As more cases of monkey pox appear around the world, scientists are beginning to notice in the current outbreak some changes from the classic symptoms observed in Africa until then. On Wednesday (15th), the CDC (Centers for Disease Control and Prevention) of the United States updated the guidelines for health professionals and warned that the disease can be confused with some STIs (sexually transmitted infections).
With more than 70 confirmed cases in the US, the health agency says that all patients diagnosed with monkeypox “experienced a rash or enanthema.” [erupção nas mucosas]”.
Classic skin lesions are usually firm, deep, well-circumscribed, and sometimes umbilicated, says the CDC.
In cases prior to this outbreak, skin lesions were most evident on the face, palms, and soles of the feet. But now, doctors have described something a little different.
“The rash usually started in mucosal areas (eg, genital, perianal, oral mucosa) and in some patients the lesions were dispersed or localized to a specific site on the body rather than diffuse and did not involve the face or extremities” , says the statement.
The CDC also draws attention to patients diagnosed with monkeypox who have experienced “anorectal pain, tenesmus [vontade intensa de evacuar] and rectal bleeding that, on physical examination, were associated with visible vesicular, pustular, or ulcerative perianal skin lesions and proctitis [inflamação na mucosa do reto]”.
For this reason, the agency states that “the clinical presentation of smallpox can be similar to some STIs, such as syphilis, herpes, lymphogranuloma venereum (LGV) or other etiologies of proctitis”.
To date, monkeypox is not classified as an STI, although studies are ongoing. In Italy, researchers found amount of virus capable of causing infection in semen of a patient.
However, it is known that the disease is transmitted by close contact, either by secretion, such as saliva, or through the skin, which occurs in sexual contact.
Recently, the smallpox secretary of the WHO (World Health Organization) Health Emergencies Program, Rosamund Lewis, said that Lesions in the current outbreak were often restricted to the genital region of patients.
“We have the image of the past, but we have [agora] a higher proportion of cases where rashes may start more locally and stay more local, possibly because of the nature of contact [sexual]. We are seeing more cases where the rashes start in the genital area – which is not new, it always has been – and more often they tend to stay there,” he said in a live stream.
The adviser to the WHO HIV, Hepatitis and STIs (sexually transmitted infections) Program, Andy Seale, stressed at the same time that monkeypox “can be transmitted through sexual contact, but it is not a sexually transmitted disease”.
“Many diseases can be spread through sexual contact. You can get a cough or a cold through sexual contact, but that doesn’t mean they are sexually transmitted diseases. Typically, you need an exchange of vaginal fluids or semen, which have a element of contagion to transmit the disease [quando é sexualmente transmissível].”
A few days before the skin lesions appear, people infected with the monkeypox virus have sudden onset high fever (above 38.5°C), swollen lymph nodes (lymphadenopathy), headache and muscle and tiredness.
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