New outbreak of monkeypox: what do we know about this virus?

In early May 2022, a new outbreak of monkeypox was reported in the UK. Let’s see what is known about it and what the infection consists of.

Last update: May 18, 2022

Monkeypox was first detected in 1958 in monkey colonies used for research. It’s about a orthopoxviruses zoonotic which first infected a human in the Democratic Republic of the Congo in 1970. In recent weeks, a new outbreak of monkeypox has been reported in the United Kingdom, Portugal and Spain.

Most of the reported human cases have so far been concentrated in Central and West Africa. Outside of these areas, transmission was very rare, although outbreaks had already occurred in 2003 in the United States and again a smaller one in late 2021. Let’s see what is known about the new 2022 monkeypox outbreak and how could be serious in the near future.

What do we know about the new outbreak of monkeypox?

On May 7, 2022, a case of monkeypox was reported to the World Health Organization (WHO) in a person who returned to the UK after a trip to Nigeria. The patient in question developed the first rashes on April 29, 2022 and had entered the UK on May 4. That same day he went to the hospital and the case was immediately isolated.

The last people who were with the patient were also contacted and have been followed up regularly since then. So far, none have shown symptoms. However, from May 7 to May 15, 2022, the UK IHR National Focal Point had confirmed a total of 7 cases.

None of these cases are related to the first reported. Nor with those who had contact with the first patient (unless it is known until now).

On Wednesday, March 18, 2022, Margarida Tavares, director of the National Program for Sexually Transmitted Infections and HIV Infection of the General Directorate of Health of Portugal, confirmed 5 cases in the country and more than a dozen under suspicion.

Similarly, the Spanish Ministry of Health announced on March 18, 2022 that it was studying 8 possible cases of monkeypox in the country; all of them in men and concentrated in the Community of Madrid.

From January 2022 to April 30 this year, the Nigerian Center for Disease Control (NCDC) had confirmed a total of 15 new cases there.

As of this writing, the UK, Portugal and Spain are the only countries to have reported cases of the new monkeypox outbreak. Nigeria was already dealing with the outbreak, as from 2017 to the present they have accumulated a total of 558 confirmed. Health authorities evaluate suspects to report outbreaks in other countries in the region.

There are no elements yet to establish that the infections are through a rapid spread path.

What is monkeypox?

Monkeypox is a viral zoonosis; that is, a virus that is transmitted to humans from animals. Experts consider it the main orthopoxviruses affecting human populations since the eradication of smallpox in the 1980s.

The first human case was reported in the Democratic Republic of the Congo (DRC) amid efforts to eradicate smallpox in the country. Since then, monkeypox outbreaks have been reported in Cameroon, Nigeria, the Central African Republic, Liberia, Ivory Coast, Gabon, and Sierra Leone.

Cases reported outside of these countries are related to tourist travel to them. We have already mentioned the best known: in the US in 2003 and 2021.

It is considered an endemic disease of the Democratic Republic of the Congo.

The virus is transmitted through direct contact with blood, body fluids, or skin or mucosal lesions of infected animals. Apes are not the only ones that transmit it. Squirrels, dormice, rats and other rodents are potential vectors.

From human to human it is transmitted through close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects. There is also congenital monkeypox, which is the infection that a fetus acquires through its mother’s placenta.

Transmission via respiratory droplet particles requires prolonged face-to-face exposure. Health workers and family members and caregivers of active patients are most at risk.

What are the symptoms?

The incubation period of the virus ranges from 5 to 21 days.. Two states are distinguished in the process:

  1. Invasion.
  2. Rash.

During the invasion (the first 5 days), the patient develops headache, fever, swollen lymph nodes, muscle aches, lack of energy, and back pain. Swollen lymph nodes, known as lymphadenopathydistinguishes the infection from other similar ones (chickenpox and measles, for example).

Between the third and fourth day, rashes begin to appear on the skin. These are concentrated on the face, the palms of the hands and the soles of the feet. Some patients also develop them on the genitals, oral mucosa, and conjunctival mucosa.

The cycle of eruptions is as follows: macules, papules, vesicles, pustules and crusts. Symptoms usually last between 2 and 4 weeks.

The disease was first known in apes. Then there was confirmation among humans in the 1970s.

How serious is the new outbreak?

The mortality rate of the monkey virus ranges from 0 to 11%, although the percentage is higher in young children, older adults and people with compromised immune systems. Most cases are mild or moderate, and with proper medical care, patients recover.

The new outbreak of monkeypox is no different from the virus cataloged more than 50 years ago. All cases reported so far have remained stable; this, considering that the virus is less aggressive than others of the same family. Despite this, the competent authorities are taking the necessary measures to prevent the addition of new cases.

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