Monkeypox in humans, two new cases reported in the UK

Two cases of monkeypox in humans have been identified in the UK, where health authorities in North Wales have reported two infections within the same household. Both people were admitted to a hospital in England after one of the two, who returned from Nigeria on May 8, remained in quarantine with her family due to anti-Covid restrictions. Two days later, the same person experienced a rash, starting on the face, remaining in self-isolation for another ten days and seeking medical treatment for symptom relief, before being transferred to the English hospital.

Two cases of monkeypox in humans

Analysis of the samples, received by the Public Health England Rare and Imported Pathogens Laboratory on May 24, confirmed that they were monkeypox, a disease similar to human smallpox which, on the African continent has recently registered a major epidemic. Specifically, sample sequencing indicated that the virus responsible for the disease (poxvirus) belongs to the strain in circulation in West Africa. On May 29, a family member with whom the patient was in quarantine began to show the same symptoms and laboratory tests confirmed the poxvirus infection. The case was confirmed on May 31 and the patient transferred to the same hospital in England where he is currently hospitalized. The other family member was discharged instead.

According to what was disclosed by Public Health Wales (PHW), in response to the two cases, appropriate public health measures were activated, including the search for all close contacts of the two patients. However, the PHW defines as “very low”The risk of person-to-person transmission. “Human confirmed cases of monkeypox are a rare occurrence in the UK and the risk to the general public is very low – stated in a statement to the BBC Richard Firth, PHW Health Care Consultant -. We worked with multi-agency colleagues, following proven protocols and procedures and identified all close contacts. Actions have been taken to minimize the likelihood of further infections”.

What is monkeypox and how is it transmitted

The disease caused by the poxvirus (which belongs to the same family as the human smallpox virus) is probably transmitted from animals to man through body fluids, including saliva or respiratory droplets, or through contact with infected wounds. Infections are rare, although cases are increasing in parts of Africa, where most have occurred in the Democratic Republic of the Congo. Since 2016, confirmed cases have also been reported in Sierra Leone, Liberia, the Central African Republic, the Republic of the Congo and Nigeria.

Despite the name, the reservoir of the virus would not be non-human primates, but most likely small rodents (such as squirrels) that live in African rainforests, mainly in West and Central Africa. The increase in cases is believed to be due to increased human exposure to the habitats of animals carrying the virus, as suggested by a monkeypox outbreak that occurred in 2003 in the United States, where some infected rodents were imported. as pets, spreading the virus to domestic prairie dogs that later infected humans in the Midwest.

From a clinical point of view, the MSD manuals indicate, the symptomatology is similar to that of human smallpox, even if the skin lesions they usually take on a cluster configuration. Complications may include lymphadenopathy (abnormal and uncontrolled enlargement of the lymph nodes) and secondary bacterial infections in the skin and lungs develop. As for treatment, there is currently no specific cure for this infection, but potentially useful drugs include some antivirals (tecovirimat, acidofovir or brincidofovir). Most infections cause a mild form of the disease, sometimes similar to chickenpox, which clears on its own within a few weeks. In Africa, the death rate varies between 4 and 22%.

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