The forum of experts sponsored this week by the World Health Organization (WHO) to analyze responses to the current outbreak of monkeypox ended today with more questions than answers, and even new hypotheses that consider that the disease can be transmitted sexually.
Although in recent weeks the WHO has insisted that monkeypox is transmitted by close physical contact, not necessarily sexual, experts participating in the two-day virtual meeting stressed that more laboratory tests must be carried out.
It is necessary, according to them, to analyze semen samples in search of the virus that causes the disease, or to investigate why in endemic countries such as Nigeria this less serious than conventional smallpox is especially prevalent in men and not in women.RELATED
Forgotten when attacking in Africa
One conclusion that did emerge from the two days of discussions was the fact that monkeypox has been a neglected disease for the four decades that it has been endemic in West and Central Africa, and has only received attention when an outbreak has been declared in developed nations such as Europe.
The current outbreak in non-endemic countries totals at least 643 cases (190 in the United Kingdom, 142 in Spain and 119 in Portugal), while in the African countries where it was prevalent this year, 1,405 infections have been detected (1,264 of them in the Democratic Republic of the Congo) and 66 deaths.
The experts stressed the need to investigate in depth the animal origin of the virus, since rodents and not monkeys are pointed out as the main transmitters, but there are thousands of species of these animals in endemic regions.
African doctors in areas with frequent cases explained that children there are the most affected by this disease, sometimes concentrating almost 90% of cases, and pointed out the possibility that they contract it in rural hunts of small animals.
In the Democratic Republic of the Congo, for example, 72% of confirmed infections were attributed to contact with rodents, and only 28% to human-to-human transmission.
Few cases, but worrying signs
Although the meetings insisted that monkeypox “is an outbreak, not a pandemic,” there were worrying conclusions about its epidemiology, such as that the disease is possibly transmissible from the pregnant mother to the fetus, or that in countries with poor health networks developed reaches a lethality of up to 7.5%.
Its spread to non-endemic areas “shows an increasingly interconnected world,” warned researcher Helen Rees, moderator of the forum, while Colombian epidemiologist Ana María Henao, from the WHO Diagnostics and Vaccines Plan, considered that the response to Monkeypox should serve to measure international health capacity in the face of post-Covid health emergencies.
The experts stressed at the beginning of the forum that despite the unusual nature of this outbreak, it is “still controllable”, and stressed that the medical community must focus on continuing to detect cases, analyze possible chains of transmission and protect health workers.
Vaccines against conventional smallpox could serve for this protection, a more serious disease that was eradicated on the planet 40 years ago, so vaccination against this disease was interrupted decades ago and many younger generations are not immunized.
Both smallpox are caused by viruses from the same family (orthopoxvirus) and it is estimated that the conventional smallpox vaccine is 85% effective against monkeypox, although this percentage may have decreased due to the long time in which the most people were inoculated decades ago.
No to mass vaccination
Experts agreed that mass vaccination of the entire population of an affected country against monkeypox should not yet be considered, something the WHO has also advocated in recent weeks.
The illness usually lasts two to four weeks, and usually begins with fever, headaches, fatigue or itching, and ends in skin rashes that usually start on the face, but can spread to other parts of the body.
At the meeting of experts it was stressed that in more serious cases the number of eruptions can exceed a quarter of a mile, and it was warned that if they spread to the eyes they can cause blindness.
As preventive measures, the WHO recommends avoiding physical contact with infected people, wearing a mask when in contact with them or their clothing, and cleaning and disinfecting possibly contaminated surfaces.
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