People infected with monkeypox should avoid contact with other people until the pustules with which the disease manifests dry and the scabs fall off, at which point they can no longer transmit the virus.
But so must their mammalian pets, who must be quarantined to prevent chains of transmission between animals that reach wildlife, a scenario that could make this pathogen "endemic in Europe".
This is the warning that the European Center for Disease Control and Prevention (ECDC) launched this afternoon in a risk report on the monkeypox outbreak that the continent is suffering and that already affects more than a hundred people , between confirmed and suspected cases, in a dozen countries.
"There is a potential risk of transmission from people to animals, so close collaboration between health and veterinary authorities is necessary, working from a global health perspective to care for exposed pets," the document states.
This highlights that the greatest risk occurs with domestic rodents, such as hamsters and different types of rats, and that this jump, although very unlikely, "can cause the virus to establish itself in European wildlife and convert smallpox monkey in an endemic zoonotic disease”.
Rodents are known to be a prominent reservoir of this virus in Africa.
The ECDC recommends that measures be taken so that all mammalian pets that have been in contact with the positive cases and their close contacts “are quarantined and tested”.
For their part, “rodents should ideally be isolated in guarded spaces” with air flow control and that ensure their well-being, such as laboratories, government spaces, kennels or dependencies of animal protection organizations.
There they must be subjected to PCR tests before the end of the quarantine, while "euthanasia should only be considered when it is not possible" to apply these measures.
"Other species of mammals can quarantine at home if welfare conditions allow it (such as going outside in fenced spaces in the case of dogs and access to veterinary services)", avoiding third-party visits people and the exit of animals out of homes and enclosed spaces.
The ECDC recommends that governments increase efforts in the identification, notification and contact tracing of emerging human cases in the coming days, when diagnoses are expected to continue.
"Countries must update contact tracing mechanisms, Orthopoxvirus
diagnostic capacity,
and review the availability of vaccines, antivirals, and protective equipment for health professionals," the document says.
The agency's experts consider "high" the risk that the monkeypox virus will continue to spread in the coming days "among people with multiple sexual partners", although they reduce the risk to their health to "moderate" because the great Most of the cases diagnosed so far have developed “mild symptoms”.
For the rest of the population, the ECDC considers the risk to be "low".
Despite the low severity of diagnosed cases, the agency warns that some population groups such as "young children, pregnant women and immunosuppressed people" may develop "more serious" forms of the disease.
In the event that the infected person lives with others, experts recommend staying in a separate room and avoiding sharing undisinfected bathrooms and unwashed clothing such as towels and sheets, since the secretions that come out of the pustules and blisters are very contagious.
The report does not explicitly recommend close contacts of positives to isolate themselves, but does "monitor for 21 days after exposure for the possible development of symptoms."
More than a hundred people in Europe have been diagnosed with monkeypox in the current outbreak.
Spain has increased the number of positives to 36, six more, and studies fifty suspects.
The United Kingdom, for its part, has reported 36 new patients, up to 57, while Portugal already adds 37 after notifying 14. These three countries account for more than 90% of the cases known to date, although the records already include Belgium, Countries Netherlands, Germany, France, Denmark, Austria, Switzerland and Sweden.
Outside of Europe, Canada is the country with the most affected, more than twenty, although there are also in the United States, Israel, Australia and Argentina.
In the last few hours, diagnoses have been known in other countries originating in Spain.
One case is that of an Argentine man from Spain.
Another, that of a young Italian from Tuscany who began to develop symptoms after returning from the Canary Islands.
A massive party held on the island of Gran Canaria between May 5 and 15, and Madrid capital (especially the Sauna Paraíso) are the two sources of the outbreak located in Spain so far.
Miguel Ángel Jiménez Clavero, research professor at the National Institute for Agricultural and Food Research and Technology (INIA-CSIC), considers the scenario to which the ECDC is warning possible.
“We know that this virus has its reservoir in Africa among small mammals, such as squirrels and other rodents, from which it jumps to humans and apes.
If this happens there, it can also happen in Europe.
We do not know, but that is why it is important to prevent.
If the virus develops in similar populations or in rabbits, it can be very difficult to eradicate and could be the cause of outbreaks in humans from now on, ”he explains.
The most important precedent for the transmission of the monkeypox virus between animals outside of Africa was the outbreak in 2003 in the United States, when dozens of prairie dogs contracted it while sharing space in the facilities of an importer of exotic species. with a type of rats from Gambia.
Subsequently, prairie dogs, a rodent that was traded as a pet, transmitted the disease to more than 70 people between the months of May and July.
Although the virus was later detected in wild fauna species, circulation did not prosper and the virus ended up becoming extinct in the country, according to Jiménez Clavero.
In that outbreak, all those affected acquired the virus from their pets and there were no recorded cases of human-to-human transmission.
There was also no death.
"Fortunately, then as now the virus causing the outbreak is of the West African strain, which is less virulent than the one found in the central part of the continent," explains this expert, who considers that "although now the number of cases, the evidence shows us that this virus is not very contagious and the outbreaks end up self-limiting”.
In the United States, 24 exposed people then received the traditional smallpox vaccine to curb transmission of the virus, something the United Kingdom has already begun to do with close contacts from the current outbreak.
There is no specific vaccine against monkeypox, but the proximity between both pathogens makes the traditional vaccine effective in more than 80% of cases.
Although the Ministry of Health has already begun the steps to acquire vaccines, it has not been made public if the purchase has been agreed, an operation that would have some type of coordination within the European Union.
“The Commission, and in particular the Health Emergency Preparedness and Response Authority (HERA), is in close contact with the Member States, the pharmaceutical industry and international experts to have the necessary information and to know the availability and access to means of diagnosis, treatments and vaccines”, responded a spokesman for the European Commission.
The Danish company Bavarian Nordic, manufacturer of the only authorized vaccine in the EU against smallpox, announced last Thursday that it has closed the sale of an undetermined number of vaccines with a European country whose name it did not make public.
