“International health emergencies” are no longer someone else’s business: Europe facing monkeypox

The WHO declared on Saturday the epidemic caused by monkeypox or simian pox as a public health emergency of international importance. This implies that the international organization raises the alert for this disease to the maximum.

The WHO decision.
The decision was not made unanimously, but since this Saturday, the epidemic caused by this virus has reached the maximum alert level among those handled by the WHO. Despite the forcefulness of this classification, the risk of this disease is, according to the agency itself, “moderate” at a global level, with Europe as the only “high” risk region.

The disease situation.
Europe is precisely where a 80% of the 16,000 cases detected of this disease. This despite the fact that it is not endemic in this continent.

Until Saturday, cases had been registered in 72 countries that had caused five deaths (three in Nigeria and two in the Central African Republic). By number of cases, of the five countries with the highest number of cases, four are European (Spain, Germany, the United Kingdom and France).

Recommendations.
In its releasethe WHO has grouped countries into four groups to issue their recommendations. The first two refer to the epidemiological situation in the country, group one to the countries where there have been no recent cases and the second to those where there have been. The third group refers to countries where the disease is endemic and the fourth to those with manufacturing capacity for the creation of medical products against the disease.

For countries like Spain, where there are active outbreaks, it is the protection of vulnerable groups such as immunosuppressed people, strengthening the capacities of laboratories, tracing the contacts of infected people or creating protocols for clinical management and disease prevention. among many.

Second meeting about it.
This decision occurs on the second try. The first meeting to decide whether to declare the alarm was exactly one month earlier, on June 23, and then the WHO decided against this classification. The committee in charge considered then that it was early to decide in favor of the measure.

The situation of monkeypox in Spain.
Spain leads the number of registered monkeypox cases. According to him latest data of the Center for the Coordination of Health Alerts and Emergencies of the Ministry of Health, as of July 19, 3,125 cases had been identified.

1,378 of the cases in Spain have been identified in the Community of Madrid, which is equivalent to an incidence of 204.1 cases per million inhabitants in the region. Most of the cases are linked to “history of relationships in a risky sexual context” according to the report itself.

The monkeypox virus.
the disease is caused by a virus of the genus orthopox viruswhich also includes the cause of common or human smallpox (variola viruses). It is believed that the high levels of vaccination that made it possible to eradicate smallpox have prevented the spread of its simian variant. However, after the disappearance of the human variant, vaccination was stopped (in 1980) and protection levels have been declining ever since.

Monkeypox is a generally mild disease, with symptoms lasting between two and four weeks, although it can lead to severe illness. Its mortality has been around 3% to 6%, although this figure is lower in this latest outbreak because it also affects developed countries with greater health capacities.

Transmission.
It is a virus that can be transmitted from animals to people or between people. This last route of transmission can occur in cases of “close contact with secretions from the respiratory tract or skin lesions of an infected person,” explains the WHO. It can also occur through contaminated objects or even in cases of prolonged contact, through respiratory droplets.

The symptoms.
The disease has an incubation period of between six and 13 days, although it can vary in some cases both in the upper and lower limits. Symptoms can be classified according to the stage of development of the disease.

In a first stage, these are fever, headache, swollen lymph nodes, muscle aches, and lack of energy. In a second stage, the disease is characterized by the appearance of a skin rash. This usually concentrates mainly on the face and extremities.

Although the presence of this disease has been overshadowed in recent months, international health authorities remain alert. It is difficult to predict how the disease will evolve, but the lessons learned will surely be useful for the future.

Image | NIH/NAID, Flickr