2022 monkeypox outbreak in South America

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2022 monkeypox outbreak in South America
DiseaseMonkeypox
Virus strainMonkeypox virus (West African clade)
Index caseBuenos Aires, Argentina
Arrival date27 May 2022 (2 years and 4 days ago)
Confirmed cases3,836
Suspected cases3,581
Deaths
3: Brazil (1), Ecuador (1), Peru (1)[1][2][3]
Territories
8
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 South America is a part of the outbreak of human monkeypox caused by the West African clade of the monkeypox virus. The outbreak reached South America on 27 May 2022 when Argentina reported their first case of monkeypox. As of 14 August 2022, 8 South American countries and territories have confirmed cases.

Background

Monkeypox is an infectious viral disease that can occur in humans and some other animals.[4] Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over.[4] The time from exposure to onset of symptoms ranges from five to twenty-one days.[5][6] The duration of symptoms is typically two to four weeks.[6] There may be mild symptoms, and it may occur without any symptoms being known.[5][7] 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.[4][8] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[9]

The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus.[10] The variola virus, the causative agent of smallpox, is also in this genus.[11] Of the two types in humans, clade II (formerly West African clade)[12] causes a less severe disease than the Central African (Congo basin) type.[13] It may spread from infected animals by handling infected meat or via bites or scratches.[14] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.[4][14] 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.[13] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[15]

There is no known cure.[16] 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.[17] A newer smallpox and monkeypox vaccine based on modified vaccinia Ankara has been approved, but with limited availability.[5] Other measures include regular hand washing and avoiding sick people and animals.[18] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[19][20] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[20] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of monkeypox have been recorded since 2017.[21]

An ongoing outbreak of monkeypox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with monkeypox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak.[22] The origin of several of the cases of monkeypox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[23] but it has been suggested that cases were already spreading in Europe in the previous months.[24]

Transmission

Stages of lesion development. Picture taken by Dr O.O. Afuye on 15 September 2019.

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.[25]

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.[26]

Timeline

Arrival

An index case was imported into Argentina on 27 May. It was unknown how the disease was contracted, but likely abroad in monkeypox-affected countries. The patient had likely showed symptoms since 25 May, and was admitted to a hospital on 26 May. The next day, the patient was confirmed to have contracted monkeypox. The following day, another monkeypox case was confirmed, and Argentina reported these cases to Reliefweb.[27]

Cases transited through South America

June

9 June

On 9 June, Brazil confirmed its first case of monkeypox. It was in a 41-year-old male who may have been infected from recently traveling to Spain and Portugal, which had already been affected by the monkeypox outbreak. It was likely contracted via skin-to-skin contact. [28]

12 June

On 12 June, Venezuela registered its first case of monkeypox. It was in a male of unknown age who had likely contracted the disease via skin-to-skin contact in Madrid, Spain which had already been affected by the monkeypox outbreak.[29]

17 June

On 17 June, Chile confirmed its first monkeypox infection. It was in a young male of unknown specific age from the Metropolitan Region. It was likely contracted via skin-to-skin contact from a trip to Europe.[30]

23 June

On 23 June, Colombia confirmed its first three cases of monkeypox in adults of unknown genders and ages. Two of the cases were found in the capital Bogota, and the third was found in Colombia's second city, Medellin. It was unknown how those cases were contracted, although it was likely skin-to-skin contact picked up abroad.[31]

26 June

On 26 June, Peru reported its first case of monkeypox. It was in a foreign citizen of unknown gender or age who resides in Lima, Peru. The patient likely got infected via while being in contact with people from abroad. It was likely skin-to-skin contact rather than sexual contact.[32]

July

6 July

On 6 July, Ecuador reported its first monkeypox infection. It was in a 30-year-old male who resides in the Southwest coastal province of Guayas, Ecuador. It is unknown how the patient contracted the disease, but likely skin-to-skin contact picked up abroad.[citation needed]

29 July

On 29 July, Uruguay registered its first case of monkeypox. It was in a patient of unknown age and gender. It is unknown how the disease was contracted, but likely skin-to-skin contact abroad. [33]

August

1 August

On 1 August, Bolivia confirmed its first case of monkeypox. It was in a 38-year-old male. It is unknown how the disease was contracted, but likely skin-to-skin contact picked up abroad.[34]

Responses

World Health Organization (WHO)

On 20 May, the WHO convened an emergency meeting of independent advisers to discuss the outbreak and assess the threat level.[35] Its European chief, Hans Kluge, expressed concern that infections could accelerate in Europe as people gather for parties and festivals over the summer.[36] On 14 June, the WHO announced plans to rename the monkeypox virus in order to combat stigma and racism surrounding the disease.[37] Another meeting convened on 23 June determined that the outbreak does not constitute a Public Health Emergency of International Concern for the time being.[38]

Countries

The majority of South American countries responded to the outbreak, and the responses of some are listed below.

  •  Brazil: The Brazilian Ministry of Health created groups of biologists to monitor monkeys and medical groups to monitor possible cases.[39] On August 8, 2022, during a podcast, the president of Brazil Jair Bolsonaro made homophobic jokes about the disease. When questioning the host about whether he would get a monkeypox vaccine, and the host says yes; Jair Bolsonaro replied: "I'm sure you want to get the vaccine. You don't fool me" followed by laughter. The host remains in his serious speech on the subject, Bolsonaro commented: "Don't you understand?" clarifying the homophobic tone of the comment.[40][41]
  •  Colombia: As of May, the Colombian Ministry of Health was taking follow-up and control measures. The Director of Epidemiology and Demography of the Ministry of Health, Claudia Cuellar, informed the Colombian population about how monkeypox is spread through people, and she spoke about the clinical presentation of the virus and international health regulations.[42] Health authorities in the Department of Norte de Santander have been on alert, since the department is a border area where people pass between Colombia and Venezuela.[43]

Cases per country and territory

This is a table of confirmed and suspected monkeypox cases in South American countries during the ongoing 2022 monkeypox outbreak. It does not include countries where suspected cases were reported but later discarded. (As of 11 August 2022)

Cases of monkeypox by countries of South America (last updated on as of 11 August 2022)
Country Confirmed Suspected Total Deaths Last update First confirmed case First confirmed death Last confirmed case
 Argentina 133 133 26 August 2022[44] 27 May 2022[45]
 Bolivia 11 50 61 12 August 2022[46] 1 August 2022[47]
Brazil 2,849 3,473 6,322 1[1] 13 August 2022[48] 9 June 2022[49][50] 29 July 2022[1]
Chile 141 1 142 12 August 2022[51] 17 June 2022[52]
Colombia 55 55 8 August 2022[53] 23 June 2022[54]
 Ecuador 16 1 17 1[2] 11 August 2022[55] 6 July 2022[56] 8 August 2022[2]
Peru 1,434 101 1,535 1[3] 27 August 2022[57] 26 June 2022[58] 1 August 2022[3]
 Uruguay 2 2 3 August 2022[59] 29 July 2022[60]
 Venezuela 1 1 12 June 2022[61] 12 June 2022[61]
 Total 3,836 3,581 7,417 3 14 August 2022

Timeline of first confirmed cases by country or territory

First confirmed monkeypox cases by country or territory
Date Countries / Territories
27 May 2022  Argentina
9 June 2022 Brazil
12 June 2022  Venezuela
17 June 2022 Chile
23 June 2022 Colombia
26 June 2022 Peru
6 July 2022  Ecuador
29 July 2022  Uruguay
1 August 2022  Bolivia
22 August 2022  Guyana
25 August 2022  Paraguay

Timeline of suspected cases by country or territory

Countries listed below had only suspected cases at the time of reporting. Some countries reported confirmed cases after reporting suspected cases. Countries listed several times reported suspected cases again after they discarded suspected cases before.

Timeline of suspected monkeypox cases by country or territory
Date Countries / Territories
23 May 2022 French Guiana[a][b] (discounted on 1 June)
25 May 2022  Bolivia (discounted between 3 and 10 June)[62]
27 May 2022  Ecuador (discounted on 30 May)
30 May 2022  Peru (discounted on 2 June) Brazil (confirmed cases reported on 9 June)
1 June 2022  Paraguay (discounted on 7 June)[63]
2 June 2022  Uruguay (confirmed cases reported on 29 July)
14 June 2022  Ecuador (discounted on 15 June)[64]

Timeline of first deaths by country or territory

Timeline of monkeypox deaths by country or territory
Date Countries / Territories
29 July 2022 Brazil
1 August 2022 Peru
8 August 2022  Ecuador

See also

Notes

References

  1. ^ a b c Fonseca, Pedro (29 July 2022). "Brazil reports first monkeypox death outside Africa in current outbreak". Reuters. Retrieved 29 July 2022.
  2. ^ a b c "COMUNICADO OFICIAL". Ministerio de Salud Pública (in Spanish). Retrieved 8 August 2022.
  3. ^ a b c "Perú confirma la muerte de un paciente afectado por viruela del mono". MachalaMovil. Retrieved 1 August 2022.
  4. ^ a b c d "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization. 4 June 2022. Archived from the original on 6 June 2022. Retrieved 7 June 2022.
  5. ^ a b c "WHO Factsheet – Monkeypox". World Health Organization. 19 May 2022. Retrieved 28 May 2022.
  6. ^ a b "Signs and Symptoms Monkeypox". CDC. 11 May 2015. Archived from the original on 15 October 2017. Retrieved 15 October 2017.
  7. ^ 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.
  8. ^ Harris, Emily (27 May 2022). "What to Know About Monkeypox". JAMA. 327 (23): 2278–2279. doi:10.1001/jama.2022.9499. PMID 35622356. S2CID 249096570.
  9. ^ "Multi-country monkeypox outbreak in non-endemic countries". World Health Organization. 21 May 2022. Retrieved 25 May 2022.
  10. ^ 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.
  11. ^ 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.
  12. ^ "Monkeypox: experts give virus variants new names". World Health Organization. 12 August 2022.
  13. ^ a b Adler, Hugh; Gould, Susan; Hine, Paul; Snell, Luke B.; Wong, Waison; Houlihan, Catherine F.; et al. (24 May 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.
  14. ^ a b "Transmission Monkeypox". CDC. 11 May 2015. Archived from the original on 15 October 2017. Retrieved 15 October 2017.
  15. ^ "2003 U.S. Outbreak Monkeypox". CDC. 11 May 2015. Archived from the original on 15 October 2017. Retrieved 15 October 2017.
  16. ^ "Treatment Monkeypox Poxvirus CDC". www.cdc.gov. 28 December 2018. Archived from the original on 15 June 2019. Retrieved 11 October 2019.
  17. ^ 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.
  18. ^ "Prevention". www.cdc.gov. 29 November 2019. Archived from the original on 14 March 2022. Retrieved 14 May 2022.
  19. ^ "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC". www.cdc.gov. 26 May 2022. Archived from the original on 7 June 2022. Retrieved 8 June 2022.
  20. ^ a b "Monkeypox". GOV.UK. 24 May 2022. Archived from the original on 18 May 2022. Retrieved 28 May 2022.
  21. ^ "Multi-country monkeypox outbreak in non-endemic countries: Update". www.who.int. Retrieved 2 July 2022.
  22. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  23. ^ Pinkstone, Joe (17 May 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  24. ^ Nsofor, Ifeanyi (2 June 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved 2 June 2022.{{cite web}}: CS1 maint: url-status (link)
  25. ^ Vargas, Ramon Antonio (7 June 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 9 June 2022.
  26. ^ "Monkeypox update: Where the outbreak stands now".
  27. ^ "Epidemiological Update: Monkeypox - 9 July 2022". www.reliefweb.int. Retrieved 9 July 2022.
  28. ^ "First case of monkeypox reported in Brazil".
  29. ^ "Venezuela confirms first case of monkeypox".
  30. ^ "Chile reports first case of monkeypox".
  31. ^ "Colombia reports first cases of monkeypox".
  32. ^ "Minsa confirms first case of monkeypox in Peru".
  33. ^ "Uruguay has first case of monkeypox confirmed".
  34. ^ "Bolivia has confirmed its first case of monkeypox".
  35. ^ Rigby, Jennifer (20 May 2022). "WHO to hold emergency meeting on monkeypox on Friday -sources". Reuters. Archived from the original on 20 May 2022. Retrieved 20 May 2022.
  36. ^ Rigby, Jennifer; Grover, Natalie (20 May 2022). "WHO calls emergency meeting as monkeypox cases top 100 in Europe". Reuters. Archived from the original on 20 May 2022. Retrieved 21 May 2022.
  37. ^ "WHO Will Rename Monkeypox Virus to Minimize Stigma, Racism". Bloomberg.com. 13 June 2022. Retrieved 15 June 2022.
  38. ^ "Meeting of the International Health Regulations (2005) Emergency Committee regarding the multi-country monkeypox outbreak". who.int. WHO. Archived from the original on 28 June 2022. Retrieved 26 June 2022.
  39. ^ "Governo cria grupo para monitorar varíola dos macacos e acompanha caso de brasileiro" [Government creates group to monitor monkeypox and follows up on Brazilian case]. CNN (in Brazilian Portuguese). 21 May 2022. Archived from the original on 24 May 2022. Retrieved 22 May 2022.
  40. ^ "Bolsonaro insinua que quem se vacinar contra monkeypox é gay" [Bolsonaro insinuates that anyone who gets vaccinated against monkeypox is gay]. Terra (in Brazilian Portuguese). Retrieved 9 August 2022.
  41. ^ Gouveia, Lais (9 August 2022). "Participação de Bolsonaro no Flow tem alerta de fake news e piada homofóbica com varíola dos macacos (vídeo)" [Bolsonaro's participation in Flow has fake news alert and homophobic joke with monkeypox (video)]. Brasil 247 (in Brazilian Portuguese). Retrieved 9 August 2022.
  42. ^ Ibarguen, Yorely (23 May 2022). "Viruela del mono: Colombia se declara en riesgo moderado por la propagación". Caracol Radio (in Spanish). Archived from the original on 5 June 2022. Retrieved 28 May 2022.
  43. ^ "Alerta en Norte de Santander por la viruela del mono". La Opinión (in Spanish). Archived from the original on 6 June 2022. Retrieved 28 May 2022.
  44. ^ "Viruela del mono en Argentina: se confirmaron 133 casos, 80% más que la semana pasada" [Monkeypox in Argentina: 133 cases confirmed, 80% more than last week]. Clarín (in Spanish). 26 August 2022. Retrieved 27 August 2022.
  45. ^ "Salud informa que el resultado de la muestra PCR tomada por ANLIS Malbrán al primer caso sospechoso de viruela símica dio positivo" (in Spanish). 27 May 2022. Archived from the original on 27 May 2022. Retrieved 27 May 2022.
  46. ^ "Suman 11 casos de viruela del mono y hay 50 sospechosos". Página Siete (in Spanish). Retrieved 12 August 2022.
  47. ^ "Confirman primer caso de viruela del mono en Bolivia" [First case of monkeypox confirmed in Bolivia]. El Deber (in Spanish). 1 August 2022. Retrieved 1 August 2022.
  48. ^ "Card Situação Epidemiológica de Monkeypox no Brasil n° 26 SE 32 - 13-08-22". Ministry of Health (Brazil). Retrieved 14 August 2022.
  49. ^ "Man in Sao Paulo hospital with Brazil's first monkeypox case -officials". Reuters. 9 June 2022. Archived from the original on 9 June 2022. Retrieved 9 June 2022.
  50. ^ "São Paulo confirma 1º caso de varíola dos macacos no Brasil". 8 June 2022. Archived from the original on 9 June 2022. Retrieved 8 June 2022.
  51. ^ "Ministerio de Salud confirman 141 casos de viruela del mono en Chile" (in Spanish).
  52. ^ "MINSAL confirma el primer caso de Viruela del Mono en Chile" [MINSAL confirms the first case of Monkeypox in Chile]. Ministry of Health of Chile (in Spanish). 17 June 2022. Archived from the original on 17 June 2022. Retrieved 17 June 2022.
  53. ^ "Los departamentos que han reportado los 55 casos de la viruela del mono en Colombia". El Espectador (in Spanish). Retrieved 8 August 2022.
  54. ^ "Minsalud e INS confirman tres casos de viruela símica en Colombia". Ministry of Health and Social Protection (Colombia) (in Spanish). Archived from the original on 24 June 2022. Retrieved 24 June 2022.
  55. ^ "16 casos confirmados de viruela del mono en Ecuador". Teleamazonas (in Spanish). Retrieved 11 August 2022.
  56. ^ "Ecuador confirms first case of monkeypox". Xinhua News Agency. Retrieved 7 July 2022.
  57. ^ Peru cases can be aggregated from the following sources:
  58. ^ "MINSA confirma primer caso de la viruela del mono en el Perú" [MINSA confirms first case of monkeypox in Peru]. Ministry of Health of Peru (in Spanish). 26 June 2022. Retrieved 28 June 2022.
  59. ^ "2022 Monkeypox Outbreak Global Map". Centers for Disease Control and Prevention. Retrieved 9 August 2022.
  60. ^ "Primer caso importado de viruela símica en Uruguay" [First imported case of monkeypox in Uruguay]. Ministry of Health of Uruguay (in Spanish). 29 July 2022. Retrieved 29 July 2022.
  61. ^ a b "Venezuela confirms first case of monkeypox". Reuters. Archived from the original on 12 June 2022. Retrieved 12 June 2022.
  62. ^ "Los casos sospechosos de viruela del mono en Bolivia fueron 'totalmente descartados'" [The suspected cases of monkeypox in Bolivia were "totally discarded"]. La Razón (in Spanish). La Paz, Bolivia. 10 June 2022. Archived from the original on 10 June 2022. Retrieved 10 June 2022.
  63. ^ "Descartan en Paraguay primer caso de viruela del mono". Prensa Latina (in Spanish). 7 June 2022. Archived from the original on 9 June 2022. Retrieved 8 June 2022.
  64. ^ "Segundo caso sospechoso de viruela del mono en Ecuador es descartado". El Comercio (in Spanish). 15 June 2022. Archived from the original on 17 June 2022. Retrieved 17 June 2022.

External links