Monkeypox, for which the WHO today declared an international emergency, is a poxvirus (monkeypox virus, MPXV) similar to the now extinct human smallpox virus, which infects monkeys. The first case of human transmission was reported in 1970. In June alone, there were 567 infections on the African continent with a dangerous increase in cases among children, including newborns. The number of cases reported so far this year has already surpassed last year’s total, with over 14,000 cases and 524 deaths.
The symptoms, according to institutional health sites, include fever, headache, muscle aches, back pain and painful lymph nodes, followed later by the appearance of skin pustules on the face and then generalizedThe disease is known as monkeypox but is scientifically defined as mpox, also to avoid the stigma of this definition.
The cases in Italy
The cases currently described in Italy were not serious but required clinical monitoring. In the last 2 months in Italy, according to the latest bulletin from the Ministry of Health, 9 new cases have occurred: 2 in Friuli Venezia Giulia, 1 in Lombardy and 6 in Veneto. Since May 2022, when the first case of infection was found in Italy, 1,056 infections have been confirmed in our country, 262 of which were linked to travel abroad.
Almost half of the cases (441) were recorded in Lombardy. Lazio (169) and Emilia Romagna (97) follow. As in the rest of the world, the vast majority of infections (1,040) involved males. The median age is 37, with a range from 14 to 71.
The contagion
Transmission occurs through direct contact with body fluids, such as blood, respiratory droplets, saliva, genital secretions, exudate from skin lesions, and crust. The greatest spread appears to occur during sexual intercourse between males.
The diagnosis
The diagnosis of human monkeypox is mainly clinical, based on the evaluation of symptoms. The diagnosis must be confirmed by other tests, such as the detection of specific viral DNA by C-reactive protein (PCR). The clinical picture of human MPXV – after an incubation period of 7 to 17 days – begins with fever, headache, muscle pain, back pain and lymphadenopathy, followed later by well-circumscribed but widespread rashes over the body, with a typical centrifugal onset, which evolve into successive phases: macular, papular, vesicular and pustular. A second febrile period occurs when the lesions become pustular and is often associated with a worsening of the patient’s condition.
The vaccine
Vaccination against smallpox offers some protection, with complications occurring more frequently among the unvaccinated (74%) than among the vaccinated (39.5%). Rare complications include: bronchopneumonia, shock secondary to diarrhea and vomiting, corneal scarring that can lead to permanent blindness, encephalitis especially in patients with secondary bacterial infection, and septicemia, with scarring of the skin as a long-term sequela