The alert on monkeypox continues, even in Italy. In English monkeypox (MPX), is a zoonotic infectious disease, that is, which is transmitted from animals to humans, caused by the Monkeypox virus and thefirst identified in 1970 in rural villages in the rainforest areas of Central and West Africawhen smallpox (in English smallpox) was in the final stages of eradication.
While smallpox was permanently eradicated in 1980, monkeypox continues to be present in Central and West African countries. With the subsequent cessation of smallpox vaccination, monkeypox emerged as the most important orthopoxvirus with regards to its possible impact on public health.
WHO Director-General Tedros Adhanom Ghebreyesuscinque explained that the WHO assessment is that the risk of monkeypox is moderate globally and in all regions, except Europe, where the risk is assessed as high. There is also a “clear risk” of further international spread, explains the number one of the World Health Organization.
Hence, a series of recommendations to implement a coordinated response to stop transmission and protect vulnerable groups, intensify surveillance and public health measures, strengthen clinical management and infection prevention and control, and accelerate research on use of vaccines, therapies and other tools.
Where it spreads and who it affects most
Cases are often found close to tropical rainforests where there are animals that carry the virus. Evidence of monkeypox virus infection has been found in animals including squirrels, rodents, Gambian rats, dormice, various species of monkeys and others.
Monkeypox is endemic to central and western Africa, where outbreaks are regularly reported, especially in the Democratic Republic of Congo. The rare cases reported in non-endemic countries are usually imported. In endemic countries, transmission occurs mainly from animal to human, while transmission between people covers a limited percentage of cases.
The illness it affects all age groups. In endemic countries, children under the age of 16 have historically made up the largest percentage of cases. In recent years there has been an increase in the incidence of cases in endemic countries with reported outbreaks of all ages and in the most diverse contexts.
Human-to-human transmission is limited, we said, with the 6 generations longer documented transmission chainwhich means that the last person to be infected in this chain was 6 links away from the original sick person.
How it is transmitted
It can be transmitted through the contact with body fluids, lesions on the skin or internal mucous surfaces, such as in the mouth or throat, respiratory droplets, and contaminated objects.
Researchers fromNational Institute for Infectious Diseases Inmi Spallanzani of Rome published a study in Lancet Infectious Diseases in which they verified that the monkeypox virus “it stays in the semen for a long time“, Up to about 20 days from the onset of symptoms,” and not only as DNA, but with the living presence of viral particles with an infectious capacity “, thus demonstrating the nature of a sexually transmitted disease (more info on sexual transmission and who is most at risk can be found here).
Detection of viral DNA by polymerase chain reaction (PCR) is the preferred laboratory test for monkeypox. The best diagnostic samples come directly from the rash: skin, fluid or scabs, or biopsy where possible.
It causes a disease with symptoms similar, but less severe, to smallpox. In humans, monkeypox often occurs with the combination of these symptoms:
- asthenia (general weakness)
- swollen lymph nodes
- muscle aches
- after one to three days from the onset of fever, a rash occurs. Skin lesions evolve into blisters, pustules and crusts.
How widespread is it in Italy and where
By June 3,040 cases had been reported to WHO from 47 countries. Since then, the epidemic has continued to grow and there are now more than 16,000 reported cases from 75 countries and 5 deaths. On 23 July 2022, WHO declared monkeypox an international public health emergency.
In Italy, there are currently 599 confirmed cases, 54 more than the last survey 4 days ago, according to the bulletin published by the Ministry of Health with data updated to 9 August. Women increased to 9, from 5 in the previous report, compared to 590 men. The infections linked to travel abroad are 169 (+10) and the median age of the patients is 37 years, for a range that goes from 20 to 71 years.
The region with the highest number of confirmed cases is Lombardy, with 265, followed by Lazio (114), Emilia Romagna (65), Veneto (42), Tuscany (25), Piedmont (22), Campania (18), Liguria and Puglia (12), Friuli Venezia Giulia (11) . 5 regions that have not yet reported any infections: Basilicata, Calabria, Molise, Umbria and Valle d’Aosta. The remainder, including the autonomous provinces of Bolzano and Trento, report less than 10 infections.
In Germany the first European case of a girl
Meanwhile, the first case of pediatric smallpox in Europe on a 4-year-old girl in the German city of Pforzheim. The little girl, who lives in a family with two infected adults, currently has no symptoms: she was examined by a doctor as a precaution and a swab was taken from her throat for diagnosis. And she hasn’t come into contact with anyone outside of her family.
The news comes after the first infections among 15- and 17-year-olds last week. Less than three months after confirmation of the first case of monkeypox in Germany, a total of 2,916 cases have been reported.