Cases continue to be added to monkeypox outbreaks, both as confirmed and suspected cases. While the risk of this disease remains limited for now, concerns are growing with the number of patients affected. Recently, the Ministry of Health announced the protocol to fight this disease to the public. It is therefore appropriate to review the evolution of this virus in our environment, what its symptoms are, and what else we know about this infection.

The evolution of the epidemic in Spain.
The number of confirmed cases has increased significantly in recent days, from 7 to 30 in the Community of Madrid alone, and all have progressed positively. The first case was detected on 17 May and the suspects have spread to various Autonomous Communities such as the Canary Islands, Galicia or the Basque Country and the Community of Madrid, adding a total of 54 suspected cases.

Currently, research is being conducted on the connection between the epidemics occurring in the Community of Madrid and the cases detected in the Canary Islands and, accordingly, the outbreaks in the United Kingdom, the European country most affected by this disease, along with Spain.

Symptoms
The symptoms of this infection are “similar to smallpox but milder than it,” as described by the United States Centers for Disease Control and Prevention (CDC). The disease initially presents with fever, headache, muscle and/or back pain, swollen lymph nodes, chills, and fatigue. Lesions usually appear as a rash one to three days after fever.

The typical incubation period is 7 to 14 days but can vary and can be as long as 21. In total, the disease disappears after a period ranging from two to four weeks, but can cause death in a limited number of people.

How it is transmitted and the precautions that those infected should take.
The virus is transmitted through contact with an infected person or animal, but can also spread through surfaces. The virus enters the body of the new host through a wound, inhalation or mucous membranes (eyes, nose, mouth).

Human-to-human transmission is still considered limited, but infected individuals must take certain precautions. It is recommended that infected persons remain isolated as much as possible. This isolation can occur at home because hospitalization is not necessary except in severe cases. It is important to have a follow-up to assess whether this hospitalization is necessary.

The Ministry of Health also recommends that people who are in contact with infected people, such as cohabitants, practice extreme hygiene and wash their hands after contact. Another precaution is the closure of skin lesions and the use of a surgical mask, especially when the disease causes respiratory symptoms.

Chronology of the epidemic and its evolution in other countries.
Outbreaks in Europe were detected on 7 May in the UK through a first patient traveling to Nigeria. In this African country, 558 cases have been confirmed since 2017, with 8 deaths. None in the past year. The data corresponds to the Nigeria Center for Disease Control, although other sources give higher figures.

Returning to the cases detected in Europe, the UK confirmed two more unrelated cases on 14 May. On the 15th, the World Health Organization (WHO) was warned. In addition to the United Kingdom and Spain, cases have also been detected in Belgium, Portugal, Canada, the United States and Australia.

The virus and its relationship with smallpox.
The virus belongs to the Orthopoxvirus family and is closely related to human or traditional smallpox, although the danger it poses to human health is much greater. Smallpox was the first disease declared eradicated.

It was WHO that announced this historic event in 1979, sparked by a global vaccination campaign. Vaccination expired the following year. We also know that this vaccine against smallpox can reduce the incidence of its variant by 85%.

The “new” variant was detected in the 1970s, but its incidence in humans was very limited in the 20th century. However, the decline in the proportion of population vaccinated against smallpox, along with other socioeconomic factors, means that epidemics of this variant have increased in recent years until the current state is reached.

Image | Andrea Picquadio