The current outbreak of monkeypox has now been established as a major health threat, since the maximum alert triggered on Saturday by the boss of the World Health Organization to try to contain it.
Here is an overview of the symptoms of the disease, which now accounts for more than 16,000 cases worldwide, diagnostic methods, treatments and vaccines.
Symptoms
Fever, headache, sharp muscle aches, unusual tiredness, swollen and painful lymph nodes in the jaw, neck or groin may occur in the first period. In a second period, skin and mucous membrane lesions may appear all over the body.
In the current outbreak of monkeypox, the genital, anal and oral areas are more often affected, with lesions sometimes appearing before lymph node involvement, fever, malaise and pain associated with lesions, WHO said it two days ago.
From one patient to another, the symptoms are however variable. After a few days or weeks, the pimples turn into scabs, which eventually fall off and the lesions heal. The patient is contagious until complete healing.
Diagnostic
Monkeypox is suspected if there is possible exposure to the virus within three weeks of contact with a confirmed or probable case, return from travel to a country in Africa where the virus is endemic, or the existence multiple sexual partners.
In the current wave, of which Europe is the epicenter, a large majority of patients have so far been men who have sex with men, relatively young, living mainly in cities, according to the WHO.
Diagnosis can be difficult because cases do not necessarily show the usual symptoms of the disease and can resemble certain sexually transmitted infections, several health authorities have warned.
The doctor doing the physical examination will rule out other rash diseases such as chickenpox, hand-foot-mouth syndrome, shingles, measles, bacterial skin infections, scabies, syphilis, herpes, skin reactions from allergies.
Confirmation of the diagnosis of monkeypox may require analysis, in particular by PCR test. Skin sampling (biopsy or swab by rubbing several vesicles), and/or nasopharyngeal if the person has an eruption in the mouth or throat, is preferred.
While waiting to take a test and know the results, you must isolate yourself. Once infection is confirmed, recommended isolation is approximately three weeks.
It is not known whether the virus can be transmitted through semen and, if so, for how long. As a precaution, the European Center for Disease Control recommends using a condom 12 weeks following recovery.
Treatments
The disease usually heals spontaneously, following two to three weeks, sometimes four. Only treatment of the symptoms, for example to stop the fever or soothe the itching, is generally necessary.
In some cases, the lesions are very painful, as several testimonials report, which may require painkillers or even hospitalization.
It is advisable not to scratch the lesions so as not to reinoculate the virus or leave scars, and to cover them to limit these risks.
In some people, the disease can be complicated by superinfection of skin lesions or by respiratory, digestive, ophthalmological or neurological disorders. If necessary, certain antiviral drugs such as tecovirimat, designed in particular once morest smallpox, can be used.
Severe cases more often concern children, pregnant women, immunocompromised. No deaths have been reported to date in Europe or the United States.
Vaccines
A third-generation smallpox vaccine from the Danish company Bavarian Nordic (Imvanex or Jynneos, a live vaccine that does not replicate in the human body) can be administered to adults, including caregivers, following a risky contact, but also as a preventive.
If given within four days post-exposure, it can have a significant protective effect, according to the European Center for Disease Control. The European Commission on Monday approved the extension of one of these vaccines to monkeypox.
In some countries (United States, United Kingdom, Canada, France), preventive vaccination can be offered to the groups most exposed to the virus, including men who have sex with men. In New York, thousands of people have already been vaccinated.
Vaccination is carried out with two doses, spaced at least 28 days apart. For people vaccinated once morest smallpox in childhood, one dose is enough. For the immunocompromised, a third is recommended.
These vaccines do not provide immediate or total protection, the health authorities invite people to remain cautious following their injection.
