What’s smallpox, which is spreading in Europe and worrying well being authorities?

Several dozen suspected or confirmed cases of monkeypox have been detected since early May in Europe and North America, raising fears of the disease’s early spread.

If France is still spared, it is almost surrounded. After Spain, Portugal and the United Kingdom, it is the turn of Italy and Sweden to be affected by smallpox, a rare viral zoonosis, usually found in isolated areas of central and western Africa, close to tropical forests.

Health officials are now concerned about dozens of cases in Europe, but also in North America.

Where does the disease come from?

Typically, monkeypox is a disease endemic to West Africa. One of the infected people identified in the UK was returning from Nigeria, but this is the only case among identified cases worldwide who has traveled to the region recently.

What is the transmission mode?

Infection in early cases results from direct contact with blood, body fluids, or lesions on the skin or mucous membranes of infected animals.

The disease is not normally very contagious, but human-to-human transmission is still possible. It can result from close contact with infected secretions from the respiratory tract, from contact with a patient or their body fluids, including saliva, skin lesions from an infected subject, or objects recently contaminated with fluids or biological materials from a patient’s wounds. However, it appears that it is not transmitted by aerosol like Covid-19.

In the UK, monkeypox has circulated within the gay community: “We are seeing transmission between men who have sex with men”, which is “new information that we need to study properly to better understand the dynamics” of transmission, said Ibrahima SocĂ© Fall, WHO deputy director general for emergency response in Geneva.

Britain’s health safety agency UKHSA urged people who are gay, bisexual or men who have sex with men to “be on the lookout for unusual skin rashes or sores”.

This uncommon illness often manifests with fever, muscle aches, swollen lymph nodes, chills, and fatigue. Rashes such as chickenpox can often occur on the face and spread to other parts of the body, including the genitals, before going through different stages, crusting and falling off. These symptoms can last anywhere from 14 to 21 days.

Although the disease can be fatal, the case fatality rate remains below 10%. Unlike Covid-19, children are more likely than adults to develop a severe form.

How to treat it?

Although smallpox is not very contagious, it remains untreated for the time being, but it usually clears up on its own. According to the WHO, smallpox vaccination “is 85% effective in preventing” smallpox, but this vaccine is no longer available to the general public “after its manufacture was stopped following the global eradication of smallpox”.

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