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2022–2023 mpox outbreak in Brazil

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2022–2023 mpox outbreak in Brazil
Confirmed cases by state.
DiseaseMpox
Virus strainMonkeypox virus (West African clade)
LocationBrazil
Index caseSão Paulo, Brazil
Date20 May 2022 – ongoing (2 years, 5 months, and 10 days)
Confirmed cases5,525 (as of 10 September 2022)
Suspected cases6
Deaths
2
Government website
(Brazil)
Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The 2022–2023 mpox outbreak in Brazil is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was first reported in Brazil on 9 June 2022 when a man in São Paulo was registered as the country's index case.[1]

Background

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Mpox (/ˈɛmpɒks/, EM-poks; formerly known as monkeypox)[2] is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most infected individuals recover within a few weeks without treatment. The time from exposure to the onset of symptoms ranges from three to seventeen days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.[3][4][5]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus. The variola virus, which causes smallpox, is also in this genus.[6] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[6] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[3] The virus may spread from infected animals through handling infected meat or via bites or scratches.[3] Diagnosis can be confirmed by polymerase chain reaction (PCR) testing a lesion for the virus's DNA.[6]

Vaccination is recommended for those at high risk of infection.[6] No vaccine has been developed specifically against mpox, but smallpox vaccines have been found to be effective.[7] There is no specific treatment for the disease, so the aim of treatment is to manage the symptoms and prevent complications.[6][8] Antiviral drugs such as tecovirimat can be used to treat mpox,[6] although their effectiveness has not been proved.[9]

In May 2022, the World Health Organization (WHO) made an emergency announcement of the existence of a multi-country outbreak of mpox, a viral disease then commonly known as "monkeypox".[10] The initial cluster of cases was found in the United Kingdom,[11] where the first case was detected in London on 6 May 2022[12] in a patient with a recent travel history from Nigeria where the disease has been endemic.[13] On 16 May, the UK Health Security Agency (UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic.[12] Subsequently, cases have been reported from many countries and regions.[14] The outbreak marked the first time mpox had spread widely outside Central and West Africa. The disease had been circulating and evolving in human hosts over several years before the outbreak and was caused by the clade IIb variant of the virus.[15]

On 23 July 2022, the Director-General of WHO, Tedros Adhanom Ghebreyesus, declared the outbreak a public health emergency of international concern (PHEIC), stating that "we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little".[16] A global response to the outbreak included public awareness campaigns in order to reduce spread of the disease, and repurposing of smallpox vaccines.[17][18]

Transmission

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Stages of lesion development.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[19]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[20]

Timeline

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Three suspected mpox cases were reported in Brazil on 30 May 2022.[21] On 9 June, a 41-year-old man, who had recently travelled to Spain and Portugal and had been admitted to a São Paulo hospital, tested positive for the virus.[1]

On 29 July, the first death was reported outside of Endemic african countries[22] and the country's first mpox cases in children were confirmed in three kids from São Paulo city.[23]

Statistics

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Cumulative cases

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Total confirmed cases

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Total confirmed Deaths

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See also

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Notes

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References

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  1. ^ a b "Man in Sao Paulo hospital with Brazil's first monkeypox case -officials". Reuters. 9 June 2022. Retrieved 26 July 2022.
  2. ^ "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). 28 November 2022. Archived from the original on 1 December 2022. Retrieved 29 November 2022.
  3. ^ a b c "Mpox". World Health Organization (WHO). 17 August 2024. Archived from the original on 19 August 2024. Retrieved 22 August 2024.
  4. ^ "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  5. ^ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). 15 March 2024. Archived from the original on 2 April 2024. Retrieved 22 August 2024.
  6. ^ a b c d e f "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  7. ^ Christodoulidou MM, Mabbott NA (1 January 2023). "Efficacy of smallpox vaccines against Mpox infections in humans". Immunotherapy Advances. 3 (1): ltad020. doi:10.1093/immadv/ltad020. PMC 10598838. PMID 37886620.
  8. ^ "Mpox (formerly Monkeypox)". NIH: National Institute of Allergy and Infectious Diseases. 6 December 2022. Archived from the original on 23 May 2023. Retrieved 24 May 2023.
  9. ^ "Patient's Guide to Mpox Treatment with Tecovirimat (TPOXX)". U.S. Centers for Disease Control and Prevention (CDC). 28 November 2022. Archived from the original on 24 May 2023. Retrieved 24 May 2023.
  10. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. 21 May 2022. Archived from the original on 22 May 2022. Retrieved 25 May 2022.
  11. ^ "So, Have You Heard About Monkeypox?". The Atlantic. 19 May 2022. Archived from the original on 23 June 2022. Retrieved 2 June 2022.
  12. ^ a b "Monkeypox cases confirmed in England – latest updates". GOV.UK. 6 September 2022. Archived from the original on 16 May 2022. Retrieved 25 September 2022.
  13. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  14. ^ "2022 Mpox Outbreak Global Map | Mpox | Poxvirus | CDC". www.cdc.gov. 12 September 2023. Archived from the original on 1 December 2023. Retrieved 1 December 2023.
  15. ^ Sample, Ian (2 November 2023). "Mpox circulated for five years before global explosion in 2022, research finds". The Guardian. ISSN 0261-3077. Archived from the original on 1 July 2024. Retrieved 1 December 2023.
  16. ^ "WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern". World Health Organization (WHO). 23 July 2022. Archived from the original on 25 July 2022. Retrieved 4 August 2022.
  17. ^ "Monkeypox – Campaign details". Department of Health and Social Care – Campaign Resource Centre. Archived from the original on 28 May 2023. Retrieved 28 May 2023.
  18. ^ "Protecting you from mpox (monkeypox): information on the smallpox vaccination". GOV.UK. Archived from the original on 28 May 2023. Retrieved 28 May 2023.
  19. ^ Vargas, Ramon Antonio (7 June 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 9 June 2022.
  20. ^ "Monkeypox update: Where the outbreak stands now".
  21. ^ "Brazil monitors three suspected cases of monkeypox". Agência Brasil. 1 June 2022. Retrieved 26 July 2022.
  22. ^ "Ministerio da saúde confirma 1 morte por variola dos macacos no brasil". G1 (in Portuguese). 29 July 2022. Retrieved 29 July 2022.
  23. ^ "Varíola dos macacos: Brasil registra três primeiros casos em crianças". archive.ph. 29 July 2022. Archived from the original on 29 July 2022. Retrieved 29 July 2022.{{cite web}}: CS1 maint: bot: original URL status unknown (link)