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THE CONVERSATION
This article was originally published in The Conversation, an independent, non-profit source of news, analysis, and commentary from academic experts. Disclosure information is available on the original site.
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Author: Sameer Elsayed, Professor of Medicine, Pathology and Laboratory Medicine and Epidemiology and Biostatistics, Western University
With cases reported in several countries, human smallpox infection is generating global interest and concern as a threat of emerging infectious disease, even amid a slowing COVID-19 pandemic.
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What is the monkeypox virus?
Monkeypox is a member of a closely related group of viruses of the genus Orthopoxvirus that includes smallpox, smallpox, and smallpox. Monkeypox virus was first discovered in the summer of 1958 as a non-lethal, smallpox-like disease of monkeys in captivity at a research institute in Denmark.
The name monkeypox is an inappropriate name, as African terrestrial rodents (rats and squirrels) serve as a natural reservoir for the virus, while monkeys and other primates are believed to be accidental hosts.
When was the smallpox first reported in humans?
The first known case of human smallpox infection was reported in the Democratic Republic of the Congo in 1970, in a nine-month-old boy with a non-fatal smallpox-like disease.
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Since then, there have been sporadic human cases in many Central and West African countries, with more frequent infections in children and young adults. In countries where monkeypox is endemic (where it is commonly found), recent increases in cases are thought to be related to climate change, deforestation, war, increased population mobility, and declining population mobility. herd immunity from smallpox vaccination.
How is the monkey’s smallpox transmitted?
Transmission occurs through close physical contact with animals or humans, their body fluids, particulate matter contaminated with respiratory secretions, or infected skin lesions and indirectly through “fomites” (inanimate objects such as sheets, towels, and hard surfaces that may be loaded with infectious virus particles).
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Animal bites and the consumption of animal meat are common modes of transmission in endemic areas. Secondary infections among unvaccinated close contacts occur in about 12.3% of domestic contacts and 3.3% of others.
When was monkeypox first reported in non-African countries?
The first group of human smallpox infections outside of Africa occurred in the United States in 2003. A multistate outbreak was attributed to 87 children and young adults in close contact with infected prairie dogs acquired as pets. from an animal dealer. The main source of infection was found to be imported Gambian rats that transmitted the infection to prairie dogs. There were no deaths, although three children were seriously ill.
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Prior to 2022, several cases involving travel to the UK, Israel, Singapore and the US had been reported among people who had visited Nigeria.
What do we know about the global outbreak of monkeypox in non-endemic countries?
On 7 May 2022, the UK public health authorities were informed of a case of human smallpox infection imported in a traveler returning from Nigeria. Since then, more than 550 confirmed cases of human infection have been reported in the UK and 29 other countries. Cases have been much higher among men who have sex with men, although the virus is not known to be sexually transmitted.
What are the symptoms of monkeypox?
The clinical manifestations of human smallpox infection mimic those of smallpox, but are usually much milder. Unlike monkeypox, smallpox is an eradicated disease, has no animal reservoir and does not usually affect the lymph nodes.
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The incubation period for smallpox in humans ranges from four to 21 days and is followed by a one- to five-day phase of fever, chills, sweating, fatigue, and enlarged and tender lymph nodes. neck and groin.
The next stage involves a multi-stage rash that progresses from small skin spots to papules (small bumps on the skin), followed by vesicles (small bumps filled with clear fluid) and then pustules (small bumps full of pus). These are most prominent on the face, palms and soles of the feet. Pustules resolve by scars or scabs within the next two to four weeks.
Exposed people may also develop sore throat, cough and / or rash on the mucous membranes of the mouth.
How serious is the monkeypox infection?
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The disease is usually mild, although serious illness and death can occur. There are two common genetic variants of the monkeypox virus: the Central African variant and the West African variant. Mortality rates of 3.6% for the West African variant and 10.6% for the Central African variant in endemic regions have been reported.
However, so far no deaths have been reported in any of the reported cases outside Africa. All confirmed cases of the 2022 outbreak in 30 non-endemic countries have been due to the West African variant.
Are there any other public health recommendations for monkeypox?
People infected with monkeypox should wear surgical masks and skin lesions should be covered until they have healed. Personal items such as towels and sheets should not be shared. Frequently touched surfaces should be periodically disinfected, contaminated clothing should be washed, and contact with household and non-household members should be avoided until the disease has resolved. .
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Healthcare workers should wear gloves, gowns and respiratory protection with N95 masks and face shields, and maintain excellent hand hygiene while treating monkeypox patients. Patients hospitalized with confirmed or suspected smallpox should be isolated with precautions for airborne, drip, and contact transmission until they are no longer contagious.
Does the smallpox vaccine protect against smallpox?
The smallpox vaccine, given before or after exposure to smallpox, can prevent or reduce the effects of human smallpox infection. However, rare but serious adverse events have been reported in older generations of smallpox vaccines. A new generation live vaccine is now available, which is not replicated and is considered safe for use in all populations, including those with compromised immune systems.
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The U.S. Centers for Disease Control and Prevention’s Immunization Practice Advisory Committee recommends pre-exposure prophylaxis (vaccination before exposure to the virus) with the next-generation vaccine for laboratory workers performing diagnostic tests of smallpox, as well as for health workers who administer smallpox. vaccine or care of patients with monkeypox. (Its trade name is Jynneos in the US, Imvamune in Canada and Imvanex in Europe.)
In Canada and other developed countries, people born before 1972 were probably vaccinated against smallpox. Although post-vaccination immunity tends to decrease with age, lifelong immunity appears to be the norm after smallpox vaccination in otherwise healthy individuals, and it is believed that their Cross-protective efficacy against monkeypox is 85%.
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Is monkeypox the next viral pandemic?
The emergence of infectious diseases such as monkeypox in non-endemic areas has created great anxiety in light of our experience with COVID-19.
Smallpox had been a neglected tropical disease until the current outbreak in the developed world. But the trajectory of these cases, along with the pattern of transmission in Africa, suggests that the virus will not become a pandemic.
The baseline number of reproduction (R0), a measure of viral contagion, where R0 is equal to the number of secondary infections transmitted in a single case in a non-immune population, is 0.6 to 1.0 for variant of Central Africa and much lower to the west. African variant.
In contrast, the R0 for the Omicron variant of SARS-CoV-2 is approximately 10, and the R0 for measles ranges from 11 to 18. The R0 for the West African variant of the virus of monkeypox may be too low to keep man a- human transmission out of endemic areas.
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Sameer Elsayed does not work, consult, own, share, or receive funding from any company or organization that benefits from this article, and has not disclosed any relevant affiliation beyond its academic appointment.
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This article is republished from The Conversation under a Creative Commons license. Disclosure information is available on the original site. Read the original article:
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