Monkeypox: what symptoms, treatments and vaccines are available

Monkeypox, for which the WHO has declared an international emergency, is a poxvirus (monkeypox virus, MPXV) similar to the missing human smallpox virus, which infects monkeys. The first case of human transmission was reported in 1970. In June alone, 567 cases were reported on the African continent, with a dangerous increase in cases among children, even infants. The number of cases reported so far this year has already surpassed last year's total of over 14,000 cases and 524 deaths.

Symptoms, institutional health sites report, include fever, headache, muscle pain, back pain and lymph node pain, followed later by the appearance of skin pustules on the face and then generalised. The disease is known as 'monkeypox' but is scientifically referred to as mpox, partly to avoid the stigma of this definition.

The cases currently described in Italy were not serious but required clinical monitoring. In the last 2 months in Italy, according to the latest Health Ministry bulletin, 9 new cases have occurred: 2 in Friuli Venezia Giulia, 1 in Lombardy and 6 in Veneto. Since May 2022, when the first case of infection was found in Italy, 1,056 infections have been confirmed in our country, 262 of which were linked to travel abroad. Almost half of the cases (441) were registered in Lombardy. This was followed by Latium (169) and Emilia Romagna (97). As in the rest of the world, the vast majority of infections (1,040) involved males. The median age is 37 years with a range of 14 to 71 years.

Transmission occurs through direct contact with body fluids, such as blood, respiratory droplets, saliva, genital secretions, exudate from skin lesions and scabs. The greatest spread seems to occur during sexual intercourse between males.

The diagnosis of human monkeypox is mainly clinical, based on the assessment of symptoms. The diagnosis must be confirmed by other tests, such as the detection of specific viral DNA by means of C-reactive protein (Pcr). The clinical picture of human MPXV - after an incubation period of 7 to 17 days - begins with fever, headache, muscle aches, backache and lymphadenopathy, followed later by well-circumscribed but diffuse rashes all over the body, with a typical centrifugal onset, which evolve in successive stages: macular, papular, vesicular and pustular. A second febrile period occurs when the lesions become pustular and is often associated with a worsening of the patient's condition.