, then assistant director of the Nigeria Centers for Disease Control and Prevention, wrote that the monkeypox virus has been circulating in the country for several years, indicating that it is no longer the kind it was previously thought. A rare, “limited human-to-human transmission” virus.
Channel News Asia reported that the increase in infections may also be related to the cessation of smallpox vaccinations.
Monkeypox virus and smallpox virus are both orthopoxviruses. African data show that the smallpox vaccine has at least 85% protection against monkeypox.
On May 8, 1980, WHO announced the eradication of smallpox worldwide and recommended that countries stop vaccinating against smallpox. “Most people under the age of 45 in the world have not been vaccinated against smallpox,” said Eric Feigl-Ding, an American epidemiologist and health economist.
“Monkeypox is emerging as an important orthopoxvirus after smallpox that will become widespread in human society.” Adesola F. Yinka-Ogunleye noted in his article.
Image caption: Medical staff at Royal Liverpool University Hospital put on personal protective equipment before coming into contact with a monkeypox patient in 2018. /Royal Liverpool and Broadgreen University Hospitals NHS Trust
Spread or accelerate in summer
WHO Regional Director for Europe, Hans Kluge, told a meeting on the 20th that so far, most monkeypox cases have been mild.
As summer begins in Europe, with mass gatherings, festivals and gatherings, he fears that the spread could accelerate.
WHO is working with relevant countries, including identifying possible sources of infection, routes of transmission, and more. The agency noted that the response should focus on those affected and close contacts. Close contact with contagious people puts you at greater risk of infection, including health workers, family members and sexual partners.
Hans Krueger says hand washing and other preventive measures implemented during the COVID-19 pandemic are critical to reducing the spread of monkeypox in healthcare settings. According to information from the US Centers for Disease Control and Prevention, ordinary household disinfectants can effectively remove monkeypox virus from surfaces.
Countries are strengthening surveillance, testing, prevention and blocking. The Robert Koch Institute, Germany’s disease control agency, urges people returning from West Africa to seek medical attention as soon as possible with skin abnormalities.
Swedish Health Minister Lena Hallengren said the country’s decision to classify “human monkeypox” as a generally dangerous disease would allow measures to prevent transmission, trace suspected case.
Indonesia, Greece and other countries have issued warnings although there are no confirmed cases. The Indonesian Ministry of Health said it is stepping up border screening. The National Public Health Organization of Greece has issued a notice to medical systems to be vigilant against human monkeypox.
The monkeypox outbreak has also prompted vaccine manufacturers and pharmaceutical companies to act.
Canadian Chief Health Officer Tan Yongshi introduced that the country has ordered 500,000 vials of non-replicating live attenuated vaccinia vaccine. The vaccine is approved in the European Union and the United States for the prevention of monkeypox and smallpox in people over 18 years old. The vaccine is due to be delivered by April 2023 and will be used for those identified as being at high risk of exposure.
The Daily Telegraph reported that the vaccine manufacturer, Bavarian Nordic, a Danish biopharmaceutical company, had signed a small number of vaccine contracts with Public Health England (PHE) as early as 2018.
Local timeOn May 20, 2022, UK Health Minister Sajid Javid confirmed that an order has been placed with Bavarian Nordic for more doses of the vaccine.
On May 18, the company announced that it will increase production of related vaccines, with a total expected production of 13 million doses in 2023-2024.
The biopharmaceutical company SIGA Technologies has an antiviral drug Tecovirimat approved in Europe and the United States for the treatment of smallpox, monkeypox and other viral infections. Dennis Hruby, the division’s chief scientific officer, told Euronews that “countries reporting confirmed cases have contacted us saying they are interested in getting the drug as soon as possible.”
“I don’t think people need to worry at this stage.” Jimmy Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, told the BBC that the monkeypox virus was not entirely new Virus. After infection, most people recover within a few weeks without treatment. The effects of infection may be severe in young children, pregnant women, and the immunocompromised.
Also, monkeypox symptoms, including a rash, are unique and difficult to ignore. This makes early diagnosis and interruption of transmission possible.
“Monkeypox is not scary, with limited human-to-human transmission. Pandemic risk remains low.” Brandon Dionne, clinical associate professor of pharmacy and health systems sciences at Northeastern University )express.
Source:
1. EXPERTS WEIGH IN: IS MONKEYPOX THE NEXT COVID-19? HERE’S WHAT WE KNOW. Northeastern University
2.Monkeypox: Time to worry or one to ignore?.BBC
3.Monkeypox outbreak: Drugmaker SIGA says EU authorities seeking to stockpile its smallpox antiviral. Euro News
4.Why wiping out smallpox has stoked risk of monkeypox. CNA
5.Europe: WHO supporting countries affected by rare monkeypox outbreak. United News
6.Monkeypox outbreak linked to superspreader event at adult sauna. The Telegraph
7. WHO working closely with countries responding to monkeypox. WHO
Source: Medicine
Editor in charge: Wang Hang
Proofreading: Zang Hengjia