32 cases in Portugal, Spain put Europe on alert for monkeypox

Officials in Spain and Portugal announced on Wednesday that they have detected around 32 suspected cases of monkeypox, days after the UK reported new cases that have triggered concerns that there may be an undetected transmission in parts of Europe.

Monkeypox is a virus that often infects people in DR Congo, Nigeria and other parts central and West Africa, leading to an eruption of lesions and other symptoms in an illness that can last 2-4 weeks. The disease is not particularly deadly, but is estimated to have a fatality rate of up to 10%. In all, Portugal had five confirmed and 20 suspected cases, Spain eight suspected cases and UK seven confirmed infections as on Wednesday.

The World Health Organization said Tuesday it was coordinating with UK, where cases have been found in those without a travel history to Africa, to investigate the outbreak. The virus typically has an incubation period of 6-13 days and leads to fever, headache, muscle aches, backache, swollen lymph nodes, a general feeling of discomfort, exhaustion, and rash.

Unusual spread

The UK Health Security Agency (UKHSA) said on Monday it detected four new cases after registering three cases earlier in May. Health officials noted some of the UK infections may be through sexual contact, which would be a new development in understanding transmission of the virus.The disease is not sexually transmitted per se, but infection can occur due to respiratory droplets, contact with lesions or a person’s clothing.

A US Centers for Disease Control (CDC) official said in a new media report that the spread needs to be watched. “We do have a level of concern that this is very different than what we typically think of from monkeypox. And I think we have some concern that there could be spread outside the UK associated with this,” Jennifer McQuiston, a senior CDC official, told STAT News in an interview.

Risks and precautions

A monkeypox infection is mostly serious for younger age group, according to a WHO information sheet. The US CDC in its own assessment notes that there are vaccines that work. “Because monkeypox virus is closely related to the virus that causes smallpox, the smallpox vaccine can protect people from getting monkeypox. Past data from Africa suggests that the smallpox vaccine is at least 85% effective in preventing monkeypox,” the CDC says.

The agency recommends the vaccine be given within 4 days from the date of exposure in order to prevent onset of the disease and, if given between 4-14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.

To avoid the virus, much of the same precautions as those for Covid-19 will work – especially avoiding close contact.