► What do we know about deaths linked to cases of monkeypox?
Spain reported this weekend the deaths of two young men infected with monkeypox, a disease also known as “monkeypox”. For the moment, the possible presence of comorbidities in these two victims is not known. Spanish health authorities said the two men had been hospitalized with encephalitis caused by the infection. In Brazil, a 41-year-old man with serious comorbidities also died.
“All viruses can cause encephalitis, from the simple flu to smallpoxrecalls Jean-Daniel Lelièvre, head of the infectious diseases department at the Henri-Mondor hospital in Créteil. But the most common complications of monkeypox remain bacterial superinfections. » As with other diseases, immunocompromised people and those with comorbidities are most at risk in Europe. In Africa, where the disease is endemic, mortality is higher among children, who suffer from malnutrition, and among people infected with HIV.
► Is the epidemic more dangerous than expected?
Impossible to say at the moment. The WHO estimates the mortality from monkeypox between 3% and 6%, but these figures must be taken with caution as they depend on access to care and the state of health of the patient. “The more infections you have, the more deaths you will statistically have”, explains Jean-Daniel Lelièvre. With 4,298 confirmed cases as of July 30, Spain is the second most affected country in the world, just behind the United States (4,906 cases as of July 30).
Overall, the epidemic is progressing everywhere in Europe. France for its part identified 1,955 cases as of July 28, mainly in Île-de-France. The WHO recalls that monkeypox is transmitted by contact with lesions in patients or even contaminated objects, such as bed linen. If the disease circulates a lot in the LGBTI community, it can affect everyone. Virologists are currently working to dissect the virus raging in Europe, to see if it presents differences in transmissibility and mortality compared to that which circulates in Africa.
► Should vaccination be accelerated?
This is the question that the health authorities will have to decide in the coming weeks. For now, vaccination is advised «to men who have sex with men, to trans people with multiple partners, to people in a situation of prostitution, and to professionals working in places of sexual consumption», according to the French authorities. On a case-by-case basis, it can also be offered to health professionals in contact with patients. The government has put in place a map of vaccination centers and a green number: 0 801 90 80 69.
If the epidemic spreads in the general population, it may be necessary to vaccinate immunocompromised people as well, say some caregivers. Which then raises the question of vaccine stocks. So far, 32,000 doses have been delivered to French centers and some 10,000 injections have been performed. The government claims to have reserves of vaccine, but refuses to communicate figures because these stocks were constituted in the event of a bioterrorist attack with the “classic” smallpox virus.
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