In a circular the recommendations on the health treatment to be guaranteed to suspected or probable cases before they are confirmed. The first report on May 7 in the UK
Isolate the patient, if possible also in his home. Monitor close contacts. Protect healthcare personnel who come into contact with one of them. The circular from the Ministry of Health, signed by the Director of Prevention, Giovanni Rezza, sent today to health departments, municipalities, scientific associations, doctors’ associations, it reports the update on the “epidemiological situation and indications for reporting, contact tracing and case management” of monkeypox. For extreme caution, positive contacts should not “donate blood, cells, tissues, organs, breast milk, sperm while under surveillance.”
The lesson of the pandemic
Six episodes of this disease have been ascertained in Italy and are transmitted between individuals between whom there is a very close relationship (in the United Kingdom there are also outbreaks within the same family). The last was reported in Lombardy. It is not an alarm situation, yet there is a high level of monitoring internationally. The pandemic due to the appearance of the Sars-CoV-2 virus has convinced all countries of the need to keep all atypical phenomena under observation (recent peak of children affected by hepatitis of unknown origin not caused by hepatitis virus). For suspected case of monkeypox, a person of any age is considered to have an acute rash of unknown cause in a country where the disease is not endemic (its natural “cradle” is West and Central Africa) .
Travel to endemic areas
Symptoms are headache, fever above 38.5 degrees, swollen lymph nodes, myalgia, back pain, asthenia . “There is no need to wait for laboratory results if you have a picture of monkeypox”, which rule out common causes (eg bacterial skin infections, herpes, syphilis or allergic reaction). On the other hand, it is probable a case in which contact is found with an individual who has already manifested symptoms or who declares “of having traveled to an endemic country in the previous 21 dayshas had multiple or anonymous sexual partners of the same period ».
The suspected patient or whose diagnosis is confirmed must be immediately isolated in a room with adequate ventilation, dedicated bathroom and staff. Between patients, if it is not possible to accommodate them in single rooms, they must be spaced one meter apart. Mask recommended. Home management is also envisaged “in isolation from cohabitants”. Then vaccination: «it can be considered for contacts at higher risk such as health workers» (the reference is the specific vaccine against this type of smallpox) which requires very careful use.
The first report of Monkeypox (transmitted to humans as well as by primates by the bite of small rodents in countries where it is endemic and which can be transmitted among infected individuals through skin lesions, breath, exchange of body fluids) is dated 7 May 2022 when the UK warned it had found the virus in a man from Nigeria. And then Other reports followed from Portugal, Spain, Belgium, Germany, France, Italy, Sweden, the Netherlands and Austria. No deaths. The ministry clarifies that “in the current outbreak the nature of the injuries suggests that the transmission occurred during sexual intercourse. Infection through contact with intact skin is less likely ». Positive contacts are observed in isolation for 21 days.
What about pets? The risk of contracting the virus from rodents (especially squirrels) is theoretically possible, suspicion cannot be completely ruled out. Here is where the knowledge is: “Little is known about the suitability of European peri-domestic animal species to act as hosts of the virus. Such a spill over event could lead the virus to settle in European wildlife and the disease to become an endemic zoonosis ».
May 25, 2022 (change May 25, 2022 | 18:58)
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