Health launches an alert after eight patients suspected of having monkeypox were detected in Madrid

Health alert in Spain due to the detection of eight suspected cases of monkeypox, a zoonotic infection that can spread to humans and is endemic to Africa. Patients with compatible symptoms have been located in Madrid and are pending confirmation by genetic tests, according to El País and has confirmed the Ministry of Health. "They are progressing well, although the disease may require hospital admission," reports the Ministry of Health of the Community of Madrid.

The voice of alarm was launched this Tuesday after three cases were confirmed in Portugal, by PCR, in addition to two pending confirmation and 15 under investigation in the neighboring country. The United Kingdom was the territory that warned of the first case in Europe and later confirmed the existence of an outbreak that already affects seven people. Four of them have no travel history to a risk area, according to Health.

Smallpox is a totally eradicated disease, but not the so-called monkeypox. It is an orthopoxvirus similar to Variola virus (the causative agent of smallpox) that can jump from rodents that act as a natural reservoir to humans. The virus is endemic to the African continent, but the disease it causes is very rare in Europe. The documented cases to date outside Africa, since the first in the world was located in 1970 in the Democratic Republic of the Congo, have been associated with imported cases or in contact with imported animals, according to the Ministry of Health.

The United Kingdom Health Security Agency (UKHSA) confirmed the first case of monkeypox on May 7 in London. The patient had a recent travel history from Nigeria, where it is suspected that he contracted the infection before traveling to the UK. It has not been possible to trace an epidemiological link between most of the cases: on May 14 two more (cohabitants) were confirmed and another four on May 16, which suggests that there are several transmission chains that are not identified.

The symptoms

The symptoms in humans are similar to those of smallpox, but are characterized above all by a striking skin rash (called a vesicular exanthema), as well as fever, headache, muscle aches, lymphadenopathy and fatigue. “It usually produces a self-limited illness and most people recover in several weeks. However, in some cases a serious illness can occur, ”reports the Ministry of Health, which also explains that there is no vaccine or specific treatment available, beyond the symptomatic one. “Person-to-person transmission is limited, in general,” adds the team led by Minister Carolina Darias in an informative note.

The Health alert also marks that one of the following three criteria is met: that he has had contact with a diagnosed case in the previous 21 days, is "a man who has sex with men" or has traveled to "West Africa or center in the 21 days prior to the onset of symptoms”, according to El País. The eight suspected cases in Madrid are men who have relationships with men, confirms the Community of Madrid.

The illness usually lasts 2 to 4 weeks, and transmission is thought to be through saliva or respiratory excretions, or by contact with exudate from the lesion or crusting material. Viral excretion through faeces may also represent another source of exposure, as explained by the professor of Microbiology Raúl Rivas González in The Conversation. The incubation period for monkeypox is usually 7 to 14 days, but can be as short as 5 and as long as 21 days.

The first known human case was reported in August 1970 in Bokenda, a village in the equatorial province of the Democratic Republic of the Congo. It was a nine-month-old boy. As a precedent, the United States recorded an outbreak in 2003 with more than 30 affected. The origin was in the importation of a shipment of animals, exotic rodents, from Ghana to Texas.

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