More deaths likely due to monkeypox: WHO

Geneva/London: Amid four deaths due to monkeypox outside Africa, including India, the World Health Organization (WHO) has said that the infectious disease is likely to lead to more fatalities. “With the continued spread of monkeypox, we will expect to see more deaths,” Catherine Smallwood, Senior Emergency Officer at WHO Europe, said in a statement. Smallwood […]

Geneva/London: Amid four deaths due to monkeypox outside Africa, including India, the World Health Organization (WHO) has said that the infectious disease is likely to lead to more fatalities. “With the continued spread of monkeypox, we will expect to see more deaths,” Catherine Smallwood, Senior Emergency Officer at WHO Europe, said in a statement. Smallwood emphasised that the goal needs to be “interrupting transmission quickly and stopping this outbreak”. However, Smallwood stressed that in most cases the disease heals itself without the need for treatment.

The latest monkeypox outbreak which was first reported in May, has since spread to 78 countries with more than 18,000 cases, according to the WHO’s last update on July 28. At the time, five monkeypox-related deaths were reported in Africa. Last week, two deaths were reported from Spain and one each from Brazil and India. A 22-year-old youth, from Kerala died on Saturday reportedly due to monkeypox.

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According to media reports, he returned to the State on July 21 from the UAE and was admitted to a private hospital on July 27 after developing encephalitis and fever. His lymph nodes were also swollen. “Time for us all to act,” Smallwood said earlier on Twitter, adding that people “who are most likely to be exposed to #monkeypox need to act to reduce their exposures”. She also stressed the need to make “testing, healthcare & vaccination easy & quick. Cannot let #Covid19 fatigue hold us back!”

Symptoms

People infected with monkeypox during the ongoing global outbreak are displaying symptoms not typically associated with the viral infection, according to a study published in the British Medical Journal. The findings are based on 197 confirmed monkeypox cases at an infectious disease centre in London, UK, between May and July 2022. Some of the common symptoms they described include rectal pain and penile swelling (oedema), which differ from those described in previous outbreaks, the researchers said.

They recommend that clinicians consider monkeypox infection in patients presenting with these symptoms. According to the researchers, those with confirmed monkeypox infection with extensive penile lesions or severe rectal pain “should be considered for ongoing review or inpatient management.” All 197 participants in the study were men (average age 38 years), of whom 196 identified as gay, bisexual, or other men who have sex with men. All patients presented with lesions on their skin or mucosal membranes, most commonly on the genitals or in the perianal area.

Most (86 per cent) of patients reported systemic illness (affecting the entire body). The most common systemic symptoms were fever (62 per cent), swollen lymph nodes (58 per cent), and muscle aches and pain (32 per cent). In contrast with existing case reports suggesting that systemic symptoms precede skin lesions, 38 per cent of patients developed systemic symptoms after the onset of mucocutaneous lesions, while 14 per cent presented with lesions without systemic features.

A total of 71 patients reported rectal pain, 33 sore throat, and 31 penile oedema, while 27 had oral lesions, 22 had a solitary lesion, and 9 had swollen tonsils.

The researchers noted that solitary lesions and swollen tonsils were not previously known to be typical features of monkeypox infection, and could be mistaken for other conditions. Just over a third (36 per cent) of participants also had HIV infection and 32 per cent of those screened for sexually transmitted infections had a sexually transmitted infection, they said.

Overall, 20 (10 per cent) of participants were admitted to the hospital for the management of symptoms, most commonly rectal pain and penile swelling. However, no deaths were reported and no patients required intensive hospital care. Only one participant had recently travelled to an endemic region, confirming ongoing transmission within the UK, and only a quarter of patients had known contact with someone with confirmed monkeypox infection, raising the possibility of transmission by people with no or very few symptoms.