Monkeypox outbreak worries, but is far from becoming a pandemic; learn more about the disease

As if that were not enough, after two years of a tragic pandemic that resists ending, the world is faced with a new threat to public health. A viral infection known to science for over 60 years, which generally affects other animals – not only primates but, above all, some rodent species -, the monkey pox has been provoking an outbreak that spreads quickly among humans.

It started in Europe in May, with the first case recorded outside Africa, and since then it has reached more than 3,400 people in 50 countries, causing one death. But, at least for now, the scenario does not configure a global emergencyaccording to the World Health Organization (WHO), and it is far from producing a health crisis on the scale of the one that emerged in China in November 2019.

In Brazil, 37 diagnoses have been confirmed so far. None of them were notified in Pernambuco, but there is already one in the Northeast, in Ceará. Thus, given the growing possibility of the disease arriving here, the State Health Department (SES-PE) published, on June 21, a technical note with guidelines on what should be done if someone suspected of the disease seeks care.

According to the document, the patient must be isolated and all cases must be notified and reported to the agency within 24 hours. The monitoring of those who had contact with the possible infected person must last at least 21 days.

Monkeypox virus particlesMonkeypox virus particles (Photo: NIAID)

Evolution of epidemics
The recent rise in monkeypox proliferation draws attention to the dynamics of viral outbreaks and epidemics. Less lethal and transmissible than the new coronavirus, Sars-Cov-2, the monkeypox virus has similarities and (many) differences in relation to other pathogens, such as Ebola, much more aggressive and deadly, but with a lower transmissibility.

“The coronavirus that causes Covid is transmitted by finer droplets and even by aerosol. So the range is much greater. In the case of Monkeypox, when there is respiratory transmission, contact is face-to-face with heavy droplets of secretion. You have to be very close, either through the kiss or if the person coughs in your face”, explains professor Clarissa Damaso, a virologist at the Federal University of Rio de Janeiro (UFRJ) and advisor to the World Health Organization (WHO) committee for research. with monkeypox virus.

Animals and no vaccine
First identified in 1958 in a primate (hence the name), the disease is most prevalent among rodent mammals.

“In 2003, SARS-Cov-1 appeared, which came from a bat. After that, in 2009, we had the swine flu, caused by the mixture of pig, bird and human Influenza viruses. Now, Covid-19, which came from a bat too. This shows that we are having a very large agglomeration of domesticated animals and, worse, one in contact with the other”, says infectologist Stefan Cunha Ujvari, doctor at the Hospital Alemão Oswaldo Cruz, in São Paulo, and author of the book “História of Epidemics” (read interview).

In addition to the unhealthy relationship with nature and other animals, the doctor considers that there is another possibility for the appearance of the current outbreak.

“The smallpox virus is genetically similar to Monkeypox and, until the 1970s, we used to vaccinate people against smallpox. But when we stopped vaccinating for smallpox, a population of children started to grow who also don’t have the protection against the monkeypox virus”, says Ujvari.

monkey pox

Symptoms by stages
With symptoms similar to smallpox, zoonosis – a term used to refer to infections transmitted between humans and other animals – is less severe than the virus eradicated by vaccination in the 1980s, and is therefore less fatal. However, it can also generate a clinical condition capable of “evolving” to death and usually causes serious disorders (see infographic).

The symptomatology gradually intensifies. First, in the phase when the virus is “installing” itself in the body, the person feels as if he has contracted the flu, having fever, fatigue and body pain. Only after a few days do small lesions begin to appear on the skin, which also gradually grow until they form blisters and then scabs.

“In the classic picture, the pustules begin on the face, hands and legs after a period of fever and more pronounced lymph nodes. But now, in the outbreak that is taking place, the number of pustules is much smaller and concentrated in the genital region. So, the picture has been much milder than that of classic monkeypox”, explains virologist Clarissa Damaso.

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