The monkeypox virus was first discovered in 1958, and the zoonosis spreading to humans was first documented in 1970. Prof. Stephan Ludwig is head of the Institute of Virology at the WWU and the UKM (Münster University Hospital) and coordinates the National Research Platform for Zoonoses at his institute - so he is very familiar with pathogens that actually originated in animals.
Prof. Ludwig, what exactly is a zoonosis?
A zoonosis is an infectious disease in which a pathogen jumps from animals to humans or vice versa. It's actually an accident in the evolution of viruses that they suddenly attack a new host species. Unfortunately, this also means that there is usually no good protection against infection because the person has not yet come into contact with the pathogen or been vaccinated against it.
Do virologists have any ideas as to why so many new cases are now occurring worldwide?
No. There are many assumptions, but they have not yet been scientifically tested. One assumption is the adaptation of the virus . Viruses change, even if a smallpox virus is genetically more stable than, for example, a corona or flu virus. There may have been a change in the monkeypox virus that suddenly made people more susceptible to these viruses. That's why it's important that we isolate infected people, especially from animals, so that people don't pass the virus back to another animal species. That would indeed be a transmission that could prove dangerous.
What is the transmission route?
So the original transmission of the virus from animals to humans probably came through close contact with animals or possibly through animal bites. At the moment there is human-to-human transmission. It is known that it happens through bodily fluids and through close contact between people. As far as we know so far, it is not an aerosol-transmissible pathogen. Droplet infections are rare and happen when pustules form in the mouth and the viruses are then in the sputum (saliva). I think it is important to say that it is absolutely not appropriate to reduce the transmissibility of the virus only to men who have sexual intercourse with other men. As with the first AIDS infections in the 1980s, it can affect anyone and everyone.
How do I know that I am infected?
The infection manifests itself through classic cold symptoms such as fever, headache and body aches. What is specific, however, is the appearance of lesions on the skin, i.e. pustules. Above all, we should now sensitize our doctors so that they can put such findings into context and then have patients tested infection As a rule, the course of the infection is mild. However, there are also more severe cases, especially in immunocompromised people. A serious complication that may well lead to death can also be a bacterial co-infection or even bacterial sepsis , which develops when the pustules open and become infected.
Do patients have to be isolated?
Yes, as long as you have symptoms you are contagious, which is usually between two and four weeks. However, it is different than Corona because the virus cannot be transmitted via aerosols in the air. But direct contact with the pustules and body fluids of infected people must be avoided.
Are there any medications for monkeypox?
There is indeed a therapeutic agent - it was actually developed against the classic smallpox. This is approved in Europe and could be used off-label in cases of infection as an individual attempt at healing. But we first have to see how this really works in the clinic.
People over 50 have often received a smallpox vaccination . Does it protect?
That seems to be the case. There are figures that show that the protective effect in the older population could be up to 85 percent. Similar to the corona virus, this does not mean that older people cannot become infected with the virus. However, severe cases would be unlikely. A vaccine against smallpox is approved in the EU - here too, similar to the medication, one could try off-label use against monkeypox. In Great Britain, the step has currently been taken to offer the vaccination to certain risk target groups as a precautionary measure.
From a virological perspective, would you recommend vaccination?
It's still too early to say anything about it. This new spread across four continents at the same time is unusual and we must monitor it. The numbers are still small, but they will certainly increase. We have to monitor this and if the whole thing picks up speed, then we would have to think about recommending vaccinations for vulnerable groups.
Source: Deutsches-Gesundheitsportal.de
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