Monkey pox epidemic: lethality in question

The laboratory of arboviruses and viral diseases of the National Center of Microbiology of the Instituto de Salud Carlos III, in Madrid, on May 27, 2022.

Three months after the first reports of monkeypox cases outside the African continent, five resulted in death in four different countries, between July 29 and August 2. If the precise causes of death have yet to be studied, certain elements have nevertheless been communicated.

In Brazil, it is a 41-year-old man suffering from “serious comorbidities” ; in Peru, an HIV-positive man who abandoned his treatment against HIV died on Monday from being infected with monkeypox. In India and Spain, three people have died with symptoms of encephalitis, an inflammation of the tissues that allow brain function. These deaths come on top of the five deaths recorded in Africa since the beginning of the year.

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The fact that these deaths occur at the same time in several places around the world is puzzling, but, given the sharp increase in the number of cases in recent weeks – there were 23,000 to 25,000 according to sources, Wednesday August 3 –, the risk of serious or even fatal cases became mathematically greater. “If cases continue to increase, it is possible that the same will happen for deaths, comments Luis Sigal, poxvirus specialist at Thomas Jefferson University in Philadelphia (Pennsylvania). The hope is that treatments, which are effective, will become more available; for this, governments will have to accelerate their availability. »

Given the cycle of the disease, whose median incubation time is seven days (but can go up to twenty days), followed by approximately three weeks of eruptions, it was also to be expected that the The most serious complications occur almost a month after the large festive gatherings held between the end of June and the beginning of July, considered by the health authorities as events with a high risk of contamination.

West African strain

“It is difficult to predict the future, but we now have a large sample size and the case fatality rate for this year is 0.05%, according to reported figures,” says Chloe Orkin, director of the Share project at Queen Mary University, London, and lead author of the largest study of the recent monkeypox outbreak published in The New England Journal of Medicine. Until then, the case fatality rate, that is to say the number of people who died among the infected population, was estimated by the World Health Organization (WHO) at between 3% and 6% for the last African epidemics. monkeypox.

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