Epidemiologist clarifies 9 myths and truths

Understand monkeypox in Brazil

Photo: Shutterstock / Saúde em Dia

A monkey pox it’s an infectious disease that quickly took over the news and put everyone on high alert. After all, we are not yet out of the Covid-19 pandemic and a new threat to global public health would be a real tragedy for society. But so far, this virus has yet to show signs of being as dangerous as the coronavirus.

Despite this, monkeypox in Brazil continues to expand. In all, there are at least 17 confirmed cases of the disease in the country. A fact that keeps that alert from the beginning on and that generates numerous doubts in people.

Therefore, to clarify everything about monkeypox in Brazil and in the world, the epidemiologist, Dr. André Ribas, who specializes in epidemiology at the Faculty of Medicine at UNICAMP and a professor at the Faculty of Medicine São Leopoldo Mandic in Campinas, separated nine myths and truths about the disease. Check out:

1 – The disease is only transmitted through contact with monkeys. Myth

The first issue to be clarified is that, despite the name, it is not transmitted, in general, from apes to humans. The main reservoir of this type of smallpox is believed to be African rodents. They call it “monkey pox” because the virus was first identified in an outbreak in a monkey cage, which was used for research. But apes are probably not nature’s main reservoirs.

2 – The current outbreak is a mutation of the virus. Myth

What motivated the current outbreak is not yet fully explained. There is a possibility that there was an increase in transmission capacity. Another hypothesis is that it was a consequence of an atypical super scattering event. There were some parties in Europe, which may have generated an event where the virus spread a lot. What we are seeing is a consequence of this wave of transmission and it is now up to us to see whether or not the outbreak will evolve.

3 – Skin lesions go away after healing. Truth

The injury itself disappears. The person stops transmitting the disease when the last crusts fall off and, in this way, what remains is the scar. The lesion can form keloids (a scar that sticks out). A lot depends on the severity of the clinical form, but there are some cases published in Europe where the lesions are not so serious. In general, they are small and localized lesions. The severity of wound sequelae will depend on the degree to which the wounds spread during the active phase of the disease.

4-Prevention measures are the same as Covid-19. Myth

Preventive measures against monkeypox involve reducing contact with people with the sores or in the prodromal phase, when you begin to feel the symptoms of the disease, such as fever and myalgia (muscle pain). Smallpox is not transmitted as easily as it is with Covid-19. It is important to differentiate one thing from the other. In Covid-19, the mask is important, as transmission occurs through respiratory droplets relatively easily. In smallpox, transmission occurs mainly when there is a more intimate and prolonged contact.

5 – The risk of transmission increases when there is close contact. Truth

Transmission occurs through more prolonged contact, especially in household contacts, sexual contacts, and more intimate contacts. There is indeed respiratory transmission in smallpox, but it is not as easy a transmission as Covid-19. So, it is not recommended, for example, to use a mask indiscriminately to control the disease. Now, anyone who takes care of a smallpox patient must wear a mask. The healthcare team needs to use the same protections that are adopted in the care of the patient with Covid-19.

6 – The pregnant woman can transmit smallpox from monkeys to the fetus. Truth

In pregnant women, transmission is dangerous. There is a risk of transmission to the fetus and this could result in miscarriage or the baby could be born with the lesions and this could result in premature death. Congenital malformations such as the Zika Virus, for example, have not been described, but the child suffers consequences.

7 – The incubation period of the disease is short. Myth

The incubation period can be from 5 to 21 days, but there are also cases where it is longer, reaching up to 30 days of incubation, which makes tracking very difficult, as the person may have had contact and develop the disease quite a bit. time after.

8 – The fatality rate is low. Truth

According to data from the WHO (World Health Organization), the lethality in Nigeria is around 3% – where the same European lineage is registered, which is spreading in several countries. The Central African Republic lineage has a higher lethality, reaching 10%. In the current outbreak, there has been no death in Europe yet, perhaps because it is just beginning. However, we also do not know whether the 3% fatality rate is also related to the quality of care in Nigeria.

9 – The complications of the disease involve secondary infections. Myth

The possible complications of the disease are encephalitis (inflammation in the brain), respiratory infections, skin infections, among others. In Africa, there is a relevant problem with skin infections in young children that, if not treated properly, can kill, as it is a gateway for various pathogens.