Monkeypox: More and more cases in Europe – what is known about the infection

disease outbreak
Cases on the rise in Europe and North America – what you should know about monkeypox

This electron micrograph shows the monkeypox virus

© Andrea Männel/RKI/ / DPA

Smallpox has been eradicated for 40 years. The first cases of monkeypox were discovered in Britain. Cases have now also been reported from the USA, Spain and Portugal, among others. The Robert Koch Institute warns doctors to be careful. What is monkeypox exactly? And how can an infection be treated?

Smallpox has been eradicated since 1980 thanks to a successful vaccination campaign. The Robert Koch Institute (RKI) describes that a large part of the world’s population is no longer vaccinated. Human cases of monkeypox have increased in Nigeria since 2017. First, there was an outbreak of the disease in the UK. The British health authority UK Health Security Agency (UKHSA) has now recorded seven cases. Now monkeypox is appearing in more and more countries: Spain, Portugal and the USA. Suspected cases are currently being examined in Canada.

What Causes Monkey Pox?

Monkeypox is caused by infection with the monkeypox virus. Monkeypoxvirus belongs to the Orthopoxvirus genus in the Poxviridae family. The Orthopoxvirus genus includes other smallpox viruses, writes the American health authority Centers for Disease Control and Prevention (CDC). Monkeypox was first discovered in 1958 in monkey colonies kept for research. Hence the name of the viral infection. Suspected cases are currently being examined in Canada. The Robert Koch Institute (RKI) had already made doctors in Germany aware of the virus after the cases in Great Britain.

How are they transmitted?

According to the RKI, people can become infected with monkeypox through contact with infected squirrels, rats or monkeys. This can happen through a bite, handling the animals as pets, and coming into contact with the animals’ blood or secretions. People can also become infected from animals by eating monkey meat or by droplet infection. The virus enters the body through broken skin, the respiratory tract or the mucous membranes.

According to the RKI, transmission from person to person has “apparently been increasing” since the 1980s. A possible explanation for this could be the decreasing protection against smallpox. According to the CDC, human-to-human transmission is primarily via droplets. Infection is also possible through direct contact with bodily fluids or the crusts of the rash. Infection through sexual contact is also possible. According to the RKI, men who have sex with men should “immediately seek medical care” if they have any unusual skin changes.

What is known about the cases so far?

The first infection, which became known in Great Britain at the beginning of May, is said to be due to an infection in Nigeria. Connections between those affected are only partially known. In some cases it is unclear where those affected were infected. Four recently reported cases involve men who have had sexual contact with other men. They are said to have been infected in London, according to the UKHSA.

In the United States, one person from the state of Massachusetts in the northeast of the country has been affected so far, the CDC said on Wednesday. In Spain, eight infections were reported in the capital Madrid, the Europa Press news agency reported on Wednesday, citing health authorities. In Portugal, the newspaper “Público” even wrote about 20 infected people. The majority of the cases that have been reported so far affect men who have had sexual contact with other men.

How big is the risk from the outbreak in the UK?

Following the emergence of the first confirmed case of monkeypox in early May, UK health experts stressed that monkeypox is not easily transmitted from person to person and that the risk to the general population is very low.

What are the symptoms of monkeypox?

According to the UKHSA, most infections are mild. But serious infections can also occur. According to the RKI, CDC and UKHSA, the following symptoms occur:

  • sudden fever
  • (strong headache
  • back pain
  • Sore throat
  • Cough
  • muscle pain/soreness
  • swollen lymph nodes
  • chills
  • exhaustion
  • rash that often starts on the face and spreads to other parts of the body The rash may look different depending on the stage of the disease and may resemble chickenpox or syphilis. Eventually it forms a scab and falls off.

How long are you sick with monkeypox?

The infection typically lasts two to four weeks, according to the CDC. According to the RKI, there is a risk of infection until the crusts of the rash fall off. But only symptomatic patients are contagious. It takes seven to 21 days for the disease to break out after infection.

How is the infection treated?

The primary goal of treating monkeypox is to relieve the symptoms. It is also important that further bacterial infections that can occur due to the weakened immune system are avoided. The RKI advises an isolation period of three weeks.

How to prevent monkeypox infection?

The CDC recommends that travelers in Central and West Africa should avoid close contact with potentially infected animals. This also applies to sick or dead animals. Litter that the animals have been in contact with should also be avoided. An infected person should be isolated when sick, and anyone who has been in contact with an infected person should pay particular attention to hand hygiene.

Sources:RKI 1, RKI 2, CDC, UKHSA report, UKHSA, with material from the dpa

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