2022 monkeypox outbreak in Israel

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2022 monkeypox outbreak in Israel
DiseaseMonkeypox
Virus strainMonkeypox virus (West African clade)
LocationIsrael
Index caseIchilov General Hospital, Tel Aviv
Date20 May 2022 – ongoing (2 years, 1 month, and 18 days)
Confirmed cases121
Suspected cases‡0
Deaths
0
Government website
Ministry of Health (Israel)
‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.

The 2022 monkeypox outbreak in Israel is a part of the ongoing outbreak of human monkeypox caused by the West African clade of the monkeypox virus. The outbreak was first reported in Israel on 20 May 2022 when the Health Ministry announced a suspected case which was confirmed on 21 May 2022. One month later, on 21 June, the first locally transmitted case was reported.

Currently, Israel is the most affected country in Asia and the 14th most affected country in the world. Israel was also the first in Asia to report a case.

Background

These paragraphs are an excerpt from Monkeypox and 2022 monkeypox outbreak.

Monkeypox is an infectious viral disease that can occur in humans and some other animals.[1] Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over.[1] The time from exposure to onset of symptoms ranges from five to twenty-one days.[2][3] The duration of symptoms is typically two to four weeks.[3] There may be mild symptoms, and it may occur without any symptoms being known.[2][4] The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common to all outbreaks.[1][5] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[6]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus.[7] The variola virus, the causative agent of smallpox, is also in this genus.[8] Of the two types in humans, clade II (formerly West African clade)[9] causes a less severe disease than the Central African (Congo basin) type.[10] It may spread from infected animals by handling infected meat or via bites or scratches.[11] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.[1][11] People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted.[10] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[12]

There is no known cure.[13] A study in 1988 found that the smallpox vaccine was around 85% protective in preventing infection in close contacts and in lessening the severity of the disease.[14] A newer smallpox and monkeypox vaccine based on modified vaccinia Ankara has been approved, but with limited availability.[2] Other measures include regular hand washing and avoiding sick people and animals.[15] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[16][17] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[17] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of monkeypox have been recorded since 2017.[18]

An ongoing outbreak of monkeypox, a viral disease, was confirmed in May 2022.[19] The initial cluster of cases was found in the United Kingdom,[20] where the first case was detected in London on 6 May 2022[21] in a patient with a recent travel history from Nigeria (where the disease is endemic).[22] On 16 May, the UK Health Security Agency (UKHSA) confirmed 4 new cases with no link to travel to a country where monkeypox is endemic. All four cases appeared to have been infected in London.[23] From 18 May onwards, cases were reported from an increasing number of countries and regions, predominantly in Europe but also in North and South America, in Asia, in Africa, and in Oceania.[30] The outbreak marks the first time monkeypox has spread widely outside Central and West Africa.

On 23 July, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, declared the outbreak a public health emergency of international concern (PHEIC).[31] As of 15 October, there had been a total of 73,087 confirmed cases in over 109 countries.[32][33]

Transmission

Stages of lesion development.

A large portion of those infected were believed to have not recently traveled to areas of Africa where monkeypox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa.[34]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out monkeypox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[35]

History

Imported case before the outbreak

In 2018, an imported case was detected in Israel. A 38-year-old man came from Rivers State, Nigeria in late September. He showed the symptoms of the disease on that month. Later on October the patient sought medical attention at Shaare-Zedek Medical Center in Jerusalem. He was confirmed to be infected with the West African Clade of Monkeypox virus that month. All of the patient's contacts were traced and followed up but no virus transmission were detected.[36]

Arrival

Ichilov General Hospital (in the middle) in Tel Aviv Sourasky Medical Center, where the first case was isolated

As the outbreak was spreading in Europe in the middle of May 2022, the Israeli Health Ministry reported a suspected monkeypox case in the country on 20 May. The case was confirmed by testing on 21 May, becoming the first case in Israel during the outbreak.

The 30-year-old man returned from Western Europe and contracted the disease from there. The ministry reported that he was in isolation in the Ichilov General Hospital in Tel Aviv.[37][38]

Spread

The Ministry of Health reported the first case of community transmission on 21 June 2022.[39]

Timeline

table

May 2022

June 2022

July 2022

Responses

Cases and Statistics

See also

References

  1. ^ a b c d "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization. June 4, 2022. Archived from the original on June 6, 2022. Retrieved June 7, 2022.
  2. ^ a b c "WHO Factsheet – Monkeypox". World Health Organization. May 19, 2022. Retrieved May 28, 2022.
  3. ^ a b "Signs and Symptoms Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  4. ^ Sutcliffe, Catherine G.; Rimone, Anne W.; Moss, William J. (2020). "32.2. Poxviruses". In Ryan, Edward T.; Hill, David R.; Solomon, Tom; Aronson, Naomi; Endy, Timothy P. (eds.). Hunter's Tropical Medicine and Emerging Infectious Diseases E-Book (Tenth ed.). Edinburgh: Elsevier. pp. 272–277. ISBN 978-0-323-55512-8.
  5. ^ Harris, Emily (May 27, 2022). "What to Know About Monkeypox". JAMA. 327 (23): 2278–2279. doi:10.1001/jama.2022.9499. PMID 35622356. S2CID 249096570.
  6. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. May 21, 2022. Retrieved May 25, 2022.
  7. ^ Taha, M. J., Abuawwad, M. T., Alrubasy, W. A., Sameer, S. K., Alsafi, T., Al-Bustanji, Y., ... & Nashwan, A. J. Ocular manifestations of recent viral pandemics: A literature. health, 13, 14.
  8. ^ Petersen, Brett W.; Damon, Inger K. (2020). "348. Smallpox, monkeypox and other poxvirus infections". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 2180–2183. ISBN 978-0-323-53266-2.
  9. ^ "Monkeypox: experts give virus variants new names". World Health Organization. August 12, 2022.
  10. ^ a b Adler, Hugh; Gould, Susan; Hine, Paul; Snell, Luke B.; Wong, Waison; Houlihan, Catherine F.; et al. (May 24, 2022). "Clinical features and management of human monkeypox: a retrospective observational study in the UK". The Lancet. Infectious Diseases. 22 (8): S1473–3099(22)00228–6. doi:10.1016/S1473-3099(22)00228-6. PMC 9300470. PMID 35623380. S2CID 249057804.
  11. ^ a b "Transmission Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  12. ^ "2003 U.S. Outbreak Monkeypox". CDC. May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
  13. ^ "Treatment Monkeypox Poxvirus CDC". www.cdc.gov. December 28, 2018. Archived from the original on June 15, 2019. Retrieved October 11, 2019.
  14. ^ Fine, P. E.; Jezek, Z.; Grab, B.; Dixon, H. (September 1988). "The transmission potential of monkeypox virus in human populations". International Journal of Epidemiology. 17 (3): 643–650. doi:10.1093/ije/17.3.643. ISSN 0300-5771. PMID 2850277.
  15. ^ "Prevention". www.cdc.gov. November 29, 2019. Archived from the original on March 14, 2022. Retrieved May 14, 2022.
  16. ^ "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC". www.cdc.gov. May 26, 2022. Archived from the original on June 7, 2022. Retrieved June 8, 2022.
  17. ^ a b "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
  18. ^ "Multi-country monkeypox outbreak in non-endemic countries: Update". www.who.int. Retrieved July 2, 2022.
  19. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. May 21, 2022. Archived from the original on May 22, 2022. Retrieved May 25, 2022.
  20. ^ "So, Have You Heard About Monkeypox?". The Atlantic. May 19, 2022. Archived from the original on June 23, 2022. Retrieved June 2, 2022.
  21. ^ "Monkeypox cases confirmed in England – latest updates". GOV.UK. Retrieved September 25, 2022.
  22. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. May 16, 2022. Archived from the original on May 17, 2022. Retrieved May 17, 2022.
  23. ^ "Monkeypox cases confirmed in England – latest updates". GOV.UK. Retrieved September 25, 2022.
  24. ^ "Viruela del mono: confirmaron el primer caso del virus en el país" (in Spanish). May 26, 2022. Archived from the original on June 24, 2022. Retrieved May 26, 2022.
  25. ^ "UAE reports first case of monkeypox in the country". Al Arabiya. May 24, 2022. Archived from the original on May 24, 2022. Retrieved May 24, 2022.
  26. ^ Efrati, Ido. "Israel Confirms First Case of Monkeypox Virus". Haaretz. Archived from the original on May 20, 2022. Retrieved May 21, 2022.
  27. ^ "Monkeypox confirmed in Melbourne and Sydney". Australian Broadcasting Corporation. May 20, 2022. Archived from the original on May 20, 2022. Retrieved May 20, 2022.
  28. ^ "Morocco Reports First Monkeypox Case". Morocco World News. Archived from the original on June 21, 2022. Retrieved June 2, 2022.
  29. ^ "5 cases of monkeypox confirmed in Ghana". MyJoyOnline.com. Archived from the original on June 21, 2022. Retrieved June 8, 2022.
  30. ^ [24][25][26][27][28][29]
  31. ^ "WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern". World Health Organization (WHO). July 23, 2022. Retrieved August 4, 2022.
  32. ^ "Monkeypox Data Explorer". OurWorldInData. Archived from the original on June 28, 2022. Retrieved May 27, 2022.
  33. ^ Kozlov, Max (July 25, 2022). "Monkeypox declared a global emergency: will it help contain the outbreak?". Nature. doi:10.1038/d41586-022-02054-7. PMID 35879614. S2CID 251067503.
  34. ^ Vargas, Ramon Antonio (June 7, 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved June 9, 2022.
  35. ^ "Monkeypox update: Where the outbreak stands now".
  36. ^ Erez, Noam; Achdout, Hagit; Milrot, Elad; Schwartz, Yuval; Wiener-Well, Yonit; Paran, Nir; Politi, Boaz; Tamir, Hadas; Israely, Tomer; Weiss, Shay; Beth-Din, Adi; Shifman, Ohad; Israeli, Ofir; Yitzhaki, Shmuel; Shapira, Shmuel C.; Melamed, Sharon; Schwartz, Eli (May 25, 2019). "Diagnosis of Imported Monkeypox, Israel, 2018". Emerging Infectious Diseases. 25 (5): 980–983. doi:10.3201/eid2505.190076. PMC 6478227. PMID 30848724.
  37. ^ Efrati, Ido. "Israel Confirms First Case of Monkeypox Virus". Haaretz. Retrieved July 11, 2022.
  38. ^ "Israel, Switzerland report first monkeypox cases as virus spreads". Al Jazeera. Retrieved July 11, 2022.
  39. ^ "שלושה גברים נוספים אובחנו בישראל כחולים באבעבועות הקוף" [Three other men diagnosed with monkeypox in Israel]. Ministry of Health (Israel) (in Hebrew). Retrieved July 11, 2022.
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