Transmission, symptoms, treatments … What we know about the virus

She dethroned Covid-19 from our disturbing subjects of conversation. Smallpox is endemic to Central and West Africa, and smallpox is generally a non-serious disease. But while the coronavirus pandemic is no longer behind us, with the proliferation of virus contamination in a common area of ​​non-contact steps with the virus, mainly in Europe and the United States, in recent days, worry.

So, should we worry that the monkey’s smallpox has left its geographical cradle? How is it transmitted? Is it a dangerous virus? Are there any treatments? 20 minutes gives an update on what is known to date about monkeypox.

Where is the virus circulating today and what are the modes of transmission?

Like Covid-19, monkeypox is a zoonosis, a disease that is initially transmitted to humans by an infected animal. “Undoubtedly, the virus has its origins in the animal world,” Steve Ahuka Mundeke, head of the virology department at the National Institute for Biomedical Research in the Democratic Republic of the Democratic Republic, confirmed at an ANRS press conference on Thursday. Congo (DRC). However, very few publications exist, the search has not yet been specified by the clear manner of those who are the reservoirs of the virus, but it is probably agitated by rodents. Endemic in West and Central Africa, monkeypox causes “epidemic outbreaks, mainly in remote, forested or rural areas, affecting people frequently in contact with the animal world, and rarely in large cities.” Thus, two thirds of the cases are zoonotic and one third result of an interhuman transmission “, he added.

A pattern “different from what we currently see in the West,” continued Steve Ahuka Mendeke. “This international monkeypox outbreak was launched in May, first with the detection of six non-passenger cases in the UK, with no direct link to countries or people returning from countries where the virus usually circulates in Africa. At the same time, there was an ongoing investigation in Portugal into infectious syndromes associated with rashes in a group of MSM people, men who have sex with men, ”was the question of a possible new fashion. of the transmission of the disease.

What is known is that human-to-human transmission “occurs primarily through direct contact with a damaged skin or mucous membrane with a healthy skin or mucosa, and also through droplets, or through contact with clothing. infected on Thursday, detailed Alexandra Mailles, an epidemiologist at Public Health France. The international balance sheet as at 31 May is 321 cases in the EU, mainly in Spain (120 cases), Portugal (96 cases) and the Netherlands (26 cases), and 236 cases outside the EU, including the United Kingdom. with 179 cases. As of June 1, France has 33 confirmed cases: 24 in Ile-de-France, 2 in Auvergne-Rhône-Alpes, 1 in Hauts-de-France, 1 in Center-Val-de-Loire, 4 in Occitania and 1 in Normandy ». These cases, identified in recent weeks, concern “the vast majority of men, who declare themselves MSM, and among them, a significant proportion say they have sex with several partners.” But to date, monkeypox is not considered an STI, it is a disease whose main transmission is through direct contact with a damaged skin or mucosa with a healthy skin or mucosa, and also by droplets, insisted the epidemiologist. Therefore, it is not sexual intercourse as such that is at stake, but contact with injuries during sexual intercourse ”.

What are the symptoms of monkeypox and is it a serious disease?

The disease is manifested mainly by the appearance of fever, severe headache, lymphadenopathy (swollen lymph nodes), back pain, myalgia (muscle pain) and marked asthenia (lack of energy ) ”, Described the World Health Organization (WHO). In the aftermath of the fever, “the rash occurs,” added the WHO. It generally focuses more on the face (in 95% of cases) and the palms of the hands and soles of the feet (in 75% of cases). The oral mucosa (in 70% of cases), the genitals (30%) and the conjunctiva (20%), as well as the cornea are also affected ”.

However, in the current outbreak, “there is a strong predominance of genital and anal lesions,” said Xavier Lescure, an infectiologist at the Department of Infectious and Tropical Diseases at Bichat Claude-Bernard AP-HP Hospital. “No one should be hospitalized because of the severity of their child’s infection, and no one should be registered,” Alexandra Mailles said.

The monkey’s smallpox “usually heals spontaneously and the symptoms last 2 to 4 weeks. Severe cases are more common in children and are related to the extent of exposure to the virus, the patient’s health and the nature of the complications, according to the World Health Organization (WHO). . The lethality rate of monkeypox has always ranged from 0 to 11% in the general population, with higher numbers among young children. In recent times, the lethality rate has been around 3 to 6%. ” In endemic countries, deaths from monkeypox are “mostly related to late-stage care, as cases occur in remote, medically less equipped areas,” said Steve Ahuka Mundeke. With respiratory complications or bacterial superinfections related to skin lesions ”. On the other hand, a fast-paced, well-adjusted medical reward reduces the risks considerably.

Are there any preventive or curative treatments?

An antiviral drug, tecovirimat, designed for smallpox, has been approved by the European Medicines Agency (EMA) for monkeypox in 2022, based on data from animal and human studies. It is no longer available, “it is indicated against severe forms” of the disease, Xavier Lescure recalled.

A third-generation vaccine against classical smallpox (non-replicating live vaccine, ie not replicated in the human body) has been allowed in Europe since July 2013. A vaccine that offers “cross-immunity” in the face of the monkey’s smallpox, Brigitte Autran, professor emeritus of immunology at the Sorbonne University School of Medicine, said on Thursday. But “for now, there is no need to design a preventive vaccination campaign because of the low number of cases and the low severity of the disease.” On the other hand, with a virus with “an incubation period of one to three weeks, it is interesting to use it in post-exposure” for contact cases, she continued, “to prevent or prevent the spread of infection ”.

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