How is monkeypox transmitted? What are the specific symptoms of a current wave? Three months after the first cases of infection, scientists begin to track these milestones.
Nearly 28,000 diagnoses of the disease have been confirmed worldwide – about 2,000 of them are in Brazil – and the first death has already been recorded.
Monkeypox has been known for several decades in some African countries. But the current epidemic has many characteristics, starting with the characteristics of patients.
They are mainly adult men who maintain same-sex relationships, unlike in Africa, where the disease mainly affects children. However, as the virus spreads around the world, it is expected to infect more and more people who do not fit this initial profile.
In recent weeks, three studies published in major medical journals – the British Medical Journal (BMJ), The Lancet and the New England Journal of Medicine (NEJM) – have described the clinical picture of the disease, but the data is early, with some from hundreds of cases.
Studies confirm that nearly all cases affect men who have sex with other men. However, anyone, regardless of gender or sexual orientation, is at risk of infection monkeypoxdisease-causing virus.
How does it move?
The predominance of the profile is not surprising because it was already documented with the disclosure of the first cases. Is the disease then transmitted through sexual contact?
Some public health experts fear that the ultimate answer will lead to stigmatization of the LGBT community.
But recent studies are clear. “Our work supports the idea that physical contact during sexual activity constitutes the dominant mechanism of transmission of monkeypox in the current epidemic,” summarizes the Lancet study, which was conducted in several hospitals in Spain.
The conclusion, in particular, is based on the fact that the viral load was significantly higher in the patients’ skin lesions, compared to that recorded in the respiratory tract.
Some researchers have mentioned the idea that airborne transmission would also play a role in pollution, but these findings raise questions about this theory.
This does not mean that the disease is transmitted by sperm. The hypothesis was not excluded, but the current research did not support the thesis.
What are the symptoms?
The three studies also confirm that the current epidemic is characterized by its symptoms, which are “different from those observed in populations affected by previous epidemics” in Africa, as the BMJ study, conducted in the United Kingdom, explains.
Two main components of the disease: fever, sometimes accompanied by muscle pain, and physical injuries that turn crusty. Details vary, and the issue is certainly related to transmission, because among new patients some physical manifestations appear to be related to contamination during intercourse.
In each study the lesions were concentrated in the anus, penis and mouth. Added to this is a complication that has so far rarely been observed: proctitis or swelling of the penis.
Nearly 40% of cases develop complications, according to a Lancet study, while 20% of patients require hospitalization, according to NEJM research.
According to this latest study, “no serious complications were detected.”
Data that is still missing
Although studies allow for a better understanding of the disease, many questions remain unanswered.
The first is the effectiveness of vaccines. The Lancet study showed that a large percentage of patients (18%) had been vaccinated against smallpox, which is supposed to protect against monkeypox.
In some cases, patients develop monkeypox decades after receiving the vaccine, which explains the lower protection.
Finally, it remains to be determined whether a person is more at risk when suffering from another disease. Approximately 40% of the patients studied by the Lancet were infected with HIV. But it is impossible to know if there is a direct link or a simple association.
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