Incidents of Monkeypox are not directly linked to travel to Central or West Africa or people returning from travel have been reported in Europe and around the world, with suspected cases being investigated. In many countries the assessment and situation is therefore changing very fast. In France, infection with the virus is subject to long-term surveillance through mandatory reporting. In light of the current warnings, surveillance on the infection has been stepped up by Public Health France and information and warning messages have been sent to healthcare professionals.
The MonkeyPix incident: Update in France
On July 05, 2022 at 2 pm, 577 cases were confirmed: 387 in Ile-de-France, 52 in Overgene-Rh -ne-Alpes, 37 in Occitan, 37 in New Aquitaine, 23 in Hautes-de-France, 23 in Provence-Alpes-C ডিte d. ‘Azure, 8 in Normandy, 6 in the Grand Estate, 5 in Brittany, 4 in Pace-de-la-Loire, 3 in Borgogne-Fran -ois-Comte and 1 in Center-Val de Loire.
As of 2:00 pm on July 4, 2022, the distribution according to the area of residence of 552 confirmed cases is presented in Figure 1.
Figure 1. Confirmed case of monkeypox (n = 552), by region of residence, France, May-July 2022 (data as of 04/07/2022 – 2:00 pm)
Of these cases, 3 women and 1 child have been infected with the monkeypox virus since the first case was identified in France on May 7, 2022.
Age for confirmed adults ranges from 19 to 71 years (median age: 35 years).
The onset of symptoms is between May 7, 2022 and July 01, 2022 (Figure 2). In this case a median of 6 days after onset of symptoms was diagnosed (range 0 to 22 days); Therefore, data for the last week are not collected.
Figure 2. Confirmed cases of monkeypox (n = 552), according to the onset of symptoms, France, May-July 2022 (data as of 04/07/2022 – 2:00 pm)
Of the cases investigated, 78% presented genito-anal rash, 73% presented eruption in other parts of the body, 75% presented fever, and 72% presented lymphadenopathy.
Of the cases investigated, 29 were immunocompromised; 149 HIV positive (27%) and no deaths.
To date, in France, 97% of cases for which sexual orientation has been provided have occurred among men who have had sex with men (MSM). In cases where data were available, 75% declared that they had had at least 2 sexual partners within 3 weeks of the onset of symptoms.
In most cases investigated, it was declared that they could not identify the person who had been infected; 100 secondary cases, i.e. three weeks before the onset of symptoms, were in contact with a case of monkeypox.
Information and prevention action
In light of what has been observed in Europe on this disease, targeted communication was quickly applied to MSM people. The site sexosafe.fr, dedicated to the sexuality of MSM people, has been updated with a summary of knowledge on the subject and preventive measures. Messages to remember the signs and what to do in case of signs were promoted through a digital campaign, posters and flyers and then action in the field. Since June 17, the digital campaign has generated nearly 192,000 banner clicks and more than 173,000 visits to the SexoSafe site. This device was supplemented with poster promotion in a confident place with about 1,350 poster spaces. At the same time, posters, flyers and advice sheets were distributed to the Association, ARS and SexoSafe teams, as part of the proud procession and were present where MSM meets. To date, 1,514 posters and 57,500 flyers have been ordered.
The actions of resistance are constantly adapted to the evolution of the situation and the state of knowledge.
In the case of a link reported in the normal absence of monkeypox in Europe and by cases identified with risk areas, the current European context creates a warning and suggests pollution in Europe. For this reason, in France, long-term monitoring of monkeypox is strengthened through mandatory notification systems and information and warning messages are sent to health professionals.. Exchanges with other European countries, WHO and ECDC continue.
What is Monkeypox?
Monkeypox is an infectious disease caused by the orthopox virus. This zoonotic disease is usually transmitted to humans by wild rats or primates in the forests of Central and West Africa, but human-to-human transmission is also possible, especially in family homes or care settings.
How is it transmitted?
The monkeypox virus can be transmitted through direct contact with a sick person’s skin or mucous membrane lesions, as well as through drops (saliva, sneezing, saliva, etc.). Sexual intercourse, with or without penetration, meets these conditions for contamination and increases the risk of exposure to the virus with multiple partners.
Contamination can also occur through contact with the patient’s environment (bed, clothing, dishes, bath linen, etc.). It is therefore important that patients observe isolation throughout the duration of the disease (until the last scabs disappear, often 3 weeks).
In Central or West Africa, humans can also be infected through contact with animals, wild or captive, dead or alive, such as rats or monkeys.
Infection with the monkeypox virus is not known as an STI, but direct contact with damaged skin during sexual intercourse facilitates infection.
What are the symptoms?
Infection with the monkeypox virus can result in blisters, which are formed with liquid-filled blisters that dry out, crust, and then stain. May cause itching. Vesicles are more concentrated on the face, in the anogenital region, the palms of the hands and the soles of the feet, may be present but may also be present in the trunk and limbs. The mucous membranes of the mouth and genitals are also affected. These rashes can be accompanied by fever, headache, body aches and athenia. Lymph nodes can be swollen and painful under the jaw, neck or groin. Sore throat has also been reported.
Incubation of the disease can last from 5 to 21 days. The fever phase lasts about 1 to 3 days. The disease often heals spontaneously, 2 to 3 weeks later but sometimes 4 weeks.
Chickenpox is serious?
The disease is more deadly in children and immunocompromised people. It can be complicated by superinfection of skin lesions or by respiratory, digestive, ophthalmic or neurological diseases.
At this stage, the cases reported in Europe are mostly mild, and no deaths have been reported.