2024-08-14 17:36:24
A health emergency of international concern – that is a turn of events that makes many people feel very anxious. It is a reminder of the pandemic with all its health and social consequences. So should we be afraid when the World Health Organization (WHO) has now decided to declare this particular emergency again in the case of Mpox? After all, it is the highest level of alertness that health care providers can tell.
Mpox, or “monkey monkey”, as the disease was originally called, caused chaos in 2022, at a time when the corona epidemic is slowly declining but not yet over. First in Great Britain and Spain, then in many countries, including Germany, and worldwide, infections with the virus, which was previously known only from Central and West Africa, occurred in early 2022. Gay and Men’s sexuality is often affected by changing partners. They suffer from fever and muscle pain, and unpleasant pox and painful sores develop on their skin.
It quickly became clear that the virus spreads from person to person primarily during sex, but also through close physical contact. Experts were able to identify two big raves in Spain and Belgium as the most widespread events in Europe. In African countries where Mpox is already known, people are infected by eating or by eating rodents or monkeys.
Abstinence from sex and vaccination
In 2022, the World Health Organization declared a “public health emergency of international concern” for the first time due to the rapid spread of Mpox of the so-called clade II. Physiologists understand clades to be close relationships within a group of viruses; The health authority is concerned that Mpox may become a global health threat. Methods such as sexual abstinence in the event of symptoms and the possibility of vaccination are mentioned. MPox cases then declined around the world in autumn 2022 and the risk seems to have been averted.
But the virus did not disappear and the infection continued under the radar. And now a new power seems to have come into play. Although transmission from one person to another is much more difficult than with respiratory viruses such as corona or influenza, the number of MPox infections registered in the Democratic Republic of Congo has risen rapidly in the past four months. The reason for this is said to be a new variant of clade I. It appears to cause more severe symptoms such as smallpox and lesions all over the body (not only at the port of entry), and it appears that it is very dangerous for children. . It is not certain that clade I is more dangerous or widespread than clade II.
Norbert Brockmeyer said: “It may be that clade I viruses move easily. He is an expert in skin and vascular diseases, founded the Center for Sexual Health and Medicine, WIR-Walk In Ruhr at Bochum University Hospital, and is the President of the German STI Society, Society for the Promotion of Sexual Health. But even if the virus doesn’t spread more easily than the clade I variant that will take over the world by 2022, the risk for the Central African region is great, Brockmeyer said. “It is a frequent pattern that large outbreaks of infectious diseases occur in civil war zones. Sexually transmitted diseases like AIDS or tuberculosis occur because sex is used as a weapon.” In addition, medical and preventive care is not available in the regions.
In Europe, North and South America and Southeast Asia, cases of Mpox infections have only occurred sporadically since the end of 2023; in the West Coast region of 2023/24, which arrives mainly by March. However, the infection process does not come to a complete stop.
A total of nearly 100,000 infections have been detected worldwide; 208 deaths have been confirmed by the WHO. The fact that the virus is able to spread is mainly due to the decrease in immunity: low immunity, which still provides a level of protection Orthopoxvirus monkeypox was canceled in many countries around the world when the number of cases fell to zero. In West Germany, children were last vaccinated against measles in 1976, and in the GDR it was in 1982 – two years after the WHO declared that the disease would be completely eradicated.
So everyone born after the end of the vaccination campaign is not protected. Then, people with an increased risk of infection can get vaccinated again. A vaccine against the monkeypox virus, Imvanex, has been available since summer 2022. It is likely to work well against both clades, they are closely related. “Demand for vaccines increases in corresponding areas in Germany and other countries after they appear in spring 2022,” said STI expert Norbert Brockmeyer. So there is no risk for Germany and other rich countries?
How often should I reboot?
Scientist Clara Lehmann heads the infection clinic and research center I for nosocomial infection at the University Hospital of Cologne and has investigated the immune response to Imvanex with colleagues from the Institute of Virology at the University Hospital of Cologne and from Berlin. “Those who have been vaccinated as children in the past can be vaccinated with Imvanex, while those who are not fully vaccinated receive two doses.” against disease. “There have been isolated cases in which people who were vaccinated twice got Mpox again after two years,” he said. There is no guarantee yet whether people vaccinated against Mpox should renew their immunity. However, Lehmann advises: “Since the vaccine is approved for ages 18 and over, we strongly recommend that sexually active people get vaccinated. turn to vaccination.” on mucous membranes. “We have to treat patients with morphine in the hospital because of the pain.”
Leif Erik Sander, director of epidemiology at the Berlin Charité, who, together with Lehmann and others, carried out a large study on the effectiveness of vaccination on behalf of the European Medicines Agency, is also based in favor of sexual vaccination groups. “As the outbreak is very fast in Europe in 2022, there is currently no good data on the long-term effectiveness of the vaccine,” he said. “After one dose of the vaccine, protection is around 60 percent. Vaccination successes that occur, however, come with more severe symptoms than infections in unvaccinated people.” This speaks clearly in favor of vaccination, especially if clade I comes to Europe and causes more symptoms. “Immunity decreases as the disease progresses.”
The virus is spreading primarily in the Democratic Republic of Congo (DRC). The African Center for Disease Control reported 14,000 confirmed and suspected cases and 455 deaths this year. There is no proper review of the infection process. Lehmann, who has a cooperation partner in Congo said “In Congo it is not possible to determine the spread of the virus using tests. The number of unreported cases is therefore estimated to be very high. It seems impossible that the virus can spread from DRC around the world. “There is a very large airport in the city of Goma. We know from Corona and Zika how fast viruses can travel around the world.”
Therefore, the World Health Organization has only been able to appeal to the countries concerned to increase the monitoring of the infection process and information about the infection routes and protection measures. With the upgrade, it is possible to send more financial aid to countries where there is no infrastructure for surveillance or opportunities for education and medical care. The WHO may also send staff to countries to assess the spread of the virus on the ground.
One thing quickly became clear as the outbreaks progressed: infected people only became ill once a small mite had formed on their skin or mucous membranes. “A complete avoidance of physical contact is very effective in stopping short-term spread,” says Lehmann. “Strong behavioral changes have led to dramatic success in 2022 outbreaks.”
Norbert Brockmeyer said: “It is good that the WHO is announcing the alert level now. Even if the pathogen does not cause any serious problems in this country, it will be good for the affected areas in Africa. The virus is widespread there and prevention and medical treatment are poor. “It is important for local people that there is more awareness, more prevention efforts and more help.”
#warns #monkeys