“Urgent and coordinated action is essential if we are to change course in the race against the spread of the disease.” The director of the European branch of the World Health Organization (WHO), Hans Kluge, issued the warning on Friday 1 July, as monkeypox continues to spread across the European continent. According to UN agency data, the region now has more than 4,500 laboratory-confirmed cases, three times more than in mid-June. The UK is the most affected country with 1,076 cases, according to data from the European Center for Disease Prevention and Control (ECDC). France had nearly 500 on Friday, according to Public Health France.
This WHO memo comes asa study, published in Infectious diseases of the lancets (in English), analyzes the symptoms identified in the first infected British patients. Conducted on about fifty patients, this research is among the first to characterize the clinical specificities of the current epidemic. The sample corresponds to more than half of the patients identified in the UK in May. In them, monkeypox manifested itself differently from what scientists knew.
A lower fever
Among the recurring symptoms of monkeypox, scientists have identified fever. According to observations made on patients in Africa, an increase in temperature is considered almost systematic. It is accompanied by severe headaches, body aches and inflammation of the lymph nodes. Back pain and fatigue may also appear.
According to the results of the British study, 57% of the patients studied experienced these symptoms. Not only are fever attacks less frequent, they also appear much shorter and require far fewer hospitalizations.
More targeted injuries
Another typical manifestation of the disease – skin lesions that appear “usually one to three days after the onset of fever”, says the WHO. These rashes are usually concentrated mostly on the face (95% of cases), palms and soles (75%). The oral mucosa (70%), the genitals (30%) and the conjunctiva (20%) are also affected, as well as the cornea.
Of the fifty British patients observed, the vast majority (94%) suffered from lesions concentrated around the genitals. For the authors of the study, this specificity suggests that the first British cases were contaminated by contact during sexual intercourse. This does not mean that the disease was sexually transmitted. The hypothesis of transmission by contact during sexual intercourse corresponds to the well-established notion that contamination is possible by touching a skin lesion in another patient. Monkeypox is transmitted by very close contacts and 99% of cases currently involve young men (20 to 40 years old) having sex with other men, the WHO recalls.
No major genetic modification of the virus
These slightly different symptoms do not mean that a new version of the virus has appeared, as could be the case with Covid-19 whose variants are multiplying. “There are no major genetic modifications” in viruses sequenced in current patients, pulmonologist Hugh Adler told AFP.
Most European – and American – cases have so far been recorded in men who have had same-sex relationships, but they are not the only ones affected. More generally, the authors of the study believe that their observations require broadening the definition of disease in order to better identify new cases. They recommend, for example, not to insist so much on fever. Hugh Adler believes that many cases in Africa, without fever or with limited injuries, may have gone unnoticed, swaying comparisons.
Most often mild, monkeypox usually heals spontaneously after two to three weeks.
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