Monkey pox, or Monkeypox, arrived in Europe at the end of spring. The World Health Organization has already identified more than 18,000 cases worldwide. In France, as of August 18, 2,889 cases had been recorded. Decryption of this new epidemic with Christine Jacomet, doctor in the infectious and tropical diseases department of the Clermont-Ferrand University Hospital and president of Corevih Auvergne Loire (Regional coordination for the fight against HIV and STIs).
Are there cases in Clermont-Ferrand?
” Yes. Every day since mid-July, we have seen a few patients who test positive. So far, no one has been hospitalized due to complications. According to the questionnaires they fill out, the patients were infected outside Clermont-Ferrand. So far there doesn’t seem to be a cluster here. There was also a case in Puy-en-Velay and a few cases in Moulins. But not a lot. »
What are the symptoms of this virus?
“It is above all about painful pimples. People are usually very distraught with pain. We are also struck by very painful angina and lesions in the sexual organs, which are often accompanied by very significant rectal and pelvic pain. »
Christine Jacomet, doctor in the infectious and tropical diseases department of Clermont-Ferrand University Hospital, sees cases of Monkeypox every day. Photo Johan Maviert.
Are there any risks of complications?
“Sometimes the pain is so strong that patients have to be hospitalized to put in place a strong analgesic treatment to prevent them from suffering at home. It can also be the lesions that become infected. If the complications go even further, we can deliver an antiviral treatment, which has not yet needed to be given here. »
“Monkeypox, in the current epidemic, can be considered as a virus responsible for a sexually transmitted infection. »
What are the modes of transmission?
“Contaminations mainly occur during sexual intercourse. However, it can also be transmitted through non-sexual contact. We see intra-family contamination, and/or via interposed objects, such as toilets, bathroom objects or the bedroom via sheets. So it’s an STI, but it’s not just that. »
Who are the people at risk?
“Today it is about people who have frequent and numerous sexual relations. These include men who have sex with men, multi-partner trans people, and sex workers. But the virus can be transmitted to everyone, it is not “reserved” for a particular group of people. It does not target a specific community. »
What to do to guard against it?
“First, those diagnosed must self-isolate for 21 days. They are prescribed painkillers and rest. Then, concerning people who are in contact and at risk, they are called upon to be vaccinated without delay. It is a smallpox vaccine that we already know. It is 85% effective against the strain of monkeypox. Over time, we see an increase in the number of people who feel concerned. But there is also social prevention. If we know we are taking risks, we limit them to reduce the risk of possible spread of the virus. It’s good civic sense, without being stigmatizing. »
“In Puy-de-Dôme, more than 300 people were vaccinated at Cegidd in Clermont-Ferrand as part of a medical prevention approach. »
Are you worried about being overwhelmed?
“We are only at the very beginning of the epidemic in Europe, we do not yet know the extent that Monkeypox can have. If we do not manage to vaccinate all those at risk, there could be a spread of the infection, including in the general population. It is therefore urgent to set up a prevention course. What all the Cegidds in our area are doing is a good thing. It also seems important to us to inform the general population precisely so that everyone can reflect on their possible risky behaviour. »
What are the issues for you when patients come to see you?
“With the Covid-19 pandemic, STI screenings have decreased. During the last two years, we have seen an 18% decrease in screenings. This new epidemic encourages us to reformulate a prevention course with the detection of other STIs, such as HIV or syphilis, and to take care of patients if necessary. If we observe that some people are very at risk, we can offer them HIV prevention (Prep) and increase the frequency of their screening. »
Do you have the feeling of reliving the 1980s with the appearance of the AIDS virus?
“I was present in university hospitals in the 1980s and 1990s. The mortality of hospitalized HIV-positive patients was close to 100%. Without antiretroviral drugs, a person with AIDS survived for three years. It was an epidemic with devastating social, human and emotional consequences. There, of course, it is a new disease, but the clinical impact, for the moment, of what we know, is relatively limited. After the symptoms, the patients are cured. But these recurring and approaching epidemics surely mean something about our society. These are zoonoses at the start, that is to say diseases that only affected animals before. Today, they affect humans. This implies that there is a very close contact between man and animal. The fault is probably deforestation and the ecosystems that have been completely disrupted. »
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