Home » Smallpox of monkeys, cases are growing in Italy: photos of symptoms

Smallpox of monkeys, cases are growing in Italy: photos of symptoms

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Smallpox of monkeys, cases are growing in Italy: photos of symptoms

The case of the 50-year-old Italian carabiniere on vacation in Cuba who, according to the island’s authorities, died of monkeypox is causing a stir. But what do we know about this virus?

Monkeypox, declared a global health emergency by the WHO, continues to spread around the world. “Now they have been more than 35 thousand cases reported to the WHO say monkeypox (his name in English, ed), from 92 countries and territories, with 12 deaths, ”said the head of the World Health Organization Tedros Adhanom Ghebreyesus. Nearly 7,500 cases were reported last week, a 20% increase over the previous one, which was already 20% higher than the week before.

What is monkeypox and how is it transmitted

Monkeypox (MPX) is a zoonotic viral disease, that is, it tends to be transmitted from animal to human.

Since it has been first recognized as a human disease in 1970cases have been increasingly reported in several African countries due to a combination of factors, including both increased exposure, brought about by deforestation, conflict and displacement, and improved surveillance and laboratory capacity in the African region.

The first reported outbreak outside of Africa was in 2003 in the United States. More recently, in 2018 and 2019, two travelers from the UK, one from Israel and one from Singapore, all with a history of traveling to Nigeria, were diagnosed with MPX. This was the first time that travelers have been associated with the transmission of monkeypox outside of an outbreak.

Who is affecting the virus the most

What is worrying the experts, as Ghebreyesus explained, is that most cases are reported in Europe and the Americas, particularly among men who have sex with men.

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“Almost all cases are reported – from Europe and the Americas – among men having sexual relations with men, underlining the importance for all countries to design and provide tailored services and information for these communities that protect health, human rights and dignity ”, he specified.

According to Dr. Demetre Daskalakis, an official with the U.S. Centers for Disease Control and Prevention (CDC) working on the response to monkeypox, this is not a sexually transmitted disease, but many people who have tested positive in the United States have had some type of sexual activity, “which can include full intercourse and oral sex,” CNN reported.

To date, there are 19,429 cases in Europe alone of monkeypox identified in 43 countries of the European region, both thanks to the surveillance of the WHO Regional Office for Europe and through the European surveillance system TESSy. Most cases are between 31 and 40 years old and it is made up of men: several cases have affected HIV-positive people.

505 cases were hospitalized (5.8%), of which 179 cases required clinical care. Three cases were admitted to ICU, of which one was admitted to ICU for reasons unrelated to monkeypox infection.

The other two cases admitted to intensive care instead, explains the European ECDC, would have died of monkeypox. Some (57) cases were reported as health care workers, however no occupational exposure was reported.

Monkeypox in Italy

Even in Italy the infections continue to rise: according to the latest bulletin of the Ministry of Health, published on August 16, they are 662 confirmed ones, with an increase of 18 cases compared to the last survey of 12 August. There are 185 cases linked to travel abroad. The median age of infected people is 37 years: it is 652 men and 10 women.

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As for the regions where the virus is most prevalent, Lombardy is in the lead, followed by Lazio: in Lombardy the confirmed cases are 291 (+8 compared to the last survey of 12 August) and in Lazio they are 121 (+3).

How it is transmitted

How worried should we be about this outbreak? As indicated by the ECDC, the disease is more likely to spread through close contact, such as during sexual intercourse as we said, and in this group the risk can be considered high. The likelihood of it spreading in people who have multiple sexual partners, including some groups of men who have sex with men, is considered to be high in the EU.

However, it should be noted that the likelihood of spread to the wider population is low and that most cases in the current outbreaks have presented with mild symptoms.

This virus does not spread easily among people. Human-to-human transmission occurs through close contact with infected material from the skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through contaminated objects, such as towels, clothes, telephones, etc.

What are the symptoms

Human monkeypox often starts with one combination of several symptoms: fever, headache, chills, exhaustion, asthenia, swollen lymph nodes, back pain and muscle aches. Most cases in general have presented with a ‘rash (7.1%) and systemic symptoms such as fever, fatigue, muscle pain, chills or headache (65%).

A rash commonly develops 1 to 3 days after the onset of fever. Skin lesions often initially present as macules, evolving into papules, vesicles, pustules, crusts and crusts.

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Especially the anogenital areas, trunk, arms and legs, face, palms, and soles of the feet, sometimes they can be scarce or limited only to the genital or peri-anal areas. In 5% of cases the onset manifestation can be represented by lesions at the level of the oro-pharyngeal hollow.

How bad is it

The clinical manifestation of monkeypox is usually mild, as in most of the cases reported so far in Europe. In Nigeria, it was noted that West African strain has a 3.3% mortality rate. Mortality is highest among children and young adults, and immunocompromised individuals are particularly at risk for severe forms of the disease. However, most people recover within a few weeks.

Close contacts of monkeypox cases should self-monitor for symptom development for 21 days after the last exposure and should avoid close physical contact with young children, pregnant women and immunocompromised individuals.

Healthcare professionals and relatives should avoid touching skin lesions with their bare hands, wear disposable gloves, and observe strict hand hygiene.

How is it treated? There is a vaccine

Treatment is mainly symptomatic and supportiveincluding the prevention and treatment of secondary bacterial infections. Antivirals are potential treatment options for severe cases.

An antiviral developed for the treatment of smallpox, the tecovirimatwas approved for the treatment of monkeypox in January 2022 by the European Medicines Agency (EMA).

There is also a vaccine against monkeypox (more info can be found here, while here you will find details on who should get the vaccine in Italy according to the indications of the Ministry of Health).

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