Monkeypox: “There is no reason to panic”

The monkeypox virus continues to spread around the world. The World Health Organization announced this week that there are more than 2,000 cases of the disease in at least 42 countries around the world. In an interview with RFI, Professor Serso Cunha of the Institute of Hygiene and Tropical Medicine, University of Lisbon explained what is known about the disease so far.

RFI: The World Health Organization (WHO) said this week that the number of cases exceeded 2,000 in 42 countries outside the African Continent where the disease is endemic. First, let’s ask why the virus, which has been prevalent in Africa for several years, is now spreading all over the world.

Cunha Cunha: I don’t think WHO has given a concrete and rigorous answer to this question, as we do not yet know when the first case occurred. Therefore, it is difficult to guess why the virus left Africa and why it left Africa. It spreads to other areas that are not endemic. What we are seeing now is that different countries are probably experiencing outbreaks of different origins.

In Portugal, we are focused on a community of men who have sex with other men, which also occurs in most cases written outside Africa. This can lead to believing that the first case occurred within the community. It is spreading due to some risk behaviors currently being performed. That is, people who are currently infected and pay less attention to the initial symptoms are helping to spread. virus. It’s a transient issue at this point, and I think it will return to normal soon.

RFI: WHO will discuss later this month whether to classify monkeypox as an “international public health emergency.” If this happens, what will change after that?

CC: CC: Nothing changes when it comes to illness. What are the changes in the measures that governments and local governments can take or advise to take? I think it’s still early at this point. There are about 2,000 cases worldwide. There are about 300 cases in Portugal and dozens of cases in France. At this time, there is no risk of a pandemic like Covid, as it is a disease with a relatively benign clinical course compared to normal smallpox, which has a relatively low mortality rate. -19. This risk does not yet exist at this time, as there was no vaccine or effective treatment when the virus broke out in connection with Covid-19. Here you already have a vaccine from the beginning and there are some medicines that are effective in treating this disease. This is not an emergency. We call it it, as it was in Covid-19. There is no reason to panic at this point.

RFI: Is there a risk that this virus will mutate, or is this factor still unknown?

CC: CC: This virus is a virus whose genetic material is, for example, in a different molecule than SARS-COV2, which causes Covid-19. Covid-19, as we know it, is a molecule called RNA. In this case, the virus is in the molecule, which is DNA, just as it is in the cell.

This molecule, DNA, proliferation, and mutations also occur, but these mutations are too small to correct. The mutation rate of DNA virus is much lower than that of RNA viruses such as SARS-COV2, HIV, and even influenza virus. In this case, for example, the genetic material of this virus, the molecule in which the gene resides, is six times as large as SARS-Cov2, which causes Covid-19, but is not considered highly relevant. Mutations that occur during this outbreak in the near future. It is not expected that there will be significant differences in genetic material, leading to more infectious, more serious illness, and high mortality mutants and strains. This is not expected with this virus.

RFI: The way the virus spreads suggests that the disease is caused by very close contact. What is the most common form of infection?

CC: CC: It is transmitted by close contact between infected and uninfected people. This close contact should, in principle, be a long-term contact and is transmitted by contact with respiratory droplets or contaminated liquids, that is, liquids containing viral particles from infected individuals.

For example, if a virus touches one of the small acne inside and a liquid appears in a sick person, the disease can be transmitted. The disease is transmitted through fluid transmission from infected people, that is, through respiratory droplets. However, another difference with Covid-19 is that here it requires longer, longer and closer contact to infect an infected person.

We are not aware of the risk of getting sick, for example, on a bus, with an infected person next to us. This is unlikely to happen. It’s not impossible, but it’s quite possible. Above all, there is contact between people who live together in the same space for a long time.

RFI: What are the main symptoms? How can I identify the illness?

CC: CC: Symptoms are relatively non-specific during the first 3 days. That is, the symptoms can manifest themselves as fever, muscle aches, headaches, and sometimes small rashes, so even the flu can be confused with another viral illness. A little late, but the first signs are relatively non-specific.

For example, the difference between this disease and the normal smallpox we are accustomed to and eradicated is that the lymph nodes here tend to appear to be quite swollen. This is, above all, the difference between this monkeypox and classic smallpox. Apart from that, the first symptoms are non-specific, after which small rashes begin to appear, which evolve to begin as small, relatively flat spots, then small bubbles appear to become a clear liquid, at a later stage. , With a darker yellow liquid. Then they burst into the crust. And when they fall, people are considered healed. The entire process from infection to healing can take about 2-4 weeks.

RFI: So far, only mild forms of the disease have been recorded. Is there a risk of death associated with this virus?

CC: CC: There is always a risk of death, but it is very low. The risk of death from monkeypox is significantly lower than that of classic smallpox. With classic smallpox, the mortality rate can be well over 30%, here about one tenth. Unfortunately, these fatal cases occur primarily only in countries with weak health systems. This is because in countries with richer, stronger and better treatment conditions, monkeypox mortality is approaching from near zero to sufficient.

RFI: Cases recorded on several continents affect men more than women. Why are men less resistant to this virus in their immune system?

CC: I don’t agree with that. That is, I agree that they affect more men. They are primarily men, but it is today that the virus has sex with other men and is not exactly about the differences between the immune systems of men and women, but about behavior and their transmission through behavior.

RFI: WHO Secretary Tedros Adhanom Ghebreyesus regrets the fact that a few days ago the virus had been epidemic in Africa for several years and was only paid attention to when the virus began to affect rich developed countries. Did. He is old. What is your view on the matter?

CC: CC: The virus has been prevalent in Africa for several years, and that’s true. It was first identified in 1970. This is the first human case. It is endemic in Central Africa and is known to occur on a regular basis, but these are very limited.

Despite the fact that sometimes dozens or even hundreds of cases have appeared, the disease is concentrated in the area. Since this is a zoonotic virus, it is related to the fact that these countries also have animal reservoirs. That is, the virus can be present in animal reservoirs, and these animals can also infect humans.

Since these reservoirs do not exist in the wild Western countries, the risk of contamination from animal contact was present, at least in the West and Africa. Therefore, these areas are unique.

What’s happening here is that it originated from a virus that was confined to one area and had a mortality rate of about 10/15%, not because of the high severity of the disease, but because of the weakness of the health care system. It is related. .. What is it now? What is happening in another way now is that the virus has spread all over the world and as a result, more attention is being paid.

RFI: Finally, when it comes to specific cases in Paris and other European cities, the number of cases has increased significantly. Are you worried when the transmission of Covid-19 is also increasing?

CC: CC: Most cases of monkeypox we have recorded do not require hospitalization and can be treated as outpatients by isolating people at home and limiting contact, which can strain the health care system. I am worried because there is.

Despite all this, it is unpredictable that this disease will have a significant impact on the healthcare system. People miss work and stay home for two to four weeks, so there may be financial weight due to abstention. If the virus is widespread, it may have some financial weight, but I don’t think there is as much pressure on the healthcare system as it does with Covid-19. This is because it does not force too many hospitalizations. As for the medical system, in principle, it does not matter.

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