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An outbreak of monkeypox in the US and the world: how it manifests itself and how it is treated for a disease for which there is no cure

An extremely rare disease called monkeypox, a much less severe relative of smallpox, is spreading throughout the world. More than 250 cases have been reported in at least 16 countries, according to the World Health Organization (WHO). Experts say the disease is spread through close and prolonged contact with an infected person. The edition told in more detail CNN.

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“The countries that are now reporting monkeypox are the ones where there are usually no outbreaks of monkeypox,” said Rosamund Lewis, head of the WHO emergency program secretariat, at a briefing at the United Nations (UN) in Geneva.

Monkeypox is endemic near tropical forests in central and western Africa, but is increasingly seen near urban areas, according to the WHO.

“This is a developing disease. It has evolved over the past 20-30 years, so it's not unknown, it's very well described, Lewis said. “Therefore, the risk to the general public seems low, because we know the main ways the disease is transmitted.”

In the United States, the first case of monkeypox in 2022 was diagnosed in a patient hospitalized in Massachusetts who had recently traveled to Canada in a private vehicle.

According to the Centers for Disease Control and Prevention (CDC), two people traveling from Nigeria to the US were diagnosed with the disease in 2021. The CDC says cases in parts of the world other than Africa are usually linked to international travel or the importation of smallpox-infected animals.

Several cases of monkeypox reported in the UK have been among people who have not traveled or been in contact with other people, but there is no cause for concern, US Surgeon General Dr Vivek Murthy said.

“Right now, we don't want people to worry,” Murthy said. — These numbers are still small; we want people to be aware of the symptoms and if they have any problems, see a doctor.”

What are the initial symptoms of monkeypox

According to the CDC, the incubation period is 7 to 14 days. Initial symptoms are usually flu-like: fever, chills, exhaustion, headache, and muscle weakness, followed by swelling of the lymph nodes that help the body fight infection and disease.

"The feature that distinguishes monkeypox infection from ordinary smallpox is the development of swollen lymph nodes," the CDC said in a statement.

Then there is an extensive rash on the face and body, including in the mouth, on the palms and soles of the feet.

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The body is covered with painful convex pearl-colored sores. They are filled with liquid, often framed with red circles. According to the Centers for Disease Control and Prevention, wounds heal and resolve within two to three weeks.

The WHO and CDC say there are more cases today causing a rash in the groin area in patients.

"Sometimes in the early stages of the disease, the rash was mainly in the genital and perianal areas," said Dr. John Brooks, chief physician of the CDC HIV/AIDS Prevention Unit. “In some cases, the virus has caused anal or genital lesions similar to other diseases such as herpes, chickenpox or syphilis.”

“A notable proportion of cases” in the current situation are among gay and bisexual men, “but by no means is the risk of contracting monkeypox a danger exclusively to the LGBT community. Anyone can get sick and spread this virus,” Brooks said.

According to a rapid risk assessment report published by the European Center for Disease Prevention and Control, overall the risk of monkeypox is moderate for people with multiple sex partners and low for the wider population.

However, monkeypox is not considered a sexually transmitted disease.

How the disease spreads

The monkeypox virus is transmitted through close contact with an infected person, experts say.

The disease can develop after contact with "damaged skin, mucous membranes, respiratory droplets, infected bodily fluids, or even touching contaminated linen," said Neil Mabbott, head of the department of immunopathology at the University of Edinburgh in Scotland.

“When the lesions begin to heal, they form scabs. They are capable of containing the monkeypox virus. Therefore, when the scab is separated, infectious dust is possible, which others are at risk of inhaling, ”said Dr. Michael Skinner, who works at the Faculty of Medicine in the Department of Infectious Diseases at Imperial College London.

The CDC says transmission between people occurs via large respiratory droplets, but because they typically only travel a few feet, "prolonged face-to-face contact is required." According to the WHO, this puts health care workers and family members caring for or living with actively infected people at great risk.

Smallpox, which was eradicated from the world in 1980, was spread primarily through direct and prolonged face-to-face contact between people and through objects contaminated with contaminated fluids, such as underwear or clothing.

“People with smallpox became contagious as soon as they developed ulcers and spread the virus through the air when they coughed or sneezed. They remained contagious until their lesions disappeared,” explained Dr. Paritosh Prasad, director of the Highly Infectious Diseases Unit at the University of Rochester Medical Center in New York.

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However, Prasad reads, based on available historical information, monkeypox appears to be less contagious than smallpox alone.

“Monkeypox can be a serious infection, mortality from this type of virus has been about 1% in other outbreaks. They often occur in low-income settings with limited access to care,” said Michael Head, Senior Global Health Scientist at the University of Southampton (UK). There are no reports of deaths from the current outbreak.

Common household disinfectants can kill the monkeypox virus, according to the CDC.

How to Treat Monkeypox

There are no specific drugs available to treat the condition, so "treatment is generally supportive," Jimmy Whitworth, professor of international public health at the London School of Hygiene and Tropical Medicine, said in a statement.

“However, a vaccine is available that can be administered to prevent the development of the disease,” Whitworth said.

In the US, a two-dose vaccine called Jynneos is currently licensed to prevent monkeypox and can be used to treat smallpox.

The US government has stockpiled the vaccine in case the eradicated disease reappears.

“We now have over 1000 doses of this drug, and we expect that level to increase very rapidly in the coming weeks,” said Dr. Jennifer McQuiston, associate director of the Division of Pathogens and Pathology at the CDC National Center for Emerging and Zoonotic Infectious Diseases.

“We hope to distribute the vaccine as much as possible to those who may become infected,” said McQuiston. “These are people who have had contact with known monkeypox cases, healthcare workers, very close personal contacts, in particular those who may be at high risk of severe illness.”

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Where did monkeypox originate?

The disease, the CDC explained, got its name in 1958, when "two outbreaks of the smallpox virus occurred in research monkey colonies."

However, the main carrier of this virus is still unknown, although African rodents are suspected to play a role in its transmission.

The CDC said the first known case of monkeypox in humans was "reported in 1970 in the Democratic Republic of the Congo during a period of intense smallpox eradication efforts."

Since then, most cases have been concentrated in 11 African countries, with several outbreaks in the US and Europe associated with travel or importation from endemic countries.

Another outbreak occurred in the United States in 2003, when forty-seven people in six states—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin—became ill from contact with their family members. prairie dogs (small rodents, native to North America; average body size is 30-40 cm in length, including a small tail).

“Pets became infected after they were housed next to small mammals imported from Ghana,” the CDC said in a statement. “This was the first case of monkeypox in humans outside of Africa.”

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