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2022–2023 mpox outbreak in Portugal

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2022–2023 mpox outbreak in Portugal
DiseaseMpox
Virus strainMonkeypox virus (West African clade)
LocationPortugal
Index caseLisbon, Portugal[1]
Arrival date18 May 2022 (2 years and 6 months ago)
DateAs of 7 July 2022[2]
Confirmed cases433[2]

The 2022–2023 mpox outbreak in Portugal is part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus. Portugal was the third country, outside of the African countries with endemic mpox, to experience an outbreak in 2022.

Background

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Mpox (/ˈɛmpɒks/, EM-poks; formerly known as monkeypox)[3] 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.[4][5][6]

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.[7] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact.[7] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed.[4] The virus may spread from infected animals through handling infected meat or via bites or scratches.[4] Diagnosis can be confirmed by polymerase chain reaction (PCR) testing a lesion for the virus's DNA.[7]

Vaccination is recommended for those at high risk of infection.[7] No vaccine has been developed specifically against mpox, but smallpox vaccines have been found to be effective.[8] There is no specific treatment for the disease, so the aim of treatment is to manage the symptoms and prevent complications.[7][9] Antiviral drugs such as tecovirimat can be used to treat mpox,[7] although their effectiveness has not been proved.[10]

An ongoing outbreak of mpox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak.[11] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[12] but it has been suggested that cases were already spreading in Europe in the previous months.[13]

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.[14]

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.[15]

History

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On 18 May 2022, Portugal reported five cases in men[16] and 15 suspected cases.[17] At the end of May, 96 people were confirmed to have mpox,[18] before the amount reached 153 after the first week of June.[19] As of 7 July, there were 433 confirmed cases in the country.[2]

See also

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Notes

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References

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  1. ^ Demoroy, Catarina (19 May 2022). "Monkeypox worries Portuguese health body but transmission risk is low". Reuters.
  2. ^ a b c "CDC Monkeypox Response Map". CDC. 25 June 2022.
  3. ^ "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.
  4. ^ a b c "Mpox". World Health Organization (WHO). 17 August 2024. Archived from the original on 19 August 2024. Retrieved 22 August 2024.
  5. ^ "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  6. ^ "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.
  7. ^ 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.
  8. ^ 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.
  9. ^ "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.
  10. ^ "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.
  11. ^ "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.
  12. ^ Pinkstone, Joe (17 May 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  13. ^ Nsofor, Ifeanyi (2 June 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved 2 June 2022.
  14. ^ Vargas, Ramon Antonio (7 June 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 9 June 2022.
  15. ^ "Monkeypox update: Where the outbreak stands now".
  16. ^ "Portugal finds 5 monkeypox cases in men as outbreak spreads". AP News. 18 May 2022. Retrieved 7 June 2022.
  17. ^ Jones, Sam (18 May 2022). "Monkeypox alert in Spain after 23 people show symptoms". The Guardian. Archived from the original on 15 June 2022. Retrieved 19 June 2022.
  18. ^ "Monkeypox cases rise in Spain to 120 and in Portugal to 96". Reuters. 30 May 2022. Archived from the original on 12 June 2022. Retrieved 19 June 2022.
  19. ^ Mazziotta, Julie (7 June 2022). "CDC Raises Monkeypox Alert to a Level 2 as Global Cases Surpass 1,000". People. Archived from the original on 18 June 2022. Retrieved 19 June 2022.