Modes of transmission, patients concerned, prevention… The questions raised by the recent cases of monkey pox

Several dozen cases of this rare disease originating in Africa have been identified in Europe since the beginning of May.

After the United Kingdom, Portugal, Spain, and even Canada and the United States, which indicated on Wednesday that they had detected people with monkeypox on their soil, Italy in turn discovered a first case at home this Thursday, while in France, a first suspected case was detected in the Paris region.

Monkeypox is a rare disease normally confined to the African continent. Characterized by its impressive pustules, it is transmitted during close contact, or exchanges of bodily fluids.

What do we know about this disease?

“Monkey pox is a neighbor of smallpox, which has been known for decades with frequent epidemics arriving from West Africa but which is little talked about”, explains for BFMTV Benjamin Davido, infectious disease specialist at Raymond-Poincaré hospital. of Garches, in the Hauts-de-Seine.

Antoine Gessain, head of the epidemiology and physiopathology of oncogenic viruses unit at the Institut Pasteur, is one of the few in France to be interested in the disease. For, he clarifies:

“The disease is of African origin. Its reservoir is rodents. There are two variants. One in West Africa, less severe, is the one we are currently talking about, and another more lethal strain in Central Africa “.

And to specify: “It is generally a little studied disease which often develops in difficult health and socioeconomic situations”. The first case reported in Europe in recent days comes from the United Kingdom, probably contaminated by a zero patient from Nigeria.

Is monkeypox an STI?

Antoine Gessain, of the Institut Pasteur, reassures, “It is a disease which is transmitted little and which does not present major risks except in exposed areas as where it usually occurs”.

Regarding its transmission, the WHO explains that it occurs mainly by particles of respiratory droplets and generally requires prolonged face-to-face contact with an infected person. This therefore makes its transmissibility quite low, explains Antoine Gessain. “It’s not at all like the Covid which stagnates in the air”.

Nonetheless, care should be taken. Indeed, in addition to the headaches and other fever that monkeypox can cause, the virus is also followed by a period of rashes similar to chickenpox. The fluids that may leak from these skin lesions are contagious. Thus, if you touch for example the handle of a door which has been in contact with a patient, you risk contamination in turn.

Is there a typical patient profile?

What about community transmission being talked about in the UK? Indeed, this outbreak of contaminations in Europe is accompanied by a fear that they result from sexual relations between men. On this point, Antoine Gessain specifies:

“It is not a specifically sexually transmitted disease. Current data do not allow establishing sexual transmission insofar as in Africa nothing has been studied in this regard. Until now, this virus had not never integrated a community at high risk of sexual transmission like here”.

In other words, it is a new point that specialists in the disease are discovering. On this, infectious disease specialist Benjamin Davido bounces:

“That’s how we detected the HIV virus a little over 30 years ago. We noticed that there was an excessive consumption of antibiotics which particularly affected people who had sexual relations. sex between men.

How to protect yourself from it?

Today, we know nothing about this mode of community transmission. Although observed, it is currently under study. In Geneva, Ibrahima Socé Fall, WHO Deputy Director General for Emergency Response, said:

“We are seeing transmissions among men who have sex with men,” which is “new information that we need to study properly to better understand the dynamics of ‘transmission’.”

Note that all profiles can potentially be affected. “Monkey pox affects a category of people who have sex between men but who can very well have sex with women”, specifies Benjamin Davido.

What to do to avoid being contaminated? “One of the first things is to have safe sex,” says Benjamin Davido, who recalls that contaminated mucous membranes are extremely contagious.

But that’s not all, since physical contact with a sick person also exposes you to contamination.

So for the rest, for Antoine Gessain, there is no need for a vaccine, given the low dangerousness of the disease. On the other hand, it is necessary “to isolate the cases identified to circumscribe it as quickly as possible”, he recommends.

Are we heading for an epidemic? “What is unprecedented is that each time we saw cases, it was sporadically. They were limited to one territory. But there, monkeypox is present on different continents”, is asks Benjamin Davido.

Not cause for alarm either, for the head of the epidemiology and physiopathology of oncogenic viruses unit at the Institut Pasteur, for whom “there is not much risk of a major pandemic”.

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