Monkey pox, a health threat for Europe

Monkey pox was previously confined to around ten African countries. But more than 3,000 cases have been recorded in Europe and the Americas since the spring. The World Health Organization on Friday called for a “urgent action” in the face of the tripling of cases observed for two weeks on the European continent.

In a statement, the regional director of the health organization called on European countries to “increase their efforts in the coming weeks and months to prevent monkeypox from taking hold in a larger geographic area”. “Urgent and coordinated action is imperative if we are to change course in the race against the spread of the disease”says the director of WHO Europe, Hans Kluge.

According to data from the UN agency, Europe now has more than 4,500 laboratory-confirmed cases, three times more than in mid-June. This corresponds to 90% of the cases recorded in the world since mid-May, when this disease until then endemic only in ten African countries began to multiply in Europe.

Health threat

Known in humans since 1970, monkeypox is considered much less dangerous and contagious than its cousin, smallpox, eradicated in 1980. An unusual upsurge in cases has been detected since May outside African countries central and western regions where the virus usually circulates.

WHO experts consider the outbreak of cases as a health threat whose evolution was very worrying, but without reaching the stage of a global health emergency for the moment. Despite this decision, “the rapid evolution and the urgent nature of this event means that the committee (of experts) will reconsider its position shortly”says WHO Europe.

New symptoms

Epicenter of this new contagion, Europe now has 31 countries or territories that have reported cases of monkeypox. In this context, the first British patients with monkeypox show symptoms different from those usually spotted in African countries, where this condition was previously limited, shows a study published on Saturday in the Lancet Infectious Diseases. While a fever attack was considered almost systematic in monkeypox, just over half of the patients studied in the United Kingdom had it.

Carried out on about fifty patients, this work, still limited, is one of the first to characterize the clinical specificities of the current epidemic of monkeypox. The United Kingdom is one of the first countries where cases have been reported this year, hence the interest of this work based on observations made at the end of May, when only a hundred British patients had been registered.

Fewer hospitalizations

The sample therefore corresponds to more than half of the known patients in the country at the time. And, among them, the monkeypox manifested itself distinctly differently from what was known in Africa. Not only are bouts of fever less frequent, but they also appear much shorter and require far fewer hospitalizations.

As for the typical lesions of the disease, they are most often concentrated around the genitals. In the previous cases, they were generally larger, reaching for example the face or the nape of the neck.

Skin bond

For the authors of the study, this specificity suggests that the first British cases were contaminated by contact during sexual relations. This hypothesis, to be clearly distinguished from the idea that the disease has become sexually transmitted, corresponds to the well-established notion that contamination is possible by touching a skin lesion in another patient.

The majority of European and American cases have so far been recorded in men who have had homosexual relations, but they are not the only ones concerned.

Redefining disease

More broadly, the authors of the study consider that their observations plead to broaden the definition of the disease in order to better detect new cases, without for example insisting so much on a fever. However, these different symptoms do not mean that the current epidemic is due to a new version of the virus, as other researchers point out.

“There is no major genetic modification” in sequenced viruses in current patients, noted pulmonologist Hugh Adler to AFP. He argues that in Africa, many cases, without fever or with limited lesions, may have gone undetected, biasing comparisons.


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