In case of skin changes see the doctor: monkeypox detected in other countries

In case of skin changes to the doctor
Monkeypox detected in other countries

Cases of monkeypox are reported in other countries in Europe and North America. Experts warn against panicking, but advise men who have sex with other men and notice skin changes to seek medical attention immediately. No cases are known in Germany.

As cases of monkeypox, however rare, are detected in more and more countries, experts are calling for vigilance. Infections have also been reported in Spain, Portugal, the United States, Sweden and Italy. The World Health Organization (WHO) has called for tracing of all contacts of those affected. According to the British health authority UK Health Security Agency (UKHSA), the viral disease usually causes only mild symptoms, but can also have severe courses. Only symptomatic patients in close contact are contagious.

The first case of infection with the monkeypox virus disease has been confirmed in Sweden. As the Swedish health authorities announced, one person in the greater Stockholm area is infected. A first monkeypox infection was also detected in Italy. The health assessor of the Lazio region, Alessio D’Amato, confirmed this. According to the clinic, the person who returned from a stay in the Canary Islands is in isolation. Two further cases of monkeypox have been recorded in the UK. There have been nine confirmed cases since the beginning of May.

Eight infections in Spain

In the United States, a person from the state of Massachusetts, in the northeast of the country, was also affected, the American health authority CDC announced on Wednesday. In Spain, eight infections have been reported in the capital Madrid, the Europa Press news agency reported on Wednesday, citing health authorities. There were also other suspected cases. In Portugal, the number of infections increased by nine to a total of 14 cases. The nine patients in Portugal are in stable condition and are being closely monitored, according to Portuguese health authority DSG.

Most cases have been reported in and around the capital, Lisbon. In Canada, health authorities are investigating a dozen suspected cases, according to local media. Canadian broadcaster CBC reported on Wednesday evening (local time) a case in the province of Quebec, authorities say there are at least 13 suspected cases. There was initially no official confirmation.

The majority of cases that have been reported so far involve men who have had sexual contact with other men. No cases were initially recorded for Germany. “The RKI has never known a case of monkeypox in Germany,” said the Robert Koch Institute when asked by the German press agency.

Patients should be isolated

WHO announced on Wednesday evening that clinics and the public should be made aware of the need for an unusual skin rash to be examined by specialists. If monkeypox is suspected, patients should be isolated. Health workers should take the usual precautions to protect themselves against infections that can be spread by contact or droplets.

Monkeypox infections in humans have so far been known mainly from parts of Africa. In view of the first known cases in Great Britain, where the virus was detected at the beginning of May, the RKI had made doctors in Germany aware of the viral infection. An article published by the RKI indicates that monkeypox should also be considered as a possible cause in the case of unclear smallpox-like skin changes if those affected have not traveled to certain areas. Men who have sex with men should “seek medical attention immediately” for any unusual skin changes.

“The cases currently occurring outside of Africa are unusual and should be thoroughly investigated and any further spread observed,” the Friedrich Loeffler Institute (FLI) said. “In the past, monkeypox outbreaks were limited in their spread,” said virologist Stephan Becker from the University of Marburg. Chains of infection between people are unusual and should be closely monitored. Jimmy Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, advised not to panic: “It won’t create a national epidemic like Covid did, but it is the serious epidemic a disease serious – and we should take it seriously.”

One pathogenic strain is significantly more deadly than the other

The disease is generally mild, although there are two main strains: the Congo strain, which is more severe – with a mortality rate of up to 10% – and the West African strain, which is fatal in around 1% cases. The cases in Britain are attributed to the West African tribe.

According to the UKHSA, early signs of illness include: fever, headache, muscle and back pain, swollen lymph nodes, chills and exhaustion. A rash may develop, which often spreads to other parts of the body, starting with the face. The rash looks different depending on the phase and can resemble chickenpox and syphilis.

There is no specific treatment or vaccination for monkeypox. According to historical records, however, a smallpox vaccination protects against monkeypox – and probably for life. However, as the RKI explains, a large part of the world’s population has no vaccine protection. In Nigeria, since 2017, there has been an increase in monkeypox infections in humans – and cases linked to travel there, particularly to the UK.

Sander: Immunity to smallpox is declining around the world

Experts suspect that the monkeypox pathogen circulates among rodents and that monkeys are considered false hosts. “Infections can be transmitted by contact with secretions of infected animals,” the RKI report states. Person-to-person transmissions through contact with bodily fluids or scabs are described with chains of infection of up to six people. “Sexual transmission of smallpox viruses is also possible,” he said.

“The current epidemic indicates a change in human-to-human transmission,” the head of the Berlin Charité infectious disease clinic, Leif Sander, wrote on Twitter. Declining population immunity since the end of smallpox vaccination probably contributes to this. The scientist describes monkeypox as less pathogenic than smallpox, but it is “still a serious disease and in some cases fatal”. Sander “certainly sees no reason to panic at the moment”: However, the epidemic shows “how infectious diseases represent a constant danger in a globalized world, for which we must better prepare”.

Meanwhile, German Health Minister Karl Lauterbach announced a smallpox pandemic simulation exercise to be organized by the G7 countries and the WHO. It’s about “finding out whether effective lessons have been learned from past mistakes,” Lauterbach said. The exercise assumes that a smallpox pandemic could develop from a leopard bite.

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