Thursday, March 28

Knowing the chain of contagion makes it difficult to control the explosion of monkeypox cases


Updated

The delay in consulting the doctor, the absence of dermatologists in some Emergencies and the incubation time of the infection complicate the tracking of those affected that already extend over a dozen countries

Close-up of the hands of a monkeypox patient during an outbreak in the Democratic Republic of the Congo between 1996 and 1997.Brian W.J. Mahy/CDC
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The explosion of cases of monkeypox has continued without stopping and everything seems to indicate that it will continue like this for a while, since knowing the chain of transmission of the virus is making it difficult to control. There are already more than ten countries affected by this outbreak, which, according to some experts, in the case of Europe, is already It will be circulating approximately a month before the first alert launched by the United Kingdom.

Portugal, Spain, the US, Canada, Sweden, Italy, Belgium, France, Germany and Australia have been added to this country, which yesterday recorded 20 cases.

In the case of Spain, the most affected community is Madrid, where 30 cases have been registered and 15 more are under study.

According to the Minister of Health, Enrique Ruiz Escudero, one of the sources of origin of the monkey virus in the region is associated with a saunaattending to the tracking work carried out by the General Directorate of Public Health of the Ministry.

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The counselor was convinced that more cases will continue to appear in the next few hours, although he did emphasize that all the symptoms are mild.

A premonition that was also shared by the Center for the Coordination of Health Alerts and Emergencies (CCAES) that yesterday warned that more cases will be detected and he did not rule out that it be transmitted to more population groupsfor which he appealed to “minimize the risk behaviors associated” with this virus.

traceability

And it is that knowing the chain of transmission of the virus is not an easy task. The World Health Organization (WHO) has requested traceability to control cases, but The characteristics of the contagion pattern shared by this new outbreak outside its endemic area, Africa, make tracking work difficult. “Many of the patients have entered the Emergency Room or a Dermatology consultation. In many cases, the onset of the lesions may have been lead patients to think it was another disease“, explains Pablo Fernndez, spokesman for the Spanish Academy of Dermatology and Venereology (AEDV).

In this sense, Javier Membrillo, spokesman for the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc), recalls that “contagion is due to very close contact between people. It is not as simple as Covid; one can sleep with someone infected and not get infected. But if you touch the vesicles or blisters that suppurate, the virus is transmitted more easily.”

Perhaps, as Fernndez points out, “the problem lies in the fact that not all emergency services have a dermatologist on call Y the pathology, although we still do not know why, does not behave the same as in endemic areas“Perhaps, that is why knowing the chains of contagion is complicated, “the problem with zoonotic infection is that it has between one and three weeks of incubation and in that period people can be contagious”, he explains.

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That and that, in addition, “many take time to consult because of shame, because of the stigma,” adds Membrillo.

The Seimc spokesman also analyzes that “the patterns of sexual behavior of men who have sex with men sporadically on many occasions do not allow the chain of transmission to be well established.”

For this reason, experts warn that for a few days there will be an explosion of cases that will then descend“after the implementation of containment elements and control practices with common sense”, points out Amés García Rojas, president of the Spanish Association of Vaccinology (AEV).

Although it is true that the experts consulted emphasize that “it would be advisable to alert the population so that risky sexual practices are absolutely avoided: dark rooms, chem-sex, glory holes, swingers… At the slightest suspicion: total abstinence from sex and consult a doctor.”

geographical dispersion

The Minister of Health of Madrid has also been surprised by “the wide geographical distribution of a disease, which was practically eradicated and controlled. You have to be very attentive. In 24 hours, the Public Health services have detected the cases and the epidemiological tracking work has been carried out.”

In this sense, it coincides with what Membrillo points out. “The alarm is due to the more or less simultaneous geographical dispersion. A case in the United Kingdom related to a trip to the African endemic zone to Nigeria is indicated as the origin, and from there an attempt is made to see how it has reached Spain and Portugal.”

also It is positive that “the infections are with the least deadly strain, 1%, which is that of West Africa, because if it corresponds to that of Central Africa, mortality rises to 10%Quince explains.

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In this scenario, the spokesman for Health of the European Commission, Stefan Keersmaecker, pointed out yesterday, appealing to the report of the European Center for Disease Control and Prevention (ECDC), that it is a virus of “moderate transmissibility between humans” , with a higher risk when the contacts are close. In any case, he said, the Commission is monitoring “very, very carefully” the evolution of monkeypox in the European Union.

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