Transmission, symptoms, treatments ... What we know about the virus

Transmission, symptoms, treatments … What we know about the virus


She dethroned him Covid-19 of our disturbing topics of conversation. Endemic disease in Central and West Africa, monkeypox is usually a non-serious disease. But while the coronavirus pandemic is not yet behind us, the proliferation of this virus in about twenty countries usually unaffected by this virus, mainly in Europe and the United States in recent days, is of concern.

So, should we worry that the monkey’s smallpox has left its geographical cradle? How is it transmitted? Is this a dangerous virus? Are there any treatments? 20 minutes gives an update on what is known to date about monkeypox.

Where is the virus circulating today and what are the modes of transmission?

Like Covid-19, monkeypox is a zoonosis, a disease that is initially transmitted to humans by an infected animal. “Undoubtedly, this virus has its origins in the animal world,” Steve Ahuka Mundeke, head of the virology department at the National Institute for Biomedical Research in the Democratic Republic of the Democratic Republic, confirmed at an ANRS press briefing on Thursday. Congo (DRC). However, very few publications exist, the research has not yet clearly specified what the reservoirs of the virus are, but they are probably rodents. Endemic disease in West Africa and from the center, smallpox smallpox causes “epidemic outbreaks mainly in remote, forested or rural areas, affecting people frequently in contact with the animal world, and rarely in large cities. Thus, two-thirds of the cases are zoonotic and one-third are the result of interhuman transmission, ”he added.

A pattern “different from what we currently see in the West,” continued Steve Ahuka Mendeke. “This international monkeypox outbreak was launched in May, first with the detection of six non-passenger cases in United Kingdom, without a direct link to countries or people returning from countries where the virus usually circulates in Africa. At the same time, there was an ongoing investigation in Portugal into infectious syndromes associated with rashes in a group of MSM people, men who have sex with men, ”raising the question of a possible new mode of treatment. transmission of the disease.

What is known is that human-to-human transmission “occurs primarily through direct contact with damaged skin or mucous membranes with healthy skin or mucous membranes, and also through droplets, or contact with clothing. infected on Thursday, detailed Alexandra Mailles, an epidemiologist at Public Health France. The international balance sheet as at 31 May was 321 cases in the EU, mainly in Spain (120 cases), Portugal (96 cases) and the Netherlands (26 cases), and 236 cases outside the EU, including the United Kingdom. with 179 cases. On June 1, France lists 33 confirmed cases : 24 in Ile-de-France, 2 in Auvergne-Rhône-Alpes, 1 in Hauts-de-France, 1 in Center-Val-de-Loire, 4 in Occitania and 1 in Normandy ”. These cases, identified in recent weeks, concern “the vast majority of men, who report being MSM, and among them, a significant proportion say they have sex with several partners.” But to date, monkeypox is not considered an STI, it is a disease whose transmission is mainly through direct contact of a damaged skin or mucosa with healthy skin or mucosa, and also by droplets, insisted the epidemiologist. Therefore, it is not sexual intercourse as such that is at stake, but contact with the lesions during sexual intercourse ”.

What are the symptoms of monkeypox and is it a serious illness?

The disease is mainly manifested by the appearance of fever, severe headache, lymphadenopathy (swollen lymph nodes), back pain, myalgia (muscle pain) and marked asthenia (lack of energy). ”He describes the World Health Organization (WHO). In the aftermath of the fever, “the rash occurs,” adds the WHO. It generally focuses more on the face (in 95% of cases) and the palms of the hands and soles of the feet (in 75% of cases). The oral mucosa (in 70% of cases), the genitals (30%) and the conjunctiva (20%), as well as the cornea are also affected ”.

However, in the current outbreak, “there is a strong predominance of genital and anal lesions,” said Xavier Lescure, an infectiologist in the Department of Infectious and Tropical Diseases at Bichat Claude-Bernard AP-HP Hospital. But “none of these people required hospitalization due to the severity of their infection and no deaths were recorded,” Alexandra Mailles said.

Monkeypox “usually heals spontaneously and lasts for 2 to 4 weeks. Severe cases are more common in children and are related to the extent of exposure to the virus, the patient’s health and the nature of the complications, according to the World Health Organization (WHO). . The lethality rate of monkeypox has always ranged from 0% to 11% in the general population, with higher numbers among young children. In recent times, the lethality rate has been around 3 to 6%. ” In endemic countries, deaths from monkeypox are “mostly related to late management, as cases occur in remote, medically gifted areas,” said Steve Ahuka Mundeke. With respiratory complications or bacterial superinfections related to skin lesions ”. On the other hand, prompt and appropriate medical care greatly reduces the risks.

Are there any preventive or curative treatments?

An antiviral drug, tecovirimat, designed for smallpox, has been approved by the European Medicines Agency (EMA) for monkeypox in 2022, based on data from animal and human studies. It is not yet widely available, “it is indicated against severe forms” of the disease, recalled Xavier Lescure.

A vaccine Conventional smallpox vaccine (non-replicating live vaccine, ie not replicating in the human body) has been licensed in Europe since July 2013. A vaccine that offers smallpox of the monkey, Brigitte Autran, professor emeritus of immunology at the Sorbonne University School of Medicine, said on Thursday. But “for now, there is no need to design a preventive vaccination campaign because of the low number of cases and the low severity of the disease.” On the other hand, with a virus with “an incubation period of one to three weeks, it is interesting to use it in post-exposure” for contact cases, she continued, “to prevent or prevent the spread of infection ”.

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