The return of a global health emergency that was hoped to be over has drawn attention in these days of August: that of monkeypoxreopened instead by the WHO after the boom in cases of its more dangerous variant in Congo and the first cases in Europe, in Sweden And Spainand 49 in Mexico. The Italian Ministry of Health has updated its circular with the indications relating to the Mpox monkey virus. Meanwhile, WHO Europe assures that the Mpox monkey virus “it’s not the new Covid“.
Monkeypox in Italy
In the last few days The Italian Ministry of Health has strengthened the surveillance network diagnoses and announced an inter-ministerial table to deal with the spread of monkeypox, following the proclamation by the WHO of a global health emergency last August 14.
The circular states that in our country, on August 8th, no cases of clade I have been reportedthat is, the most dangerous and potentially deadly variety of monkey viruses. However, there are several cases of clade II, the least difficult to combat.
Starting from May 20, 2022 – the date of the first report of the first case of Mpox in Italy – to date a total of 1,056 confirmed casesmost of which occurred in the summer of 2022. From 1 January to 8 August 2024, 65 confirmed cases were reported by 12 regions. All cases refer to infections in 2023 and in the first months of the current year: no new cases are attributable to the month of August.
WHO Europe: “Mpox is not the new Covid”
While many have started to fear – in a rather alarmist way – the possibility of a “lockdown for monkeys”, the World Health Organization Regional Director for Europe, Hans Klugeto calm people’s spirits.
Today, we are witnessing about 100 new cases of Mpox clade II each month in Europe but “Mpox is not the ‘new Covid,’” he said (Covid cases have quintupled this summer). “Regardless of whether it is clade I of the virus, responsible for the current outbreak in central and eastern Africa, or clade II, responsible for the 2022 outbreak that initially hit Europe and has continued to circulate.”
An advantage, he explains, is also that “we know how to control Mpox and, in the European region, the steps needed to eliminate transmission altogether.” Certainly, this disease represents a “test of global equity,” and, he warns, “how we respond now and in the years to come will prove a crucial test for Europe and the world.” “We already know a lot about clade II. We still need to know more about clade I,” he clarifies. Based on what is known today.
Knowing means being able to control and therefore fight. “Two years ago,” he continues, “we controlled Mpox in Europe thanks to the direct involvement of the most affected communities, men who have sex with men. We implemented robust surveillance; we thoroughly investigated new contact cases; and we provided solid public health advice. Behavior change, non-discriminatory public health action, and vaccination have helped control the epidemic.”
But be careful not to repeat the mistakes of the past, Kluge warns. “Mpox has shown us that it can spread rapidly across the world. We can and must tackle the virus together, across all regions and continents. Will we choose to put systems in place to control and eliminate it globally? Or will we enter another cycle of panic and then neglect?”
Deputy Prime Minister Matteo Salvini himself assured “no risk of lockdown“: “No, no, no, no and no, everything is under control, no lockdown, no alarms and no fear” the minister clarified. “Maybe there is someone nostalgic for fear and closure – he added -, not me, not the League, not this government”.
What the circular from the Ministry of Health says
The Ministry’s circular refers to how the monkeypox virus is transmitted. Whether it is variant I or II, it can equally pass from person to person through close physical contact, such as sexual intercoursebut also with direct contact skin to skin with infected skin lesions, you kissbut also with the salivaThe sneezingThe sweat And linen or clothes.
THE symptoms usually appear 6-14 days (up to 21 days) after infection. It can cause fever, headache, backache and muscle pain, and in as many as 95% of cases a characteristic rash (often also with lesions in the mouth), which can spread rapidly throughout the body within 3 days of the first symptoms appearing. Only in rare cases can it be very serious.
Who should get vaccinated
As the Ministry of Health clarifies, there is a Vaccine against monkeypox, the one currently used in Italy, that is the one produced by the Danish Bavarian Nordicindicated for the prevention of “classic” smallpox in subjects aged 18 and over, at high risk of infection.
The commercial name of the product in Italy is JYNNEO (the other commercial names of the same product are IMVANEX and IMVAMUNE). The vaccine, as stated in the Ministry’s FAQs, is offered to:
- laboratory personnel with possible direct exposure to the virus
- gay, transgender, bisexual people and other men who have sex with men, who fit the following risk criteria:
– recent history (last 3 months) with multiple sexual partners
– participation in group sex events
– participation in sexual encounters in clubs/clubs/cruising/saunas
– recent sexually transmitted infection (at least one episode in the last year)
– habit of associating sexual acts with the consumption of chemical drugs (Chemsex).
Risks for travellers
The ECDC, as of 16 August 2024, has estimated that there are some Countries where the risk of contagion is highest:
- for European citizens travelling to infected areas and having close contact (healthcare workers, household contacts or other close contacts and/or multiple sexual contacts) with affected communities or permanently living in affected areas, the probability of infection with MPXV clade I is considered high. However, the impact, i.e. the estimated severity of the disease, is considered low and the overall risk moderate
- for EU citizens travelling to affected countries and who do not have close contact with the affected communities the overall risk is assessed as low
- for the general European populationin case of sporadic importations of MPXV clade I into the EU/EEA, the overall risk is currently assessed as low (very low probability of infection, provided that imported cases are diagnosed promptly and control measures are implemented, and low impact)
- for close contacts of possible or confirmed imported casesthe probability of infection with monkeypox clade I is assessed as high (but much lower for contacts who have been vaccinated or who have a history of previous infection with MPXV clade II), the impact is low and the overall risk is moderate. However, in immunocompromised persons or those who are HIV positive and not on treatment, the impact is assessed as moderate and the overall risk is high.
