Monkeypox: “We are only seeing the tip of the iceberg in Brazil” – 01/08/2022

Brazilian specialists criticize the government’s delay in guiding the population, training health professionals to make the diagnosis and negotiating the purchase of vaccines against monkeypox. Young children, the elderly and the immunosuppressed can develop severe symptoms of the disease.

There are about a thousand confirmed cases in Brazil, including children, adolescents and even a pregnant woman, but experts say that the federal government’s action in the face of the advance of “monkeypox”, called monkeypox in the country, has fallen short of what is necessary, as if the country had learned nothing from the covid-19 pandemic.

“The Ministry of Health has relativized the matter, saying that it is a disease that affects more Europe. But, in fact, we are only seeing the tip of the iceberg in Brazil, because there is still no really effective campaign to guide people about which injuries must take them to the health center. There is also no medical education for health workers to diagnose injuries”, he told RFI doctor Alexandre Naime Barbosa, researcher at Unesp and vice president of the Brazilian Society of Infectious Diseases.

While the disease results in mild symptoms in most cases, there may be a greater risk for young children and the elderly, and there is certainly a danger for patients with compromised immunity, as was the case with the man who died of the disease in Brazil last week. He was HIV positive and battling lymphoma.

“At the moment, men who have sex with men are the clearest exposure category for ‘monkeypox’, but the virus has no preference, it is democratic. There are at least five cases in children already reported in Brazil, one pregnant woman, several cases in women as well. The problem is when the disease finds immunosuppressed individuals. Then it can be serious”, said Barbosa.

Difficulty for governments

Another expert heard by the RFI, sanitarian Jonas Brant, professor at the Department of Health Sciences at the University of Brasília (UnB), stated that many governments have had difficulties in organizing the health system in order to stop the spread of the virus. “It has gotten out of control. The number of cases has been growing very quickly. The first measure in this case is that health centers are prepared for the diagnosis because the patient with ‘monkeypox’ in general does not go to the emergency room, because is so serious, but to the health post because of the wounds”, he says.

Brant explains that it is from the post, in the primary care of the public network, that isolation guidance for suspected cases comes, at the same time that the search is made for other people who had contact with the possible infected person. “It’s to break the chain of contagion. This tracking has been a basic tool for centuries and we’re not able to maintain it”, he points out.

He believes that the situation in Brazil is worsening due to the climate of intense politicization and that this serious vacuum of communication by the health authorities is due to the fact that initially monkeypox has affected more homosexual men. “This is a taboo topic, a problem topic for the current government, even more so in an election year”.

But he also highlights that “in several parts of the world there are already reports, for example, of contagion in children and this shows that there will be changes in this target group over time”, said the epidemiologist from UnB.

Brazil will receive 20,000 doses of the vaccine in September

In a difficult account to close in the short term, the Ministry of Health says that immunization will focus on health professionals and on people who have had direct contact with unvaccinated infected. However, the first shipment will bring only 20,000 doses to the country in September, through an agreement with the Pan American Health Organization (PAHO), as the Danish company that produces the vaccine does not have an office in Brazil. In October another thirty thousand doses should arrive.

“Countries like Canada have already started to vaccinate people. And, unfortunately, Brazil continues to sin at this point of vaccination, as was the delay in acquiring doses in the coronavirus pandemic”, compared infectologist Alexandre Barbosa.

There are many questions that research still needs to answer. One is the degree of protection that people who were vaccinated against smallpox more than 40 years ago have today from monkeypox. Experts also wonder if the immunizer will be enough to protect the elderly. Another question is whether, in addition to the known forms of contagion – such as contact with wounds, salivary secretions or objects used by the patient – it is also possible to catch the disease through sexual intercourse.

What is certain, experts say, is that Brazil needs to show effort to guarantee the population access to medicines and immunizations. “Medications and vaccines were developed for smallpox and today only the great powers have this technology. So, there is a work of geopolitics, diplomacy so that all countries can have access to this technology”, says the health specialist at UnB.

“The vaccine, in the case of ‘monkeypox’, has a great advantage, it can be applied after exposure. So I can vaccinate people after they have had contact with an infected person, and this helps to block transmission”, concludes Jonas Brant.

About Abhishek Pratap

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