Researchers confirm that the main transmission of monkeypox is by skin contact

The WHO confirmed that there are already 20,000 confirmed cases of monkeypox in 78 countries around the world

Smallpox has spread rapidly throughout the world, becoming an international concern. Photo: Shutterstock.

Contact during sexual intercourse is the most likely mechanism of transmission. Cases in men who have sex with men have been described in this outbreak and are strongly associated with high-risk sexual behavior.

This was indicated by Dr. Alba Catalá, dermatologist at the Dermatology Service of the Hospital Clínic de Barcelona and lead author of the study, who highlighted that the clinical findings in this outbreak differ from previous findings and highly suggest transmission by contact and onset in the entry site. Characterizing the epidemiology of this outbreak has implications for control.

The study was coordinated by the AEDV Research Unit and published in the British Journal of Dermatology, which was a prospective cross-sectional study, in which 185 cases collected by Spanish dermatologists were analyzed.

Among the results they highlighted that the general symptoms of the monkey pox include fever and Swelling of the lymph nodes, followed by a generalized rash that progresses through four distinct stages. Although the fever and Swelling of the lymph nodes are still common in this outbreak, the research found that cases tend to have few skin lesions.

“Usually, skin symptoms appear in areas of contact during sexual intercourse. This can include lesions in the pharynx, the anal canal, the face and the fingers,” explains Dr. Catalá.

On the other hand, and contrary to what was previously described, this study shows that the possible dermatological lesions that may appear due to the disease are not pustules, but hard papules that look like pustules (pseudopustules).

“This finding is important because it makes it much easier to recognize the disease, since very few diseases produce this type of lesion,” says Petunia Clavo, a dermatologist at the Sandoval Center in Madrid, who is also the author of the study.

However, he assures that some of these papules become necrotic and can lead to genital ulcers, “making diagnosis difficult due to their similarity to other diseases.”

Other conclusions of this work reflect, although with less certainty, that neither well-controlled HIV disease nor previous smallpox vaccination (before 1972) have affected the severity of the lesions in the study patients.

In addition, according to the authors, the fact that a patient has another sexually transmitted infection (STI) does not exclude him from suffering monkey poxin the same way that patients with smallpox should be studied to rule out other sexually transmitted diseases.

Regarding the patient’s profile, the cases studied were basically made up of men who have sex with men and were associated with frequent risk behaviors for acquiring sexually transmitted diseases, although Catalá considers the probability that this will change over time.

“Epidemics often start in a specific group and then spread, but currently efforts to protect against the disease should focus on this group,” he says.

The authors of this paper have concluded that more research is needed to better understand when patients become most infectious and the precautionary advice is clear: “Although we are not sure when patients start to be infectious, avoid close contact with people who have injuries of monkey poxand checking for them before having sex can help reduce the risk of the disease.”

Source consulted here.

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