China News Service, June 22. According to the official WeChat account of China CDC, since May 2022, a large number of monkeypox cases have been found in some countries in non-endemic areas, and human-to-human transmission has occurred.

In order to protect the health of Chinese citizens, CDC has put forward relevant health tips.

It mentioned that monkeypox is a self-limiting disease with a good prognosis in most cases.

At present, there is no specific anti-monkeypox virus drug in China.

There are no monkeypox cases reported in my country, and no monkeypox virus has been found in wild animals or in entry quarantine. The general population has no risk of infection.

  The health tips are as follows:

Monkeypox outbreak

  The world's first human case of monkeypox virus infection was confirmed in the Democratic Republic of Congo in 1970.

Since then, monkeypox cases have been reported in successive African countries. Currently, 11 African countries (Benin, Democratic Republic of Congo, Republic of Congo, Cameroon, Central African Republic, Nigeria, Côte d’Ivoire, Liberia, Sierra Leone, Gabon and South Sudan) have reported cases of monkeypox. Over the monkeypox epidemic.

Therefore, it is currently believed that the central and western regions of Africa are endemic areas of monkeypox, and the cases are mainly distributed in the tropical rain forests of central and western Africa.

  Areas outside of Africa are non-endemic areas with fewer previous monkeypox outbreaks and limited local transmission.

The 2003 monkeypox outbreak in the United States was the first time in history that monkeypox cases were found outside of Africa.

The UK has since reported small numbers of monkeypox cases in 2018, 2019 and 2021.

Most of the above cases have a history of sojourn in Africa.

  On May 13, 2022, the UK first reported local monkeypox cases. Since then, monkeypox cases have been found in Europe, America, Asia, Oceania and Africa (non-endemic countries). As of June 8, the global non-endemic epidemic Monkeypox epidemics have been detected in 28 countries on 5 continents in the region, with a total of 1,285 confirmed cases and 1 suspected case reported, and no deaths.

Among them, 86.5% (1112 cases) were from Europe, followed by the Americas (153 cases), Asia (13 cases), Oceania (6 cases) and Africa (1 case).

List of national monkeypox case reports in non-endemic areas in 2022

  In addition, there are also cases reported in African monkeypox endemic countries in 2022. As of June 8, a total of 8 African countries have found monkeypox epidemics, with a total of 1,526 reported cases and 72 deaths, with a crude case fatality rate of 4.7%.

Among them, the Democratic Republic of Congo reported the largest number of cases (1366 cases, 64 deaths), followed by Nigeria (141 cases, 1 death), Cameroon (31 cases, 2 deaths), Central African Republic (25 cases) , 2 deaths), Ghana (17 cases, no deaths), Republic of Congo (9 cases, 3 deaths), Libya (4 cases, no deaths) and Sierra Leone (2 cases, no deaths).

  Both the number of cases and the scope of this epidemic have grown rapidly, which is the highest in history for non-endemic areas.

Most of the cases are young and middle-aged men; most of them are gay men, and the spread of the epidemic is closely related to sexual activity; the vast majority of cases have not traveled to areas where monkeypox is endemic (ie, 11 monkeys in central and western Africa have reported monkeypox before 2022). countries with acne cases); the clinical manifestations are relatively mild and atypical, the rash is mainly distributed in the genital area, and the number is obviously low, with only a few or even one rash, and no further spread has been seen.

Monkeypox Basics

  (1) Monkeypox virus

  Monkeypox virus is a double-stranded DNA virus with a total length of about 197kb. It belongs to the genus Orthopoxvirus of the family Poxviridae. Virus).

There are two branches of monkeypox virus (West African branch and Congo Basin branch). Among them, the case fatality rate of West African branch is about 3.6%, and the case fatality rate of Congo Basin branch can reach 10.6%.

Sequencing analysis of monkeypox case samples found in non-endemic areas since May 2022 showed the West African branch.

  Monkeypox virus is sensitive to heat and can be inactivated at 56°C for 30 minutes or 60°C for 10 minutes. It can also be inactivated by ultraviolet rays and general disinfectants. It is sensitive to sodium hypochlorite, chloroxylenol, glutaraldehyde, formaldehyde and paraformaldehyde.

  (2) Epidemiology of monkeypox

  Monkeypox virus mainly exists in African rodents (African squirrel, tree squirrel, Gambian kangaroo, dormouse, etc.) in nature.

Primates (monkeys, chimpanzees, humans, etc.) are also infected after contact with rodents infected with monkeypox virus.

Animals infected with monkeypox virus and monkeypox patients are the source of infection for the disease.

  Monkeypox virus mainly invades the human body through mucous membranes and damaged skin.

Humans are mainly infected by contact with respiratory secretions, lesion exudates, blood, and other body fluids of infected animals, or by being bitten or scratched by infected animals.

It is mainly transmitted between people through close contact, and can also be transmitted through droplets during long-term close contact. Contact with virus-contaminated items may also be infected.

This monkeypox epidemic also found that most of the cases had same-sex sexual behavior before the onset of the disease, which may be mainly related to close contact transmission during sexual activities.

Monkeypox virus can also be transmitted from the pregnant woman to the fetus through the placenta.

  There is a certain degree of cross-protection against monkeypox virus in people who have been vaccinated against smallpox in the past.

People who have not been vaccinated against smallpox (especially those born after 1981) are generally susceptible to monkeypox virus.

  (3) Clinical manifestations of monkeypox patients

  The incubation period is 5-21 days, mostly 6-13 days.

  In the early stage of the onset, chills and fever, mostly fever, with body temperature above 38.5°C, accompanied by symptoms such as headache, lethargy, fatigue, back pain and myalgia.

Most patients have superficial lymph node enlargement in the neck, armpit, groin and other parts.

  A rash develops 1-3 days after onset (see image below).

The typical rash is that it first appears on the face, and gradually spreads to the extremities and other parts. The rash is mostly centrifugally distributed. The rash on the face and extremities is more common than the trunk. The rash can appear on the palms and soles of the feet. The number of rashes varies from several to There are thousands; it can also involve the oral mucosa, digestive tract, genitals, conjunctiva, and cornea.

The rash changes in several stages from macules, papules, herpes, pustules to scabs. Herpes and pustules are mostly spherical, about 0.5-1 cm in diameter, hard in texture, and may be accompanied by obvious itching and pain.

It takes about 2-4 weeks from the onset to the scab shedding.

Erythema or hyperpigmentation, or even scarring, may remain after the scab falls off, and the scarring may last for several years.

  Complications may occur in some patients, including secondary bacterial infection at the skin lesions, bronchopneumonia, encephalitis, corneal infection, and sepsis.

Severe cases are common in young children and immunocompromised people.

  The clinical symptoms of monkeypox patients found in non-endemic areas outside Africa this year are generally mild and atypical.

  (4) Treatment and prevention of monkeypox

  Monkeypox is a self-limiting disease with a good prognosis in most cases.

At present, there is no specific anti-monkeypox virus drug in China.

Treatment is mainly symptomatic supportive care and treatment of complications.

Health Tips

  (1) Personal prevention

  1. Those who are traveling or living in the affected countries.

You need to pay attention to the monkeypox epidemic information in your country.

Avoid contact with rodents and primates (including animal blood and meat) and must be cooked thoroughly before consumption.

If you must come into contact with a monkeypox patient, you should avoid close physical contact, avoid having sex with suspected infected persons, avoid common household items (such as bedding, clothing, etc.), and take personal protection when taking care of or visiting patients (such as wearing disposable Latex gloves, medical protective masks, disposable isolation gowns, etc.).

Pay attention to good hand hygiene and wash your hands under running water with soap and hand sanitizer in time.

  2. Those who have recently returned or are about to return.

Those who have recently returned to China should pay attention to self-health monitoring. If they have contact history and exposure history of suspicious animals and people or monkeypox cases abroad, they can take the initiative to contact the local disease control agency for consultation and report; if symptoms such as fever and rash appear , should take the initiative to seek medical treatment, and inform the receiving doctor of the overseas travel history to assist in diagnosis and treatment.

In addition to paying attention to the above matters, those who are about to return to China must cooperate with the customs to take the initiative to report when entering the health declaration.

  3. Those who plan to go abroad in the near future.

It is necessary to pay close attention to the monkeypox epidemic in the destination country, and learn about monkeypox prevention and treatment as soon as possible, such as avoiding contact with rodents and monkeypox patients, avoiding sharing items with patients, avoiding sex with suspected infected persons, and doing Practice personal hand hygiene and seek medical attention immediately if symptoms such as unexplained rash appear.

  4. Other general population in China.

There are no monkeypox cases reported in my country, and no monkeypox virus has been found in wild animals or in entry quarantine. The general population has no risk of infection.

If imported cases of monkeypox are found, there is a certain risk of infection mainly among their contacts.

  (2) Infection control in medical and health institutions

  When medical personnel receive a rash patient, if they find that they have a history of living in a country with a reported case of monkeypox within 21 days, they need to consider the possibility of monkeypox.

When providing diagnosis and treatment services for suspected or confirmed monkeypox patients, and when handling patient specimens, standard precautions should be implemented, namely wearing disposable latex gloves, medical protective masks, protective face shields or goggles, disposable isolation gowns, etc. Also do good hand hygiene.

The collection of samples from patients suspected of being infected with monkeypox virus should be performed by trained personnel.

Transporting patient samples should ensure safe packaging and follow infectious material handling guidelines.

The environment and items that may be contaminated in the hospital by suspected or confirmed monkeypox patients need to be disinfected at any time.

  (3) Animal trade

  It is recommended not to import rodents and primates unless it is necessary, and to strengthen the quarantine of animals carried and delivered, as well as the quarantine of imported rodents and primates.