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Monkey pox: WHO warns of an upcoming increase in the number of cases, vaccination on the table

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The first case of monkeypox was detected in France last week. The World Health Organization predicts that the number of cases across the world will increase. The Covid is not yet behind us that we speak of monkey pox. This is a viral zoonosis, that is to say a virus that is transmitted from animals to humans. Since May 14, dozens of cases have been detected in the United States, England and Spain. This Friday, May 20, a first case was confirmed in France. If, in the majority of cases, the disease is mild for humans, even if the symptoms can be serious in men, the question of treatments and the vaccine arises. What are the symptoms ? Monkeypox can manifest as fever, intense headache, lymphadenopathy, muscle aches, back pain, and intense fatigue. But it is also characterized by rashes on the face, the palms of the hands, and the soles of the feet, essentially, which can extend, but to a lesser extent, to other parts of the body. The WHO specifies that “the incubation period is generally 6 to 16 days but can range from 5 to 21 days”. However, the disease “is generally cured spontaneously”. The world health authority wants to be generally reassuring on the cases concerned, affirming that “the fatality rate during outbreaks of simian orthopoxvirus has been between 1% and 10%, with most deaths occurring in the youngest”. The evolution of the disease would therefore be rather positive. Would vaccination really be effective? According to the World Health Organization, the “classic” smallpox vaccine, which caused serious epidemics in Europe until the 18th century, is 85% effective in preventing monkeypox, for which it does not there is no specific vaccine. Previous vaccination against smallpox may therefore lead to less severe disease, reports CNews. Nevertheless, the WHO recalls that the first generation of vaccines against smallpox “is no longer accessible to the general public” today. Indeed, smallpox was eradicated globally in 1980, after the launch in 1967 by the WHO of the “Intensified Smallpox Eradication Program”, recalls franceinfo. In Spain, the Ministry of Health has prepared the order for thousands of doses, according to El Pais (in Spanish), and Canada does not rule out using its stock of vaccines in the face of these contaminations. According to La Croix, the High Authority for Health (HAS) should decide on Monday May 23 on the advisability of the first vaccinations against monkey pox. According to the High Council of Public Health, in 2012, there were just over 82 million doses of first-generation vaccines left. On the other hand, after the eradication of the disease, “the States were invited to destroy their stocks of virus [nécessaires à la fabrication des vaccins] and the remaining virus stocks have been entrusted to two security laboratories”, in the United States and Russia, according to a document from the Ministry of Health dating from 2006. Questioned by franceinfo, virologist Antoine Gessain, head of the unit of epidemiology of the Pasteur Institute, believes that “vaccination does not seem to me to be, to date, justified. The European Center for Disease Prevention meanwhile indicated Thursday in a situation update that vaccination against monkeypox “high-risk close contacts should be considered after an assessment of the benefit/risk ratio”, such as young children or immunocompromised people. Towards a next epidemic? “We are detecting more cases every day”, thus indicated to the BBC Susan Hopkins, the medical officer of the UK Health Security Agency (UKHSA): “As we enter the summer season (…) with gatherings, festivals and parties, I fear that the trans mission is accelerating,” said WHO Director for Europe Hans Kluge. If the number of cases observed since the beginning of May raises fears of the start of the spread of monkeypox, the WHO specifies that “person-to-person transmission alone cannot sustain an outbreak” of the disease. I do not believe in a strong spread in the general population Among our colleagues from Paris, Antoine Gessain, virologist at the Pasteur Institute, procrastinates. ANRS epidemiologist Eric D’Ortenzio specifies: “We will quickly need data on these first cases outside Africa to know if we should expect an epidemic outbreak”. The virologist also rejected any similarity with the Covid epidemic among our colleagues at franceinfo: “The mode of transmission is completely different, as is the severity of the disease. In addition, this virus, which is a DNA virus, is very steady.” The fact remains that to reduce the “limited” risk of human-to-human transmission, the world health authority recommends “to avoid any close physical contact with infected subjects or contaminated materials”. How is “Monkeypox” transmitted? Initial infection occurs through direct contact with blood, biological fluids or skin or mucous membrane lesions of infected animals. In Africa, infected monkeys, Gambian giant rats and squirrels appear to be the main reservoirs of the virus. But in the spring of 2003, cases of monkeypox were confirmed in the United States, the first appearance of the virus outside the African continent. Most of the patients had been in contact with domestic prairie dogs, infected with imported African rodents. “Secondary, i.e. human-to-human, transmission may result from close contact with infected secretions from the respiratory tract, skin lesions of an infected subject, or objects recently contaminated with biological fluids or materials from the lesions of a patient”, explains the WHO. “Transmission occurs primarily through respiratory droplet particles and usually requires prolonged face-to-face contact.”

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