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Scientists who have tracked numerous outbreaks of monkeypox in Africa say they are baffled by the disease’s recent spread to Europe and North America.
On Friday, France, Germany, Belgium and Australia reported their first infections.
Cases of the smallpox-related disease have previously only been seen among people with links to West and Central Africa. But over the past week, Britain, Spain, Portugal, Italy, the United States, Sweden and Canada have all reported infections, mostly in young men who had never traveled to Africa before.
The World Health Organization (WHO) wrote that monkeypox has been reported in 11 countries that do not normally have the disease.
“There are approximately 80 confirmed cases and 50 ongoing investigations. More likely to be reported,” he said, noting that member states and other partners were working to better understand the outbreak.
According to the Centers for Disease Control (CDC), symptoms of monkeypox include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and exhaustion.
Within 1-3 days (sometimes longer) after the onset of fever, the patient develops a rash, often starting on the face and then spreading to other parts of the body. The rash may resemble chickenpox or syphilis, and scabs may form and then fall off.
The incubation period for monkeypox is usually six to 13 days, but can range from five to 21 days.
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According to the World Health Organization, there have been two cases of monkeypox in the United States in 2021, both linked to recent travel to Nigeria. Nigeria has been experiencing a moneypox epidemic since 2017.
“I am amazed by this. Every day I wake up and there are more countries infected,” said Oyewale Tomori, a virologist who previously headed the Nigerian Academy of Sciences and sits on several World Health Organization advisory boards.
“This is not the kind of spread we have seen in West Africa, so there may be something new happening in the West,” he said.
To date, no one has died in the outbreak. Monkeypox usually causes fever, chills, rash, and lesions on the face or genitals. The WHO estimates the disease is fatal for up to one in 10 people, but smallpox vaccines are protective and some antiviral drugs are in development.
British health officials are investigating whether the disease is sexually transmitted. Health officials asked doctors and nurses to be on alert for potential cases, but said the risk to the general population was low. The European Center for Disease Control and Prevention has recommended that all suspected cases be isolated and high-risk contacts offered the smallpox vaccine.
Nigeria reports around 3,000 cases of monkeypox a year, according to the WHO. Outbreaks usually occur in rural areas, when people come into close contact with infected rats and squirrels, Tomori said. He said many cases are likely missed.
Dr Ifedayo Adetifa, head of the country’s Center for Disease Control, said none of the UK patients’ Nigerian contacts had developed symptoms and investigations were ongoing.
WHO director for Europe Dr Hans Kluge called the outbreak “atypical”, saying the outbreak of the disease in so many countries across the continent suggested “transmission is continuing since a while “. He said most European cases are mild.
According to the US Centers for Disease Control and Prevention, monkeypox usually requires prolonged contact with an infected person to spread.
The UK Health Security Agency reported 11 new cases of monkeypox on Friday, saying ‘a notable proportion’ of the most recent infections in the UK and Europe were in young men with no travel history to Africa who were gay , bisexual or had sex. with men.
Authorities in Spain and Portugal also said their cases involved young men who mostly had sex with other men and said the cases were detected when the men presented with lesions to clinics. sexual health.
Experts have stressed that they do not know whether the disease is spread through sex or through other close sex-related contacts.
Nigeria has not experienced sexual transmission, Tomori said, but he noted that viruses that were not initially known to be sexually transmitted, such as Ebola, were later found to do so after more large epidemics have shown different patterns of spread.
The same could be true for monkeypox, Tomori said.
In Germany, Health Minister Karl Lauterbach said the government was confident the outbreak could be contained. He said the virus was being sequenced to see if there were any genetic changes that could have made it more infectious.
Sajid Javid announced on Friday that eleven new cases of monkeypox have been confirmed. Javid tweeted that he had briefed G7 health ministers on what was known about the spread of the virus.
There are now 20 recorded cases in the UK. Javid wrote: “Most cases are mild, and I can confirm that we have purchased further doses of effective monkeypox vaccines. »
Javid said the UK was stocking up on smallpox vaccines to help guard against monkeypox.
“I can confirm that we have purchased other doses,” he said.
A smallpox vaccine provides protection against monkeypox since the two viruses are similar.
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Rolf Gustafson, a professor of infectious diseases, told Swedish TV channel SVT it was “very difficult” to imagine the situation could get worse.
“We will definitely find more cases in Sweden, but I don’t think there will be an outbreak in any way,” Gustafson said. “At the moment, there is nothing to suggest that.”
Scientists have said that while it is possible that the first patient in the outbreak caught the disease in Africa, what is happening now is exceptional.
“We have never seen anything like this happening in Europe,” said Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases. “We haven’t seen anything to indicate that monkeypox transmission patterns have changed in Africa. So if something different happens in Europe, then Europe needs to investigate it. »
Happi also pointed out that the suspension of smallpox vaccination campaigns after the disease was eradicated in 1980 could inadvertently contribute to the spread of monkeypox. Smallpox vaccines also protect against monkeypox, but mass vaccination was stopped decades ago.
“Apart from people in West and Central Africa who may have some immunity to monkeypox from past exposure, lack of smallpox vaccination means no one has any kind of immunity to monkeypox,” Happi said.
Shabir Mahdi, professor of vaccinology at the University of the Witwatersrand in Johannesburg, said a detailed investigation of the outbreak in Europe, including determining who the first patients were, was now essential.
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“We really need to understand how it started and why the virus is now gaining traction,” he said. “In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If that changes now, we really need to understand why. »
The Associated Press contributed to this report.