Monkeypox Outbreak: Cases, Symptoms, and Vaccines in 2023

Monkeypox or Mpox is a viral infection that causes skin rashes or mucosal lesions that can last 2 to 4 weeks, among other symptoms (REUTERS/Dado Ruvic)

Monkeypox or Mpox is a viral disease that causes skin rashes or mucosal lesions that can last 2 to 4 weeks. Affected people may also have fever, headache, muscle aches, back pain, lack of energy, and swollen lymph nodes as symptoms.

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A global outbreak of Mpox was confirmed in the first half of last year. In May 2023, the World Health Organization (WHO) declared the end of the public health emergency of international concern due to this disease.

However, the United Nations health agency reported that the virus still circulates in countries where it did not occur before 2022. During the month of November, 906 cases confirmed by testing were reported in 26 countries. That is, there were 26% more cases than those registered the previous month.

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Since the outbreak began last year, there have been 171 deaths reported worldwide.

The monkeypox or Mpox outbreak that affected more than the population of 116 countries in 2022 is still ongoing. In November, 906 cases confirmed by testing were reported in 26 countries (NIAID)

The Americas region has the highest number of reported cases of Mpox (followed by Europe, Asia and Africa). The United States, Brazil, Colombia, Mexico and Peru are among the countries with the most reported patients.

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In Argentina, from January to October of this year, 118 cases were confirmed. 98% of the confirmed cases were people of the legal male sex, according to the epidemiological bulletin of the Ministry of Health of the Nation. 1,024 cases had been confirmed in all of 2022.

“The Mpox outbreak is receding in Argentina. “We have not seen cases in our hospital for weeks, which has been one of the hospitals that treated the most patients with the infection,” Viviana Leiro, head of the Dermatology Service at the Muñiz Hospital in the city of Buenos Aires and member of the Argentine Society, told Infobae. of Dermatology.

The expert commented that “network immunity has been achieved to control the infection. But it must be taken into account that this immunity can be lost and new outbreaks can occur. This immunity occurred in people who engage in risky sexual practices because some already had the infection and others were vaccinated (some patients were vaccinated in the United States).”

“The most serious cases occurred in HIV patients with poor immunological status: the two deaths reported in Argentina were in patients who had HIV with CD4 lymphocytes less than 50. All patients with Mpox should be tested for HIV. If it is positive, a CD4 count should be done,” Leiro emphasized.

In Argentina, 1,142 cases of patients with monkeypox or Mpox were diagnosed from 2023 to last October/ REUTERS/Dado Ruvic/

The MPXV virus was discovered in Denmark in 1958. It was detected in monkeys intended for use in scientific research.

The first case of a person affected by this pathogen was reported in the Democratic Republic of the Congo in a 9-month-old child in 1970. The natural reservoir of the virus is still unknown, but there are several vulnerable small mammals, such as rodents.

Last November, a study in the journal Science, which suggested that the virus was circulating in humans for more than five years before the 2022 explosion of cases.

The countries with the most reported cases are the United States (31,070), Brazil (10,967), Spain (7,684), France (4,164), Colombia (4,090), Mexico (4,071), United Kingdom (3,867), Peru (3,812), Germany (3,779) and China (2,024).

Now, the WHO warned that “the Mpox outbreak continues in most regions” of the world. He pointed out that the most extensive transmission has been recorded in Europe and the Americas.

The ten countries that have reported the highest cumulative number of cases worldwide are the United States (31,070), Brazil (10,967), Spain (7,684), France (4,164), Colombia (4,090), Mexico (4,071), United Kingdom (3,867), Peru (3,812), Germany (3,779) and China (2,024). Together, these countries account for 81.4% of reported cases worldwide.

“The persistence of a high number of cases around the world shows that this outbreak has not ended, and that the virus continues to find pockets of susceptible individuals,” said the health agency.

The global outbreak has been caused mainly by clade IIb viruses. And the disease has been found to start differently in some people.

In just over half of cases, a rash may appear before or at the same time as other symptoms and does not always progress throughout the body. The first injury may occur in the groin, anus, or around or inside the mouth.

While the major clade IIb outbreak continues, there is also another clade I outbreak, which is generally considered more virulent, in the Democratic Republic of the Congo (DRC). There have been 12,569 cases reported between January 1 and November 12, 2023.

Sexual encounters have been the main route of transmission of the virus that causes Mpox between 2022 and 2023 in the world (Getty Images)

During the global outbreak, it has been identified that sexual encounter has been the most common mode of transmission of the infection. It accounts for 83.1% of all reported transmission events, followed by non-sexual person-to-person contact. That pattern has persisted over the past six months, with 97.1% of new cases reporting sexual contact.

According to WHO, transmission from person to person can occur through direct contact with infectious lesions on the skin or other areas, such as the mouth or genitals. Contagion can be done:

• face to face (when speaking or breathing);
• skin to skin (when touching or having vaginal or anal sex);
• mouth to mouth (when kissing);
• mouth to skin (when kissing skin or having oral sex)
• by respiratory droplets or short-range aerosols in case of prolonged close contact.

The virus enters the body through broken skin, mucous membranes (for example, oral, pharyngeal, ocular, genital, anorectal), or the respiratory tract. It can be transmitted to other family members and sexual partners. “People with multiple sexual partners are most at risk,” she said. Also the pathogen that can be transmitted from animals to humans.

Using a condom reduces the risk of Mpox, although the protection is not total. Its use is also recommended to prevent other infections (iStock)

The use of a condom can reduce the risk of transmission by avoiding direct contact with lesions on the vaginal, anal or oral mucosa, reported the Argentine Health Ministry. “However, it should be noted that it does not prevent transmission” of the infection. This is because the virus can be acquired through contact with lesions in other parts of the body.

Likewise, the health authority recommended that condoms should always be used to prevent other infections such as HIV.

The population of developed countries with the highest risk of acquiring the infection had access to vaccines against Mpox/ REUTERS/Henry Nicholls/File

The global outbreak triggered increased demand for the Mpox vaccine. But access has been facilitated mainly for patients in developed countries until now.

Days ago, a new study confirmed that giving smaller doses of the vaccine may be a strategy that provokes an equally strong immune response, even in people whose immune system is compromised due to HIV infection.

He study was led by Angelica Kottkamp and colleagues at New York University Grossman School of Medicine, United States. It was published in The New England Journal of Medicine. They studied 145 people who received the vaccine intradermally or subcutaneously.

2023-12-28 16:01:00
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