A case of monkeypox has also been confirmed in Germany for the first time. The Bavarian Ministry of Health announced on Friday that a 26-year-old from Brazil who had traveled from Portugal to Munich via Spain was affected. He has been in the Bavarian capital for about a week, having previously been to Düsseldorf and Frankfurt am Main. It is the first case of monkeypox ever recorded in Germany. According to the Robert Koch Institute, the virus had never been detected in this country before.
The patient has only minor symptoms with slight dysphagia and elevated temperature and does not yet need any special medication. He will remain in the hospital as it is expected to be infectious for three to four weeks.
According to health authorities, the virus usually causes only mild symptoms, but can also have severe courses. In individual cases, fatal diseases are possible. The virus is mainly transmitted via direct contact or contact with contaminated materials. Transmission via droplets in the air is also possible over shorter distances – which is probably very rare.
Federal Health Minister Karl Lauterbach is not surprised by this first detection: “It was only a matter of time before monkeypox was also detected in Germany.” Doctors and patients in Germany are sensitized by the reports from other countries. He does not assume that there is a large number of unreported cases in Germany at the moment, he said. “Based on the knowledge available so far, we assume that the virus is not so easily transmitted and that this outbreak can be contained,” explained Lauterbach. There are two variants of the pathogen – for the time being it can be assumed that the West African variant, which causes less severe courses, is currently circulating, not the Congo variant. The virus will be analyzed in more detail for clarification.
The Charité infectiologist Leif Sander sees the now well over 100 cases worldwide in which monkeypox is suspected or has already been confirmed, an unusually dynamic situation. “With the long incubation period, I expect a further significant increase in cases,” he wrote on Twitter. It should be noted that monkeypox is not so contagious that it can be expected to spread over a wide area like Corona. “It’s very serious, but we’re prepared.”
The observed accumulation is already an epidemic – but it is “very unlikely that this epidemic will last long,” said Fabian Leendertz, founding director of the Helmholtz Institute for One Health (HIOH) in Greifswald and head of the project group Epidemiology of highly pathogenic Pathogen at the Robert Koch Institute (RKI). The cases can be narrowed down well via contact tracing and there are drugs and effective vaccines that could be used. According to Leendertz, more data is urgently needed in order to be able to understand whether and how the recorded cases are related. It is also important to decipher the genome of virus material from samples from those affected in order to check whether the pathogen has changed – for example in the direction of better transmissibility.
Virus detections also in France, Canada, Australia and the USA
Monkeypox infections are currently being detected in more and more countries. France also reported a first case on Friday, and the virus was also discovered in the USA, Canada and Australia and thus other regions of the world. The extent to which the pathogen, which originated in Africa, has already spread internationally is unclear. With the large number of cases, he assumes that the virus has been circulating unnoticed for a while, said the doctor Norbert Brockmeyer, President of the German STI Society. STI stands for Sexually Transmitted Infections.
According to a media report, 30 cases have now been confirmed in Spain. There are also 23 suspected cases, the newspaper reported La Vanguardia on Friday, citing the Ministry of Health. In Portugal, according to the newspaper publico 23 cases confirmed. The infected person in Australia had previously returned from the UK. The number of cases recorded there has meanwhile increased from 9 to 20, as British Health Minister Sajid Javid announced on Friday. The country has bought smallpox vaccine – how much and who should be vaccinated with it was initially unclear.
The World Health Organization (WHO) had called for a rigorous follow-up of all contacts of those affected. Clinics and the population would have to be made aware of the symptoms. The majority or possibly even all of the cases so far have involved men, and in many cases they have reportedly had sexual contact with men. According to Brockmeyer, people who have sexual contact with many different people are most at risk of infection. The German Aidshilfe warned against wrong conclusions and stigmatization in view of the cases in gay men. “Of course there are superficial similarities between monkeypox and HIV back then – it’s another disease from Africa that also affects gay men. But the comparison doesn’t fit in many other respects,” said AIDS spokesman Holger Wicht.
In contrast to HIV, the virus that causes monkeypox was known longer in the 1980s, and the disease also healed on its own. “It is very important to us that panic and unreasonable fears do not arise here.” There are still uncertainties when assessing the severity of the disease – for example about how well the immunocompromised – this can include, for example, HIV-infected people who have not been treated for many years – cope with the disease. The disease is named monkeypox after the pathogen was first detected in monkeys in a Danish laboratory in 1958. Experts suspect that the virus actually circulates in squirrels and rodents, while monkeys and humans are considered false hosts.
The first monkeypox patient was described in 1970 in the Democratic Republic of the Congo. To this day, the disease is observed primarily in remote villages in the tropical rainforest of western and central Africa. The hardest hit is the Congo, where at times more than 1,000 patients per year were registered. Outside of Africa, monkeypox has only been described in a handful of countries; these were always imported cases.