What do you know about the disease?

IThe first case of monkeypox has been confirmed in Germany. The virus had been detected in a patient, the Bundeswehr Institute for Microbiology in Munich announced on Friday. He therefore showed the skin changes typical of the disease.

According to the treating hospital, the young man is doing relatively well. He “underwent medical care very responsibly immediately after the onset of symptoms to protect others from infection,” says Clemens Wendtner, chief physician for infectious diseases at the Schwabing Clinic in Munich. The man has mild swallowing problems and a high temperature and does not currently require any special medication. He will remain in isolation in hospital for as long as doctors think he may be contagious for three to four weeks. He is therefore a 26-year-old Brazilian. According to the Bavarian Ministry of Health, he traveled from Portugal to Germany via Spain and has been in Munich for around a week. He had previously stayed in Düsseldorf and Frankfurt.

The Robert Koch Institute (RKI) on Thursday called for heightened vigilance after several cases of monkeypox were recorded in other European countries. So far, monkeypox has mainly occurred in parts of Africa. The virus usually spreads in rodents and from there it spreads to humans. Human infections are more likely to occur through close physical contact or through so-called smear infections. According to the RKI, men who have sex with men should “seek medical attention immediately” if they experience any unusual skin changes.

According to the institute, the incubation period after infection is between seven and 21 days. The virus can cause fever, headache, muscle and back pain, and swollen lymph nodes. Changes in the skin may occur later. The so-called skin blooms the crust over time, and then falls off. They often start on the face and spread to other parts of the body. In the most recently reported cases, the skin changes started in the urogenital area. Unlike eradicated human smallpox, monkeypox is generally milder. According to the RKI, most infected people recover within a few weeks. The prognosis is therefore “to be qualified as favorable”. However, more serious illnesses are also possible.

Experts currently have no explanation for the backlog of cases. “We haven’t had any major outbreaks of monkeypox in Europe, so the current pattern is unusual,” says epidemiologist Charlotte Hammer from the University of Cambridge. “Previously, cases of monkeypox in Europe were usually very sporadic and associated with people returning from Nigeria, for example.” According to the current state, the virus is transmitted through close physical contact. “But smear infections on surfaces are also possible.” Since early May, dozens of suspected and confirmed cases of monkeypox have been reported in several European and North American countries.

The infected person is currently in isolation at the Schwabing Clinic in Munich (archive image)


The infected person is currently in isolation at the Schwabing Clinic in Munich (archive image)
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Image: dpa

There is a lack of epidemiological data on the virus

“We urgently need good epidemiological data to understand if and how the cases are linked,” explains Fabian Leendertz. He is founding director of the Helmholtz Institute for “One Health” in Greifswald and leader of a project group for the epidemiology of highly contagious and pathogenic microorganisms at the RKI in Berlin. “Based on my current assessments, this is an acute event and I don’t believe it is solely due to heightened awareness.” It is important to genetically examine the monkeypox virus to find out if there is evidence of a change in the pathogen, which, for example, suggests better transferability. Treatment options for a disease are available, Leendertz says. “There are effective drugs and vaccines work too.”

Experiences with the pathogen in Africa also suggest that the disease is rarely severe. “In the case of infections in West Africa, we generally observe milder forms, which are characterized by the occurrence of fever and generally only isolated lesions of smallpox on the skin or mucous membranes”, explains Gerd Sutter, professor of virology at the Institute of Infectiology. Medicine and Zoonoses at Ludwig-Maximilians- University of Munich. “The monkeypox cases currently seen in Europe are most likely imported infections originally from Nigeria, which are now likely transmitted from person to person in limited chains of infection.”

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