Monkeypox Outbreak in Spain: High Death Rate and Impact on Infections

A year ago, monkeypox triggered health alarms. On July 29, 2022, the Valencian Community reported the first death from this disease in Spain and the next day, Andalusia reported the second death while the Ministry of Health found new outbreaks and the number of infected increased.

The World Health Organization (WHO) had declared this virus a public health emergency of international concern on July 23, the highest alert level. They were the worst moments because, in addition, the vaccines came in drops. Weeks later, on September 19, Madrid reported the third death, which would be the last in Spain.

Since then, and thanks to preventive measures and vaccination in the majority of risk groups, mpox, the new name given by the WHO to the disease, has been under control, but the data shows that Spain has been one of the countries in which this virus has impacted the most. In these 14 months, Spain has registered 7,559 cases of monkeypox, 29% of the total number of those computed in Europe (25,935) and 8.5% in the world (88,600), according to data compiled by the European Center for the Disease Prevention and Control (ECDC) and WHO. Only the United States (30,404) and Brazil (10,967) have added more infections than Spain. The mpox has also left 152 dead, seven of them in Europe.

But after the peak of July 2022, the infections entered a constant decline. Now, a year later, the horizon has radically changed. On May 10, the WHO declared the end of the monkeypox health emergency and the disease is remitting throughout the world.

Thus, in its latest bulletin, the ECDC considers that the risk of contracting the disease is “moderate” for men who have sex with men and low for the rest of the population and attributes the decrease in cases to “changes of behavior of risk groups”, the increase in group immunity due to “vaccination and natural immunity” and the decrease in large cultural and social events after the summer.

“The impact of this virus around the world has been much stronger than expected”

Raul Rivas

Microbiologist

But surveillance is increasing again with the arrival of the most propitious months for the spread of infections, and even more so after Portugal declared a major outbreak last week with 37 cases, all of them in the Lisbon region and in the valley of the Block. In fact, and although in Spain only three infections were recorded in June, the Ministry of Health has promoted vaccination to prevent the appearance of new cases. The department of José Miñones has launched the campaign «Monkey Smallpox (MPOX)? Because the virus has not gone away… Think about getting vaccinated” and keeps the vaccination centers open, spread throughout all the communities.

The documents of the Ministry of Health call for vaccination “those people susceptible to becoming infected by their unprotected sexual behaviors and practices or, after having had contact with the virus (post-exposure prophylaxis), all close contacts who have not passed the disease”.

The current pre-exposure vaccination strategy “prioritizes people who engage in unprotected sexual practices, mainly, but not exclusively, the group of gay, bisexual, and other men who have sex with men (GBHSM), especially those who have high levels of partner exchange. sexual, practice group sex and / or have recently presented sexually transmitted infections (STIs), “says the Ministry.

96% of cases

According to Health reports, 96% of the diagnosed cases have been in “men who had had sexual relations with other men”, 2.4% in “heterosexual men” and 1.4% in “heterosexual women”. The group that has registered the most infections is that of men between 31 and 44 years of age and 93% of infections have occurred through close contact in the context of high-risk sexual relations.

“The disease has behaved as we expected, with a rapid rise in infections in the first months, as a consequence of the fact that it was an unknown virus and that there were no preventive measures, and with an equally rapid decrease once control increased. and surveillance”, exposes the professor of Microbiology at the University of Salamanca Raúl Rivas, who grants a key role to the WHO for having declared mpox as an international emergency. Even so, Rivas points out that “the impact of monkeypox around the world has been much stronger than expected.” “Once again, we find ourselves with an emerging disease of zoonotic origin that has caught us off guard, which should make us aware of the importance of prevention and surveillance,” adds this expert.

2023-07-28 22:17:16
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