On July 14, the Chinese Center for Disease Control and Prevention released the surveillance of monkeypox epidemic in June 2023, and from June 2 to June 30, 2023, 106 new confirmed cases of monkeypox were reported in Chinese mainland (excluding Hong Kong, Macao and Taiwan).
Among the 106 confirmed cases of monkeypox, 48 cases were reported in Guangdong Province, 45 cases were reported in Beijing Municipality, 8 cases were reported in Jiangsu Province, 2 cases were reported in Hubei Province, 2 cases were reported in Shandong Province and 1 case was reported in Zhejiang Province, with no severe cases or deaths.
Experts said that at present, there are monkeypox vaccines on the market abroad, domestic monkeypox vaccines are under development, there is currently no vaccine that can be used to prevent monkeypox, and the treatment is mainly symptomatic treatment to prevent secondary infections.
On July 13, the clinical trial application of replication-deficient monkeypox vaccine independently developed by the Beijing Institute of Biological Products of China Biotech was officially accepted by the Center for Drug Evaluation (CDE) of the National Medical Products Administration.
Spread mainly through this! Tips for disease control
Some people became infected by living in bed with a confirmed case
What are the main ways through which monkeypox outbreaks are transmitted? Will it cause widespread transmission?
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According to the notification of China Disease Control and Control, the epidemic situation presents the following characteristics:
First, the vast majority of cases are men who have sex with men, mainly through male sex transmission.
Second, the risk of transmission through other contact methods is low, and the vast majority of close contacts other than sexual contact have not been infected.
Third, most of the cases were found during medical visits, and a few cases were found by close contact tracing and screening.
Fourth, the clinical manifestations of most cases are typical, mainly fever, herpes, lymphadenopathy and other symptoms, and there are no severe and death cases.
Shi Guoqing, deputy director of the Health Emergency Center of the Chinese Center for Disease Control and Prevention, said that this round of monkeypox epidemic is mainly transmitted through close contact between men who have sex with men, the 106 cases reported in the mainland in June are all men, 101 cases are clearly men who have sex with men, of which 96 cases have a history of male sex 21 days before the onset, monkeypox is mainly limited to men who have sex with men and transmitted through sexual contact, compared with the transmission speed of respiratory infectious diseases such as new crown and influenza, monkeypox spread relatively slowly, However, localized clusters may occur.
According to the results of the flow of close contacts of the cases in June, there were more than 370 close contacts other than sexual contact, of which only one person was infected because he lived in the same bed as the confirmed case, indicating that the risk of transmission by other modes of contact is low.
Lu Hongzhou, president of Shenzhen Third People's Hospital and director of the National Clinical Research Center for Infectious Diseases, said that monkeypox virus enters the human body from broken skin and mucous membranes, so transmission between people is mainly through close contact. The cases reported so far are mainly transmitted through sexual behaviour, particularly men who have sex with men. However, other modes of transmission, such as respiratory droplet transmission, vertical mother-to-child transmission, and indirect contact transmission of pollutants cannot be ruled out.
The incubation period of monkeypox virus is 5-21 days, and symptoms such as chills, fever, headache, drowsiness, and fatigue occur. Patients develop a rash 1-3 days after the onset, which is more common on the face and extremities, and can also involve the oral mucosa, digestive tract, genitals, conjunctiva and cornea. After the rash has crusted off, it can range from erythema or pigmentation to scarring for years. Some patients may present with complications, including secondary bacterial infection at the lesion site, severe dehydration from vomiting and diarrhea, bronchopneumonia, encephalitis, and corneal infection.
Source: China CDC official website
Suspected and confirmed cases of monkeypox
Treatment should be isolated
The relevant person in charge of the Chinese Center for Disease Control and Prevention said that at present, suspected and confirmed cases of monkeypox in mainland China should be transferred to medical institutions for isolation and treatment in time in principle.
Shi Guoqing, deputy director of the Health Emergency Center of the Chinese Center for Disease Control and Prevention, said that the patient's clinical manifestations improved, and the lesion site scabbed over, and after evaluation, it could be transferred to home isolation treatment until the scab site naturally fell off and was released from isolation treatment. For some patients with mild disease and home isolation treatment conditions, home isolation treatment can be directly adopted after joint evaluation by clinical and disease control agencies. During home isolation, patients should live in a single room, avoid contact with family members with skin and mucous membranes, disinfect pollutants, try not to go out, if you must go out, wear long clothes and trousers, wear masks, do not go to crowded places, do not have contact with other people with skin and mucous membranes.
Why is there a sudden increase in monkeypox infections?
Lu Hongzhou said that although monkeypox cases worldwide have now fallen to low levels, there has been an increase in monkeypox cases in the Asia-Pacific region this year. As a result, Chinese mainland recent sudden increase in monkeypox cases "is mainly due to spillover transmission and increased mobility of monkeypox outbreaks in other regions." ”
Wei Sheng, a professor of epidemiology at the School of Public Health and Emergency Management at Southern University of Science and Technology, also believes that another reason for the increase in cases is that with the improvement of people's awareness and testing level, cases are now easier to detect than before.
With the gradual increase in Chinese mainland cases of monkeypox infection, a large number of netizens commented that the details of the relevant infected people were disclosed. Does this help with monkeypox epidemic control?
Lu Hongzhou believes that as far as the current situation is concerned, there is a possibility of further increase in local cases in a short period of time, but even if the scale of cases expands, it will peak in a short period of time and gradually decline, and the risk of large-scale epidemics in the future is very low.
Lu Hongzhou did not believe it was necessary to disclose patient information. He said that monkeypox is mainly transmitted through close contact, and the general public is less at risk of being infected, and publishing information such as the patient's activity trajectory and area is less beneficial for the prevention and control of monkeypox. "Moreover, the main transmission mode of monkeypox involves the privacy of personal life, so it is not appropriate and unnecessary to publish the patient's information."
Wei Sheng also believes that monkeypox virus is mainly transmitted through close contact between people and people, and is not as contagious as the new crown virus. He stressed that monkeypox virus could not be characterized as a sexually transmitted disease "to avoid stigmatization."
There are no anti-monkeypox virus drugs in China
According to the "Monkeypox Prevention and Control Technical Guidelines (2022 Edition)", there are currently no anti-monkeypox virus drugs in China. Treatment mainly includes symptomatic supportive care and treatment of secondary bacterial infections.
Source: Technical Guidelines for Monkeypox Prevention and Control (2022 Edition)
According to Yicai, there are currently three vaccines available to deal with monkeypox, namely ACAM2000, MVA-BN and LC16m8, which were originally developed to prevent smallpox, of which MVA-BN and LC16 have been approved for pre-exposure and post-exposure prophylaxis of monkeypox virus.
However, these monkeypox vaccines are primarily targeted at specific populations (e.g., post-exposure or high-risk infections). Since there are currently no studies on the efficacy of monkeypox vaccine based on large-scale samples, the Interim Guidelines for Monkeypox Vaccination and Immunization issued by the World Health Organization and the Technical Guidelines for Monkeypox Prevention and Control (2022 Edition) issued by the mainland do not recommend large-scale vaccination in the general population.
Domestic monkeypox vaccine development is accelerating
In the context of the gradual increase in monkeypox cases, the development of domestic monkeypox vaccines is accelerating.
On July 14, China Biotech announced that on July 13, the clinical trial application of replication-deficient monkeypox vaccine independently developed by Sinopharm China Biotech Beijing Institute of Biological Products was officially accepted by the Center for Drug Evaluation (CDE) of the National Medical Products Administration.
At present, monkeypox cases have been detected in 111 countries and regions around the world, with a total of more than 80,000 infected cases reported, including 146 deaths. China CDC recommends that returnees from epidemic areas should pay attention to self-health monitoring, and should take the initiative to seek medical attention when symptoms such as rashes appear.
On 23 July 2022, the World Health Organization (WHO) declared monkeypox a global public health emergency (PHEIC).
On 11 May 2023, the World Health Organization declared that the monkeypox outbreak no longer constitutes a "public health emergency of international concern".
Source: China CDC official website, Guangdong CDC, Central Radio Network, "China Bio" WeChat public account, interface news, Yicai