As monkeypox is on the rise around the world, experts are gathering more evidence on how people get it and what typical symptoms they have.
Several months after the start of the epidemic, it is clear that the wave of infections is mainly related to sexual intercourse between men.
In the past three months, nearly 28,000 cases have been confirmed worldwide and the first deaths are being recorded.
Here’s a summary of what we know:
– Who catches it? –
Monkeypox has been present in a dozen African countries for decades, but unlike previous outbreaks on the continent, the virus is now predominantly spread through sexual activity.
About 99 percent of US cases to date have involved men who have sex with men (MSM).
In Africa, the virus mainly affects children.
Over the past three weeks, studies in leading medical publications – British Medical Journal (BMJ), The Lancet and New England Journal of Medicine (NEJM) – have painted a clinical picture of the current surge in infections, albeit early days and the Results are based on only a few hundred cases.
In every study, the MSM community is responsible for almost all cases.
– How is it transmitted? –
The male sex connection came as no surprise as it emerged from the first recorded observations and was targeted by health authorities.
This raises the thorny question of whether the virus is transmitted through sexual activity.
The latest clinical reports leave little doubt.
“Our study strengthens the evidence for skin-to-skin contact during sex as the dominant mechanism of monkeypox transmission, with important implications for disease control,” The Lancet said, using data from several Spanish hospitals.
It was found that the viral load in the patients’ skin lesions was much higher than in their respirators.
This observation seems to undermine the idea put forward by some researchers that airborne transmission also played an important role in the spread of cases.
At the same time, monkeypox is not thought to be transmitted through semen, and while it hasn’t been entirely ruled out, current research is far from proving it.
– Symptoms? –
All three studies agreed on the main symptoms.
“The characteristics of the cohort we are describing differ from those of the populations affected in previous outbreaks in endemic regions,” the BMJ noted in the study of UK cases.
The two key elements are fever, often with muscle pain, and skin lesions that become scabs.
However, details vary, likely due to the mode of transmission, with recent cases being heavily linked to sexual activity.
In all three studies, lesions commonly erupt in the anus, penis, and mouth. A complication that has rarely been observed until now is inflammation of the rectum or swelling of the penis.
The Lancet noted that complications occurred in 40 percent of cases and the NEJM in about 20 percent.
But there was also good news about the severity of the disease.
“The clinical results in this case series were reassuring. Most cases were mild and self-limiting, and there were no fatalities,” the NEJM said.
“Although 13 percent of those admitted were hospitalized, the majority of those admitted had no reported serious complications.”
– questions remain –
The Lancet report raised questions about the effectiveness of vaccines, as 18 percent of cases involved people who had already received a vaccine to protect against monkeypox.
However, some patients had the vaccine many years, even decades, before contracting the virus.
It is also unclear how other diseases increase the risk of contracting monkeypox. About 40 percent of the patients in the Lancet study carried HIV, but it was impossible to determine if there was a direct link between the two.
#symptoms #spread #monkeypox
