Monkeypox cases worldwide - what does it mean?

Created: 05/19/2022Updated: 05/19/2022 15:03

Image provided by the UK Health Security Agency (UKHSA) shows skin lesions in patients diagnosed with monkeypox.

© UKHSA/dpa

Smallpox has long been one of the most dangerous diseases of all for humans.

Vaccines came to the rescue, and since 1980 the world has been considered smallpox-free.

A related but harmless pathogen is now responsible for an unusual accumulation of infections.

What does that mean?

Berlin - At first it was a case in Great Britain that was probably brought in from Nigeria, but evidence and suspected cases of monkeypox are now being reported from more and more countries.

The extent is surprising and draws the attention of experts.

What is this pathogen and how worrying is the outbreak?

Questions and answers about this:

What is the current situation in Western countries?

Apparently, the pathogen has been spreading unnoticed in several western countries for a long time, and on Thursday numerous evidences from Europe and North America were already known, including Great Britain, Spain, Portugal and Sweden.

No case was initially recorded for Germany.

However, in the course of the increased attention, further evidence can be expected, probably also in other regions of the world.

Has a case of monkeypox ever been detected in humans in Germany?

no

"The RKI has never known a case of monkeypox in Germany," said the RKI on Thursday morning at the request of the German Press Agency.

What is monkey pox?

Monkeypox is a disease caused by a virus.

The pathogen was first detected in monkeys in a Danish laboratory in 1958 - hence the name monkeypox.

Experts suspect, however, that the pathogen actually circulates in squirrels and rodents, monkeys are considered so-called false hosts.

The monkeypox virus can also be transmitted to humans.

Smallpox, caused by a virus from the same group, used to spread great terror.

A large proportion of those affected died from the infection.

The smallpox disease has been eradicated since 1980 following vaccination campaigns.

The last case in Germany was recorded in 1972.

How dangerous is monkeypox?

According to the British authority UKHSA, the circulating variant of the monkeypox virus usually causes only mild symptoms, but can also have severe courses.

Epidemiologist Paul Hunter from the University of East Anglia considers it very unlikely that diseases will be fatal in western countries.

But it's not impossible, he told the BBC.

The West African variant of the virus, which occurs in Europe and the USA, kills around one percent of those infected in Africa.

There is also a Central African variant, with ten percent of cases on the continent being fatal.

According to the RKI, all age groups and both genders are equally susceptible.

Children are particularly affected by fatal courses in Africa.

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Monkeypox infections in humans have so far been known primarily from regions in West and Central Africa.

The first case of monkeypox infection in humans was registered in 1970 in the Democratic Republic of the Congo, writes an international team of researchers in the journal Plos Neglected Tropical Diseases.

The virus then spread to other African countries and was first detected outside of the continent in 2003.

According to the local health authority, 15 cases of monkeypox were recorded in West African Nigeria between January and the end of April this year.

According to the WHO, there have been repeated outbreaks in Nigeria, Cameroon and the Democratic Republic of the Congo over the past five years.

Hardly anything is known about the infection process in the animal world.

Larger outbreaks in Africa in animals are poorly documented, so there is no overview, said Elke Reinking, spokeswoman for the Friedrich Loeffler Institute (FLI).

Is the current outbreak unusual in people outside of Africa?

"The cases now occurring outside of Africa are unusual and must be carefully investigated and any further spread carefully monitored," said the FLI on Thursday.

"In the past, the monkeypox outbreaks were limited in their spread," said the virologist Stephan Becker from the University of Marburg of the German Press Agency.

Chains of infection between people are unusual and must be closely monitored.

The WHO called for rigorous tracing of all contacts of those affected.

Clinics and the population would have to be made aware of the need for an unusual skin rash to be examined by specialist staff.

If monkeypox is suspected, patients should be isolated.

According to the analysis presented in Plos Neglected Tropical Diseases, the global number of proven, probable and suspected cases has increased more than tenfold over the past five decades.

The researchers cite declining immune protection after the cessation of smallpox vaccinations in 1980 as a possible reason. Deforestation is also a possible cause or could act as an intensifier.

Overall, monkeypox is gradually gaining global importance, the researchers said.

Marburg virologist Becker explained that it is not yet possible to assess whether the virus will occupy the niche that has been vacated by the eradication of smallpox.

How is the virus transmitted?

In the cases currently recorded, the majority are men who have had sexual contact with other men.

The virus currently seems to be spreading mainly between homosexual or bisexual men, said Becker.

However, intimate contact is only one possibility of transmission - it may be a coincidence that the virus was first carried to this group of people and then continued to circulate there.

According to the RKI, transmission to humans generally occurs through contact with infected animals or animal blood and secretions, through eating infected monkey meat and through droplet infection.

Epidemiologist Hunter told the BBC the virus infects contacts by getting from the pustules of sick people into wounds or the eyes of contacts, and inhaling droplets containing the particles is also a way.

How is an infection detected?

As with the corona virus and other pathogens, the detection is carried out with a sample of the person concerned using a so-called PCR test.

If the monkeypox virus is present, its genetic material is specifically multiplied in a special device and can then be easily detected.

How contagious is monkeypox from person to person?

The virus is actually considered to be less contagious.

With the current accumulation of infections, the detailed chains of infection are still largely unclear.

For the first known case in Great Britain, the health authority UKHSA assumes that it is due to an infection in Nigeria.

It remains to be clarified to what extent there were further entries from African regions into western countries.

However, it seems clear that the pathogen was then passed on to other people unusually often.

The Marburg virologist Becker estimates that the transmission of monkeypox does not seem to take place through aerosols at the moment.

"Then the pattern of propagation would be different."

Have you ever had an outbreak of monkeypox?

Outside of Africa, monkeypox infections in humans have only been detected a few times.

However, the frequency seems to be increasing.

According to WHO statistics, in 2021 there were five recorded infections in the United Kingdom and the United States.

Three times people who had been in Nigeria were affected, with one of these patients in Great Britain two family members staked themselves out.

What are the symptoms of monkeypox?

The symptoms include: sudden onset of fever, severe headache, back pain, sore throat, cough, and often also swollen lymph nodes.

A typical smallpox rash that spreads from the face to the body is also typical.

Blindness and disfiguring scars rarely occur as permanent damage.

What other infectious diseases can monkeypox be confused with?

According to the UKHSA, at certain stages of the disease the rash can resemble chickenpox or syphilis.

The RKI sensitized doctors in Germany: Monkeypox should also be considered as a possible cause in the case of unclear smallpox-like skin changes if those affected have not traveled to certain areas.

According to the RKI, men who have sex with men should “immediately seek medical care” if they have any unusual skin changes.

Is there a protective vaccine?

There is no approved vaccination specifically against monkeypox.

According to historical data, however, a smallpox vaccination protects against monkeypox - and probably for life.

Vaccination with this vaccine is therefore considered a possible measure to at least protect people who have come into contact with monkeypox infected people.

According to Paul Hunter of the University of East Anglia, it "helps quite effectively".

Appropriate supplies are therefore available and can be used with contact persons.

How is the infection treated?

The symptoms and possible secondary bacterial infections are treated; there is no therapy specifically aimed at monkeypox.

dpa