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 is being stepped up by Public Health France and information and warning messages have been sent to healthcare professionals.
The MonkeyPix incident: Update in France
As of 2:00 pm on July 12, 2022, 912 cases have been confirmed: 569 in Ile-de-France, 87 in Auvergne-Rhône-Alpes, 68 in Occitanie, 47 in New Aquitaine, 47 in Provence-Alpes, 34 in the House-de-France, 18 in the Grand Estate, 13 in Normandy, 9 in Brittany, 8 in the Center-de-de-Loire, 5 in the Pace-de-la-Loire, 3 in the Borgogne-French-less and 4 in the Unknown.
As of 12:00 noon on 11 July 2022, 824 confirmed cases living in France have been distributed according to the area of residence which has been investigated as presented in Figure 1.
Figure 1. Confirmed case of monkeypox (n = 824), by region of residence, France, May-July 2022 (data as of 07/11/2022 – 12:00 pm)
Details of 828 confirmed cases that have been investigated are given below.
Of all confirmed cases, 5 female adults and 2 children were identified.
19 to 84 years for adults (average age: 36 years).
The onset of symptoms is between May 7, 2022 and July 7, 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.
In the case of the investigation, the median time taken to use screening tests per week since the onset of the epidemic has sharply decreased, from 13 days in S18-2022 (May 2 to 8) to 4 days in S26-2022 (June 27) from July 03. ).
Figure 2. Confirmed case of monkeypox (n = 828), according to the onset of symptoms, France, May-July 2022 (data as of 07/11/2022 – 12:00 pm)
Among the cases, 81% had genito-anal rash, 73% rash on other parts of the body, 78% fever, 76% lymphadenopathy and 37% sore throat.
In cases, 40 immunocompromised; 211 HIV positive (26%). Of the HIV-free cases, 403 were prep (70%). No case has died.
To date, in France, 97% of cases for which sexual orientation has been reported have occurred in 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 it has been complained that they are unable to identify the infected person; 153 secondary cases, i.e. three weeks before the onset of symptoms, reported being in contact with a case of monkeypox.
The next update of this report will be on Wednesday, July 20, 2022.
Information and prevention action
In light of what has been observed in Europe about the 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 symptoms and what to do in case of symptoms were relayed through a digital campaign. Since June 17, the digital campaign has generated about 307,173 clicks on banners and more than 246,484 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 thanks to the association, ARS and the SexoSafe team present on the field, as part of the proud procession and where MSM meets. To date, 1,636 posters and 67,050 flyers have been ordered.
The message will be broadcast on community radio in the coming days. In the case of immunization, equipment for the field will also be made available after the July 07 opinion of the higher authority for health.
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.
MonkeyPix Information Service: A listening device for answering questions about MonkeyPix
Since Wednesday, July 13, a listening device has been open to answer questions raised by MonkeyPox. Public Health is subsidized by France and supported by the SIS Association (Sexuality Info Services Association), the “MonkeyPix Info Service” telephone line is accessible on the toll-free number 0 801 90 80 69 (free call) every day from 8am to 11pm. And services, anonymous and confidential) This device is responsible for providing prevention messages and information on protective measures, symptoms, treatment and immunizations, advising and directing towards care devices.
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 the damaged skin during sexual intercourse facilitates infection.
What are the symptoms?
Infection with the monkeypox virus can lead to blistering rashes, which are formed with fluid-filled blisters that dry out, itch, and then stain. May cause itching. Vesicles are more concentrated on the face, in the anogenital area, palms of the hands and 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, in the neck or in the folds of the 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.
Is MonkeyPix Serious?
The disease is more severe in children and immunocompromised people. It can be complicated by superinfection of skin lesions or by respiratory, digestive, ophthalmic or neurological diseases.
No deaths were reported in Europe, especially in France.