Regarding "monkeypox", which has been reported one after another mainly in Europe and the United States, WHO = World Health Organization declared "Internationally Concerned Public Health Emergency" on July 23.
More than 16,000 people have been confirmed infected worldwide, and experts point out that it is safe to have infected people in Japan at any time.
I summarized the current situation and how to prepare.
(As of July 25, 2022)
“Rapid spread of infection can be prevented by appropriate measures”
"It is rapidly spreading to many countries that have never been identified."
On July 23, 2022, WHO Secretary-General Tedros declared that the spread of monkeypox infection was a "public health emergency of international concern."
Since May, reports of monkeypox infection have continued, mainly in Europe and the United States.
According to the WHO, more than 16,000 people have been confirmed infected in 75 countries and territories, and five have died in Africa.
The "Public Health Emergency of International Concern" issued this time is a procedure stipulated in the "International Health Regulations".
It is issued "when a situation arises that poses a public health hazard to other countries and requires urgent international coordination."
Currently, there are "emergency situations" in the spread of the new coronavirus and polio, and there are three monkeypox cases.
Secretary-General Tedros said he made the declaration, saying that there are many unknowns about the spread of monkeypox and that it is spreading rapidly all over the world.
On the other hand, he said that if appropriate measures were taken, the spread of the infection could be prevented, and he said that the virus monitoring system should be strengthened, including in countries where the infection has not yet been confirmed.
"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. are usually 1 to 5 days. Then there is a rash.
The rash typically begins on the face and spreads throughout the body.
It gradually swells into blisters, scabs, and scabs that heal within 2 to 4 weeks of onset.
In most cases, it is mild and recovers spontaneously, but it can 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 WHO, most of the people confirmed to be infected in this outbreak are men, and most of them are caused by sexual contact between men.
In areas other than Africa, the symptoms of monkeypox are characterized by cases where the rash is confined to the area around the genitals and anus, and cases where the rash appears before fever.
The "basic reproduction number", which indicates how many people are infected from one patient when all people are not immune, is set to 1 or less, compared to the new coronavirus, which is said to exceed 2. It is not so infectious.
The infection route is
Monkeypox is generally transmitted by being bitten by infected animals such as mice and squirrels, or by coming into contact with blood, body fluids, or rashes.
In addition, it has been pointed out that anyone can be infected by contact with the rash, body fluids, scabs, bedding and clothing used by the patient, or by being exposed to flying shots at a short distance. increase.
Patients who are considered to be so-called "community-acquired infections" whose infection route cannot be identified, and female patients have also been confirmed, and it is said that caution should be exercised without considering it as a disease of a specific group of people.
Vaccine
For monkeypox, the smallpox vaccine that was once inoculated is highly effective, and according to WHO, the effect of preventing monkeypox infection is up to 85%.
However, smallpox was eradicated from the earth in 1980 as a result of active vaccination, and the last vaccination in Japan was in 1976, when a child was born. The current generation in their late 40s and above is 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.
The Ministry of Health, Labor and Welfare has established a system to inoculate this vaccine at the National Center for Global Health and Medical Research Hospital in Tokyo, targeting the families of patients with close contact.
At the hospital, 50 people, including doctors and nurses in charge of inpatients, have been vaccinated, and we are considering expanding the scope of vaccination to include staff at health centers and prefectural health research institutes.
And on the 29th of this month, we will hold an expert group to start deliberation on whether to approve this vaccine as a monkeypox vaccine.
The remedy is
The therapeutic drug is also 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.
Currently, 4 of the National Center for Global Health and Medical Research in Tokyo, Rinku General Medical Center in Osaka, Fujita Medical University Hospital in Aichi, and Ryukyu University Hospital in Okinawa can be administered to patients as "specific clinical research". It's a place.
No reports of infection in Japan
According to the Ministry of Health, Labor and Welfare, no monkeypox infections have been reported in Japan since 2003, when the data was started.
Expert "Masks and hand-washing disinfection are also quite effective in preventing monkeypox infection"
We interviewed Professor Shigeru Morikawa of Okayama University of Science, a former director of the Department of Veterinary Sciences at the National Institute of Infectious Diseases, who has been studying "monkeypox", about the infection situation and countermeasures.
Q.
What do you think of the state of emergency
?
This is the first time that human-to-human transmission has spread to this extent, the spread has spread to many countries, the increase in the number of patients has not been stopped, and it is difficult to respond without international cooperation. There is no doubt that it is an abnormal situation.
However, there are no deaths outside Africa and there are few seriously ill people, and the infection to medical staff, children and pregnant women who are said to be liable to become severe, and people with poor immune status is very limited, so it is an emergency committee member. It seems that some people in the meeting thought that the severity was not so high.
In addition, although the spread of infection has been suppressed in some countries, the increase has not stopped in the world as a whole, so I think that the secretary-general finally decided that it was an emergency.
I think there was also a reflection on the fact that the new Corona declared an emergency after the spread of the infection.
Q.
The new findings are
A.
As for patients, the overwhelming majority are men, and the fact that many men have had sexual contact with each other has not changed so far.
Infections in women, children and healthcare professionals are very low and trends have not changed significantly.
I think that the reason why few people get seriously ill is that most patients are adult men.
Q.
How do you see the infectivity and pathogenicity of the virus
?
The risk of infection is high when the skin comes into direct contact with the lesion and touches the lesion.
It has also been reported that the virus is detected in the patient's semen, but it is not known if it is actually the source of the infection.
Recently, a paper has been published in Germany investigating the spread of the virus in a hospital room where two patients were hospitalized.
According to the report, for example, the virus was detected on the edge of the bed, and also on the toilet seat and the faucet of the toilet used by the patient.
Q.
The risks in Japan are
A.
The infection has spread not only in Europe and the United States, but also in Asia such as South Korea, Singapore, and Thailand, and it is safe to have infected people in Japan at any time.
Even in Japan, preparations for inspection and diagnosis systems are underway at health research institutes in various regions, and the government, government, and medical institutions are preparing with a sense of crisis.
The National Center for Global Health and Medical Research has issued guidelines on how to deal with patients, and clinics such as dermatologists are ready to prepare.
However, as the new corona continues to expand, medical institutions are facing a difficult situation, and I am worried that they will not be able to respond appropriately to monkeypox.
Q.
How should we prepare
?
It has become clear that there is an indirect risk of infection when the patient touches the touched area, but fortunately Japan has a thorough response to corona, so be sure to mask, wash your hands, and disinfect. If so, I think it is quite effective in preventing monkeypox infection.
Also, it seems that some patients complain that the part that is infected with monkeypox and a rash appears is extremely painful, but since there are few cases that are life-threatening so far, I think that it is not necessary to be so scared. ..
I don't think it's dangerous to travel to an area where infected people are present, but I think it's best to avoid shaking hands with your bare hands or touching anything. ..
If you take care like a corona, your risk of infection will be significantly reduced.