WHO: “Monkeypox is a real risk to public health”

Monkeypox: The emergency committee has been called for June 23rd. The concern of a greater spread of the virus in the summer months. “The longer the virus circulates, the wider its scope will be”

How common is monkeypox?

Europe is at the heart of the spread of monkeypox. This was stated by the European office of the World Health Organization (WHO), which worried about the risk of the disease taking hold. “Europe remains the epicenter of this growing wave, with 25 countries reporting more than 1,500 cases or 85% of the global total,” said Hans Kluge, the director of WHO Europe, at a press conference.

brings together 53 countries including some from Central Asia. As of June 14, the UK has confirmed 524 cases. In Italy , a work published on 9 June in Eurosurveillance by researchers from Spallanzani in Rome reports29 cases, including only one woman, but the real cases actually exceed thirty.

Monkeypox: Why is WHO concerned?

For the World Health Organization, the priority is to contain transmission. “The scale of this epidemic presents a real risk: the longer the virus circulates, the more it will extend its reach and the more the disease will take hold in non-endemic countries,” Kluge warned.

“The disease is endemic in Africa – explains the immunologist Antonella Viola – but now the virus is also circulating in the rest of Europe, as never before. In the past we have the virus spread to non-endemic areas with small outbreaks that have been contained. 

Now it is spreading everywhere and by now it seems difficult to block. It is very likely that monkeypox will be a new disease in addition to the ones we have to live with. In a globalized world, it is not surprising.

Kluge said he was concerned that the spread of monkeypox could accelerate during the summer months in Europe when hundreds of Pride events, music festivals, and other mass gatherings are held.

“The unprecedented geographic expansion of the virus means that a coordinated international response may be needed,” said WHO Director-General Tedros Adhanom Ghebreyesus who announced that he had called an emergency committee meeting for June 23.

On this day it will be assessed whether the current spread of monkeypox constitutes a public health emergency of international concern.

To proclaim the international health emergency “the situation must be serious, sudden, unusual or unexpected, have implications for public health across borders, and require international action.”

WHO is also working to change the name of monkeypox, to find a name that is not discriminatory and does not create any stigma towards Africa, even more so since the geographical origin of the epidemic is unknown.

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Monkeypox: How is the disease transmitted?

Monkeypox is a viral infection that is mainly transmitted by close physical contact, through body fluids, skin contact, and respiratory droplets for this reason healthcare workers, family members, and sexual partners are more at risk of infection.

Lesions in the oral cavity or on the skin of an infected individual are contagious, as are the sheets or clothes that have been in contact with the pus emitted by the blisters. Recently, researchers from the Spallanzani Institute and German colleagues isolated the virus in the seminal fluid of infected patients and this supports the hypothesis of transmission also by the sexual way and not only by contact.

“It is not a pure sexually transmitted disease, but sexual activity is one more mode of transmission” specifies Antonella Viola. A discussion is also underway on the possibility that the monkey virus is also transmitted via aerosol, with small droplets that remain in the air for a long time, so much so that the American CDC had suggested the use of the mask to also defend against monkeypox, to then turn around. 

The mode of transmission via airborne is much debated today: many scientists argue that there is no evidence that the disease is transmitted only by large droplets and at close distances but that aerosol also plays a role.

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Monkeypox: Who affects the disease?

So far it has been found that monkeypox affects men who have sex with other men (MSM) overwhelmingly. The average age of the patients varies from 20 to 40 years.

However, it should be remembered that inter-human contagion can also occur through saliva, respiratory droplets, and contact with contaminated clothing or sheets.

“It is not a disease of gays because everyone can get sick – specifies Antonella Viola – however at the moment the virus is circulating more in the homosexual community and that is why attention is required.

The virus entered this group by chance through two events (the Gay Pride in the Canary Islands and the sauna in Madrid, ed .) but it could also have happened in another community, with a similar lifestyle, such as a rave, where physical proximity and promiscuity are prolonged.

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Monkeypox: What are the symptoms?

Monkeypox causes a variety of flu-like symptoms such as fatigue, body aches, headache, fever, swollen lymph nodes, and skin lesions described as very painful.

Most of the reported cases have lesions on the genitals or on the perinatal area, a signal that transmission probably occurs during close physical contact during sexual activities “. You also report many oral ulcerations.

Monkeypox: Is the disease serious?

Most people recover within a few weeks. So far, no deaths have been reported outside Africa (investigations are underway on a case in Brazil with a death possibly related to monkeypox) while in the African continent, according to WHO data, since January 2022, 72 have been registered. deaths starting from January 2022.

Out of 1500 infections in Europe we would have expected some severe cases or some deaths – reflects the immunologist – but fortunately, this was not the case. It is as if the virus is adapting, even if it does not appear to have changed at the moment. The disease is now affecting healthy young people, who respond to the virus with an efficient immune system.

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Are there any people at risk?

However, the disease can occur severely in some population groups, such as young children, pregnant women and immunosuppressed people.

In these categories of people, the disease can develop severely with complications, including serious ones: bronchopneumonia, a secondary shock to diarrhea and vomiting, corneal scars that can lead to permanent blindness, and encephalitis especially in patients with secondary bacterial infection, and septicemia: all situations that require a hospital stay. This is also why the WHO is worried: with a greater spread, the disease could hit the most vulnerable, with serious consequences.

Is vaccination recommended?

With the current epidemiological situation, the World Health Organization does not recommend mass vaccination, however, the Organization is concerned that rich countries may repeat the mistakes of the Covid-19 pandemic, quickly monopolizing limited stocks of vaccines.

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Post-exposure vaccination (ideally within four days of exposure) may be considered for higher-risk contacts such as healthcare professionals, including laboratory personnel, after careful evaluation of the risks and benefits. People with a previous smallpox vaccination have some protection against monkeypox (estimated at 85%) and this part of the population (over 50 years of age) is expected to possibly contract a milder disease, even if the effective protection must now be verified after years (investigations are ongoing).

In Italy, the smallpox vaccination was abolished in 1981. “At the moment the cases are still limited with symptoms that are not serious – concludes Antonella Viola – but if we were to find ourselves faced with a real epidemic with growing infections, a strategy could be rethought vaccination to protect even those who have not been vaccinated against smallpox.

In this regard, the European health authorities have ordered more than 100,000 doses of the Bavarian Nordic smallpox vaccine that will soon be available to member countries that need it most.

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