Direct Monkeypox: last minute of the cases in Spain
Health Monkeypox Outbreak Clues: Less Immunity Due to Unvaccination and Increased Exposure to Virus Reservoirs
Podcast Monkeypox: what is it, how is it spread and what are its symptoms
Case accounting Madrid confirms seven cases of monkeypox and maintains 22 as suspects
United Kingdom, Portugal and
The alert and public health systems of the different countries are studying how and
why this rebound in cases occurs outside the usual areas
Given the alarm that may arise and the doubts about
dermatological lesions that make this
from the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc), its spokesman, Francisco Javier Membrillo de Novales, points out (in a Twitter thread) that "
Those who have doubts that they may be infected are advised to contact their reference hospital
to make the appropriate therapeutic diagnostic decisions."
How is the disease that causes monkeypox?
a rare viral zoonotic disease, it is not a sexually transmitted infection.
The first human cases were identified in the Democratic Republic of the Congo in 1970. The number of cases in West and Central African countries has increased over the last decade.
Outside of Africa, cases of human infections with
have been documented in different countries, including the US, UK, Israel and Singapore.
In all cases, it has been associated with an imported case or with contact with imported animals.
From the Seimc it is explained that according to the
case definition of
the United Kingdom Health Security Agency (UKHSA) and provisionally adopted since last Tuesday by the Center for the Coordination of Health Alerts and Emergencies (CCAES) of Health and the Autonomous Communities, there would have been This infection should be suspected in: "A person with an
unexplained vesicular rash anywhere on the body
, plus at least one of the main symptoms (described in the next question). In addition to having an
epidemiological link to a confirmed case
or probable case of monkeypox in the 21 days before symptom onset; be
a man who has sex with men (MSM)
; or have
history of travel to West or Central Africa within 21 days prior
to symptom onset.
What are the main symptoms of this virus?
According to Fernando Fariñas, international coordinator of the group of experts on emerging infectious diseases and zoonoses of the Spanish Society of Virology and director of the Institute of Clinical Immunology and Infectious Diseases, "it is the sum of a series of
. It is not just one of them. ".
The initial clinical picture usually includes:
, with temperatures above 38º-38.5ºC.
or muscle pain and
or joint pain "similar to body pain or discomfort from the flu," says Fariñas.
, that is, an increase in lymph nodes, "which are palpable in the cervical area and under the jaw," highlights the director of the Institute of Clinical Immunology and Infectious Diseases
A few days after the onset of fever, a
develops, often starting on the face and then spreading to other parts of the body.
Monkey pox on the skin
One of the most striking characteristics of
"There is a certain
resemblance to the spots produced by chickenpox
, but here we must emphasize that
their progression is simultaneous
," explains Raúl Ortiz de Lejarazu, professor of microbiology at the University of Valladolid and former director of the National Center for Influenza from Valladolid.
This skin rash that
often starts on the face and spreads to other parts of the body
, including the genitals.
traces on the skin
have the following evolution: "
First it looks like a spot
, which after two or three days becomes a
(less than a centimeter lesion with well-defined edges). Later it becomes a kind of
and later it is scarified", explains Ortiz de Lejarazu.
"The rash evolves and goes through various stages.
It can have an appearance similar to chickenpox or syphilis
, before finally forming a scab that later falls off," the British authorities describe.
It usually produces
a self-limited disease and most people recover in several weeks
, from two to four according to Seimc.
However, in some cases serious illness can occur.
How is monkeypox spread?
is not considered particularly contagious between people.
In general, person-to-person transmission is limited.
From the Seimc it is stated that
the transmission is through saliva or respiratory excretions, or by contact with the exudate of the lesion or the material of the scab
Viral excretion through
feces and sexual intercourse
may represent another source of exposure.
In the latter case, most of the infections produced in Spain to date are framed.
What is the incubation and contagion period of this virus?
period (interval between infection and onset of symptoms) for monkeypox
is usually 6 to 16 days, although it can range from 5 to 21 days.
Furthermore, it is usually a self-limited illness with
symptoms lasting 14 to 21 days.
Severe cases occur more frequently among children and their evolution depends on the degree of exposure to the
, the patient's health status and the severity of complications.
If most cases have been among men who have sex with men, is it a sexually transmitted infection?
No. Experts insist that it
is a zoonotic infection
The main route of infection common to current cases is through
fluids in sexual intercourse
, but it can also be spread in the ways described above.
Despite this, the UKHSA
recommends "particularly those gay, bisexual and men who have sex with other men
to be alert to any rash or unusual injury."
What is the treatment for monkeypox?
There is no vaccine or specific treatment available.
There is no vaccine or specific treatment available.
Treatment is symptomatic and supportive, including prevention and treatment of secondary bacterial infections.
The people under study in Spain evolve positively and are
isolated in their homes,
although they must maintain close surveillance since they may require hospital admission.
Does the smallpox vaccine serve or protect against the simian virus?
Since 1980 there has been no vaccination against
, understood as the infectious disease of humans.
There are observational works
that indicate that
this vaccine could protect against other smallpox, like this one
", explains Ortiz de Lejarazu.
How did monkeypox arise?
It first appeared in humans
in 1970 in the Democratic Republic of the Congo
(then called Zaire) in a nine-year-old boy, in a region where smallpox had been eradicated in 1968.
most reported cases have come from rural rainforest regions of the Congo Basin and West Africa
, particularly the Democratic Republic of the Congo, where it is considered endemic.
In 2017, Nigeria suffered the largest documented outbreak, approximately 40 years after the last confirmed cases.
Cases of monkeypox were confirmed in the United States in
the spring of 2003, marking
the first time the disease had been detected outside of the African continent.
Most of the patients had had close contact with domestic prairie dogs that had been infected by African rodents imported into the country.
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