Origin, transmission, contamination… A dangerous virus?


monkey pox. While several cases of monkeypox have been identified in France, the virus is spreading in several countries around the world and should circulate even more, according to the WHO. Should we fear an epidemic?

The essential

  • Monkeypox – also “Monkeypox” – spreads and disturbs. It is given special attention by the WHO: to date, more than 100 cases of contamination have been identified in almost 20 countries around the world. The virus is circulating more and more, especially in Portugal (37 cases), Spain (34) and Great Britain (57). The WHO has warned that the virus will spread more actively.
  • Three first cases of monkeypox have been detected in France. On May 23, the health agency states that these contaminations are “unrelated directly to people returning from endemic areas,” namely Central and West Africa.
  • Monkeypox is often mild but can cause serious symptoms, especially in humans. It is potentially fatal in very rare and very severe cases. There is no vaccine.
  • Santé Publique France has looked into the monkeypox virus and provided some information: “Monkeypox is a disease that is transmitted from animals to humans. Cases are often seen near tropical rainforests where there are animals carrying the virus,” SPF states, adding, “Transmission occurs through direct contact with blood, body fluids, or lesions on the skin or mucous membrane of infected animals, e.g. by a bite or a scratch”. Clarification needs to be added on contamination: “Human-to-human transmission occurs through prolonged face-to-face contact through respiratory droplets or through direct contact with an infected person, through bodily fluids, skin lesions of the disease, or the internal mucous membranes such as the mouth, as well as by items that the patient has contaminated, such as clothing or bedding”.
  • Transmission is “mainly seen in people who identify as gay or bisexual, or in men who have sex with men,” the UK Health Security Agency (UKHSA) told the BBC on Sunday.

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10:42 – Monkeypox infections closely monitored

At a time when more than 100 cases of monkeypox have been officially recorded worldwide, European countries are particularly affected, with the UK alone having 57 cases, Spain 34 and Portugal 37. Only three cases have been identified in France, making the situation less worrying. However, in its update of Monday May 23, Public Health France confirms that these contaminations are the subject of “long-term surveillance” and are “reinforced” in France by a mandatory reporting system. In addition, healthcare professionals will receive information and alerts on the topic. SPF works in coordination with other European countries through discussions with the European Center for Disease Prevention and Control and WHO.

10:13 – Are the cases reported on European territory worrying?

While monkeypox has reached nearly twenty countries, mostly located in Europe, the population is worried about an outbreak of the epidemic. At a time when the health restrictions associated with Covid-19 have just been lifted, should we be concerned about the spread of this zoonosis? If, according to Public Health France, the current context “represents an alarm”, precisely because the recent contaminations always appear in Europe, although the virus is usually absent from the continent, the seriousness of the situation remains relative. In its last point, SPF estimates that “at this stage, the cases reported in Europe are mostly mild and there are no reported deaths”.

09:45 – Three confirmed cases in France

According to a situation report published on May 23 by Public Health France, three people in the area are currently suffering from monkeypox. The most surprising thing is that these contaminations are apparently “not directly related to those returning from endemic areas”. Public Health France believes that the contamination could therefore have occurred in Europe, where the current context “constitutes a warning” given that this virus is usually absent from the continent.

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The Directorate General of Health (DSG) announced on Monday May 23, 2022 the detection of two new cases of monkeypox in France, bringing the number of infected to 3. As with the very first infection, the Ministry of Health has clarified that “As soon as there was a suspicion that he was infected, that person was treated. He is being isolated at home due to gravity.” The first patient was “a 29-year-old male with no history of travel to a country where the virus is circulating.” In order to limit the spread of the virus, the health authorities announced that “an in-depth epidemiological investigation will be carried out by the Public Health France teams” and that “the people who have been in close contact with these patients will be identified”.

According to the first findings of the World Health Organization (WHO), monkeypox originates from Central and West Africa. Countries like Nigeria or Cameroon would be the main sources of origin. Known since the 1970s, this disease usually develops in tropical areas. To see how it develops in countries without this climate comes as a surprise to scientists.

Cases of monkeypox have been imported into western countries since their discovery, including the United States, where they have remained “rare” according to the US Centers for Disease Prevention and Control (CDC). In fact, in the spring of 2003, cases were confirmed in the country, marking the first occurrence of this disease outside of the African continent.

England sounded the alarm first. A first patient with monkeypox was identified there on May 7, a person returning from a trip to Nigeria. The UK Health Security Agency assures that with the exception of the first case detected, transmission would have taken place between the other cases within the country. Since then the number of cases has continued to rise: as of Tuesday 24 May the number of cases registered in the UK stands at 57.

For their part, Spain, Portugal, Canada and the United States have reported detecting the presence of monkeypox, or what appears to be it, on their territories. Sweden and Italy followed. After the first French case on Friday May 20, two other contaminations were identified. On this May 24th, the number of cases registered worldwide exceeds one hundred. Almost 20 countries are affected.

According to the World Health Organization, monkeypox is contracted by “eating undercooked meat from infected animals.” In fact, originally it is an infectious disease caused by a virus transmitted by animals, mainly rodents. Transmission to humans would be the result of contact with an already contaminated person or with their organic fluids (especially saliva).

But monkeypox can also be transmitted through close contact with infected respiratory secretions, skin lesions from an infected person, or objects recently contaminated with bodily fluids or material from a patient’s lesions. According to the British Health Safety Authority, sexual relations could spread the disease. Protected sex is therefore recommended.

The symptoms are similar to those of smallpox patients, but are milder. In the first 5 days, the infection causes several symptoms: fever, headache, swelling of the lymph nodes (adenopathy), back pain, muscle pain (myalgia) and fatigue (asthenia).

Within 1-3 days (sometimes longer) of the onset of fever, the patient develops rash symptoms, which often begin on the face and then spread to other parts of the body, including the palms of the hands, the soles of the feet, and the mucous membranes (mouth and genital areas). Itching is common. The lesions go through different successive stages: patches, papules, vesicles, pustules and crusts. When the scabs fall off, people are no longer contagious.

The other mucous membranes (ENT, conjunctiva) can also be affected. “The incubation period of the disease can range from 5 to 21 days. The fever phase lasts about 1 to 3 days. The disease, which is generally mild, usually resolves spontaneously after 2 to 3 weeks,” emphasizes Public Health France.

When symptoms appear virulent, particularly in males, the mortality rate remains low. In fact, the World Health Organization (WHO) confirms that “in general, the mortality rate is between 1% and 10%, with most deaths occurring in the youngest”.

Two years after the start of the coronavirus epidemic, should we be concerned about the spread of a new virus? According to Antoine Gessain, head of the Department of Epidemiology and Physiopathology of Oncogenic Viruses at the Pasteur Institute, monkeypox poses little danger, he explained BFM TV. No vaccination is required. He even wants to calm down: “The risk of a major pandemic is not great.”

Some countries have taken quick action to prevent the spread of the virus. The health authorities of Portugal and Spain have therefore issued a national health alert. Italy said the situation was “under constant surveillance” and Swedish authorities “are now investigating with regional infection control centers to see if there are any other cases”.

Spain chose to take the lead. The Iberian kingdom said on Thursday it was preparing to buy thousands of smallpox vaccines, which are usually intended to combat smallpox, an extremely serious disease that the WHO declared eradicated in 1980. “We have to find a way to buy these vaccines quickly because it is a very valuable tool to stop the epidemic,” commented Elena Andradas, the general director of public health for the Autonomous Community of Madrid, to Madrid daily El Pais This vaccine is not intended to be administered to the general population, only to contacts of confirmed cases.

According to an article in La Tribune, at the end of 2012 France had a strategic stockpile of first-generation vaccines of more than 82 million doses. These inventories have been held by the Army Health Service (SSA) for 40 years.

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