According to the announcement of the National Health Commission, since September 9, monkeypox has been included in the management of Class B infectious diseases. Earlier, testing data released by the Chinese Center for Disease Control and Prevention on September 20 showed that 9 new confirmed cases of monkeypox were reported in August Chinese mainland, of which 8 were infected in women for the first time. Some experts said that the number of infected women may increase in the future, and even intra-family transmission may occur.
Will household transmission become the main mode of monkeypox transmission in the future? What is the importance of managing monkeypox as a category B infectious disease to curb its spread? The reporter of Science and Technology Daily interviewed relevant experts for this purpose.
Spread will expand from "high-risk groups" to the general population
Dr. Jiang Tianjun, deputy director and chief physician of the Department of Infectious Diseases Medicine of the Fifth Medical Center of the General Hospital of the People's Liberation Army Chinese People's Liberation Army, introduced that monkeypox is a zoonotic infectious disease caused by monkeypox virus infection, named because it was first discovered in wild cynomolgus monkeys in 1958. In 1970, a 9-month-old boy from Congo became the first human case of monkeypox infection. Since then, monkeypox has been endemic in Central and West African countries. In September 2022, China reported the first imported case of monkeypox; Since June 9, many cases of monkeypox have been reported in many provinces in China.
"Prior to 2021, monkeypox outbreaks were mainly endemic in Central and West Africa, with short chains of human-to-human transmission. However, since May 2022, monkeypox outbreaks have occurred in many countries, with most cases in young and middle-aged men. Jiang Tianjun said that the emergence of infected women means that the spread of monkeypox has indeed expanded, from the local transmission mode between the main "high-risk groups" to the mode of transmission to the family and the general population.
"Although it is only a few cases, this trend is very alarming." Jiang Tianjun believes that at present, the probability of infection between men and women is very different. In 2022, the CDC summarized 1195 early monkeypox cases and found that 98.7% of cases were men.
"At present, close contact, including sexual activity, is the main route of monkeypox transmission, and the risk of infection due to general contact between family members is low." Jiang Tianjun believes that at present, China's inclusion of monkeypox into the management of Class B infectious diseases can make monkeypox prevention and control have a law to follow, help timely detect potential risk groups, understand their transmission scope and characteristics, and carry out targeted publicity and education and comprehensive intervention, so as to effectively prevent the spread of the epidemic.
Increase the publicity of science to avoid the expansion of the spread population
Jiang Tianjun believes that in view of the current situation of monkeypox transmission, scientific popularization should be increased, so that the general public can understand the relevant knowledge of preventing monkeypox infection, and avoid the expansion of monkeypox transmission population to the greatest extent.
In this regard, Lin Min, chief physician of Jiangxi Provincial Children's Hospital, also expressed the same view. Lin said that although monkeypox is a self-limiting disease and the symptoms disappear on their own in most cases, children, pregnant women and immunocompromised people are still at risk of severe disease and death.
In monkeypox outbreaks in multiple countries globally since 2022, the case fatality rate for cases in non-endemic areas is approximately 0.1%. "Although this percentage is small, if the base of infected people expands, the number of deaths will rise sharply." Lin Min believes that the public urgently needs to understand that monkeypox is not limited to sexual transmission. Close contact with items contaminated with the virus, respiratory droplets from an infected person can also contribute to monkeypox transmission, and even infected mothers may infect the fetus through vertical transmission. In addition, animal-to-human transmission may also be caused by consumption of meat from uncooked infected animals, contact with bodily fluids such as exudate or blood from infected animals, or bites and scratches from infected animals.
Lin Min introduced that monkeypox virus and smallpox virus belong to the genus of orthopoxvirus, therefore, smallpox vaccine has a certain cross-protection against monkeypox, but not lifelong immunization, people who have been vaccinated with smallpox vaccine for more than 10 years and people who have not been vaccinated with smallpox vaccine are generally susceptible. Infection data from Central and West African countries suggest that children are also susceptible to monkeypox.
"In the face of monkeypox virus, the public does not need to panic, do a good job of personal protection, eliminate unclean sexual contact, can minimize the spread of monkeypox." Lin Min said that 75% ethanol, chlorine-containing disinfectants, peracetic acid and other commonly used disinfectants, as well as ultraviolet rays can effectively inactivate the virus. (Science and Technology Daily reporter Luo Chaoshu)