[Details] "Monkeypox" WHO declares an emergency What are the characteristics and infection routes?

Regarding "monkeypox", which has been reported one after another mainly in Europe and the United States, WHO = World Health Organization held a press conference on the night of July 23, Japan time, saying that the spread of infection is continuing, "Public health concerns internationally. "Emergency situation" was declared.

WHO is currently continuing to declare a state of emergency regarding the spread of the new coronavirus and polio, making "monkeypox" the third.

We have compiled information that has been known so far regarding the characteristics of "monkeypox" and the infection route.

"Monkeypox" with a characteristic rash In this infection

Monkeypox is a disease caused by infection with the "monkeypox virus," which is similar to the smallpox virus.

According to the National Institute of Infectious Diseases and WHO, the incubation period of monkeypox virus is usually 7 to 14 days, and after the incubation period, fever, headache, swollen lymph nodes, myalgia, etc. continue for 1 to 5 days. After that, a rash appears.

The rash typically begins on the face and spreads throughout the body.

It gradually swells and becomes blisters (blisters), scabs appear, and it heals within 2 to 4 weeks after the onset.

In many cases, it is mild and recovers spontaneously, but it may cause complications such as pneumonia and sepsis, and it is said that the younger the age, the more severe it may be.

However, the appearance of monkeypox that is spreading this time is different.

According to the materials released by WHO after the emergency committee in June, the spread of this infection is characterized by cases where the rash is limited to a part such as around the genitals and anus, and cases where the rash appears before fever. It means that it is a target.

There are almost no cases of hospitalization.

The "basic reproduction number", which indicates how many people are infected from one patient when all people are not immune, is 0.8, which is not so much compared to the new coronavirus, which is said to exceed 2. It is not very infectious.

According to the analysis in the Netherlands, the incubation period from infection to onset is 8.5 days on average, and according to the analysis in the United Kingdom, the onset interval is one infected person and the next infected person. It is estimated to be 9.8 days on average.

In addition, although 10 cases of health care worker infections have been reported so far, at least 9 cases were not work-related infections.

What is the infection route?

Monkeypox is generally transmitted by being bitten by infected animals such as mice and squirrels, or by touching blood, body fluids, or rashes.

It has also been pointed out that anyone can be infected by contact with the infected person's rash, body fluids, scabs, bedding or clothing used by the patient, or by being exposed to flying shots at a short distance.

WHO states that "close contact can infect anyone," and that many of the patients identified in previous studies had sexual contact between men.

Some experts suggest that the infection may have spread through large-scale events held throughout Europe.

On the other hand, patients who are considered to be so-called "community-acquired infections" and female patients whose infection route cannot be identified have been confirmed, and it is said that caution should be exercised without considering it as a disease of a specific group of people.

And anyone who has had close contact with a person with monkeypox is at risk of getting infected, saying, "No one should be treated unfairly because of illness."

WHO encourages people with symptoms to be tested and to avoid close contact with others and seek medical attention.

ECDC = European Centers for Disease Control and Prevention states that "the possibility is very low", and if human-to-human transmission continues, it may eventually spread from human to animal and spread among animals and become established in Europe. I'm pointing out.

Origin of the "monkeypox" name and previous infections

Monkeypox was named after it was first discovered in 1958 in cynomolgus monkeys at a facility where primates from around the world were gathered to produce the polio vaccine.

However, the natural host carrying this virus under normal conditions is thought to be a reservoir, not a monkey.

WHO is currently considering changing the name "monkeypox".

Human transmission was first identified in the current Democratic Republic of the Congo in 1970, and is still frequent in Africa.

It is said that different strains of virus are spreading in West Africa such as Nigeria and Central Africa such as the Democratic Republic of the Congo.

The monkeypox virus found in Central Africa is more likely to become severe, with case fatality rates ranging from a few percent to 10%.

On the other hand, it is said that the virus of West African strain, which has relatively low pathogenicity, is currently spreading in various countries such as Europe.

In 2003, the virus was introduced to the United States through small animals imported as pets from Africa, and 71 people were infected with monkeypox.

In recent years, all cases confirmed outside Africa have a pattern of onset of returnees from Nigeria, and several cases have been confirmed annually.

No one has died outside of Africa.

What about vaccines and remedies?

The once inoculated smallpox vaccine is highly effective against monkeypox, and according to the WHO, it is up to 85% effective in preventing monkeypox infection.

However, as a result of active vaccination, smallpox was eradicated from the earth in 1980, and the last vaccination in Japan was in 1976, when I was a child at that time. People in their late 40s and older are vaccinated and may be immune to monkeypox.

There is a smallpox vaccine in Japan, which is said to be highly effective and has few side reactions, and is stockpiled nationally as part of counterterrorism measures.

However, it has not been approved as a monkeypox vaccine, and the Ministry of Health, Labor and Welfare has conducted a "specific clinical study" to investigate the safety and efficacy of the drug, targeting the families of patients with close contact at the National Center for Global Health and Medical Research Hospital in Tokyo. We have put in place a system for inoculation.

At the subcommittee made up of infectious disease experts from the Ministry of Health, Labor and Welfare held on June 29, the target of inoculation was

▽ medical workers such as doctors and nurses in charge of hospitalization of

patients ▽ staff of health centers that transport patients

▽

It is reported that it is also being considered to extend it

to the person in charge of the local health research institute that conducts the inspection .

In the United States, Canada, and the United Kingdom, smallpox vaccination has begun as a countermeasure against monkeypox infection.

Initially, people who had direct contact with medical personnel and patients were targeted for vaccination, but in the United Kingdom and the United States, the target has been expanded to include people who have had sexual contact between men and an unspecified number of people. People who have sexual intercourse are also targeted.

However, due to the low supply of vaccines, there are cases where vaccines are in short supply.

In New York, where expanded vaccination began on June 23, 1000 vaccine reservations were filled up that day.

The US government announced on June 28 that it would supply approximately 300,000 doses of vaccine to medical institutions across the United States within a few weeks.

The EU is also accelerating the movement to secure vaccines, including the announcement that it will purchase 110,000 new vaccines.

Therapeutic agents are being considered for administration in clinical studies in Japan.

The drug used is a drug called "Tekobirimat" developed by an American pharmaceutical company as a treatment for smallpox, and is approved in Europe as an antiviral drug for monkeypox.

In addition to being able to be administered to patients as a "specific clinical study" at the National Center for Global Health and Medical Research Hospital, it is being considered for introduction to medical institutions in metropolitan areas other than the Kanto region.

However, according to WHO, etc., there is a limit to the amount of medicines that can be distributed, and in many cases, symptomatic treatment is used.