Cases of Monkeypox (Monkeypox) not directly linked to travel to Central or West Africa or people returning from travel have been reported in Europe and around the world, suspected cases are being investigated. evaluation in many countries and the situation is therefore changing very rapidly. In France, infections by this virus are subject to long-term surveillance by means of compulsory reporting. Given the current alerts, surveillance of these infections is being reinforced by Public Health France and information and alert messages are sent to healthcare professionals.
Case of monkeypox: update in France
As of July 12, 2022 at 2:00 p.m., 912 cases have been confirmed: 569 in Ile-de-France, 87 in Auvergne-Rhône-Alpes, 68 in Occitanie, 47 in New Aquitaine, 47 in Provence-Alpes-Côte d’Azur, 34 in Hauts-de-France, 18 in Grand Est, 13 in Normandy, 9 in Brittany, 8 in Centre-Val de Loire, 5 in Pays-de-la-Loire, 3 in Bourgogne-Franche-Comté and 4 cases in the stranger.
As of 11 July 2022 at 12:00 p.m., the distribution by region of residence of the 824 confirmed cases residing in France who have been investigated is presented in figure 1.
Figure 1. Confirmed cases of monkeypox (n=824), by region of residence, France, May-July 2022 (data as of 07/11/2022 – 12:00 p.m.)
The description of the 828 confirmed cases that have been investigated is given below.
Among all the confirmed cases, 5 female adult cases and 2 children are identified.
Adult cases are between 19 and 84 years old (median age: 36 years).
Symptom onset dates range between May 7, 2022 and July 7, 2022 (Figure 2). These cases were diagnosed a median of 6 days (range 0 to 22 days) after the onset of symptoms; therefore, data for the last week is not consolidated.
In the cases investigated, the median time taken to use the test per screening week has fallen sharply since the start of the epidemic, going from 13 days in S18-2022 (May 2 to 8) to 4 days in S26-2022 ( June 27 to July 03).
Figure 2. Confirmed cases of monkeypox (n=828), by date of onset of symptoms, France, May-July 2022 (data as of 07/11/2022 – 12:00 p.m.)
Among the cases, 81% presented a genito-anal rash, 73% a rash on another part of the body, 78% a fever, 76% lymphadenopathy and 37% a sore throat.
Of the cases, 40 are immunocompromised; 211 are HIV positive (26%). Among the HIV-free cases, 403 are on PreP (70%). No case died.
To date, in France, 97% of cases for which sexual orientation is reported have occurred among men who have sex with men (MSM). Among the cases for which information is available, 75% declare having had at least 2 sexual partners in the 3 weeks before the onset of symptoms.
Most cases report not being able to identify the person who allegedly infected them; 153 are secondary cases, ie reporting having been in contact with a case of monkeypox in the three weeks preceding the onset of symptoms.
The next update of this report will take place on Wednesday July 20, 2022.
Information and prevention actions
Given what has been observed in Europe on the disease, targeted communication was quickly implemented towards MSM people. The website sexosafe.fr, dedicated to the sexuality of MSM people, has been updated with a summary of knowledge on the subject and prevention measures. The messages recalling the symptoms and what to do in the event of symptoms were relayed via a digital campaign. Since June 17, the digital campaign has generated nearly 307,173 clicks on the banners and more than 246,484 visits to the Sexosafe site. This device was supplemented with a poster campaign in places of conviviality with nearly 1,350 poster spaces. At the same time, posters, flyers and advice sheets were distributed thanks to associations, ARS and Sexosafe teams present in the field, as part of pride marches and in places where MSM meet. To date, 1,636 posters and 67,050 flyers have been ordered.
In the coming days, messages will be broadcast on community radios. On preventive vaccination, tools for the field will also be made available, following the publication of the opinion of the High Authority for Health of July 07.
Prevention actions are continuously adapted to the evolution of the situation and the state of knowledge.
In the usual absence of monkeypox in Europe and of a link reported by the cases identified with a risk zone, the current European context constitutes an alert and suggests contamination in Europe. This is why, in France, the long-term monitoring of monkeypox through the mandatory notification system is reinforced and information and alert messages are sent to health professionals. Exchanges are also continuing with other European countries, the WHO and the ECDC.
Monkeypox info service: a listening device to answer questions about monkeypox
Since Wednesday, July 13, a listening device has been open to answer questions raised by monkey pox. Subsidized by Public Health France and supported by SIS Association (Sexuality info service Association), the “Monkeypox info service” telephone line is accessible every day from 8 a.m. to 11 p.m., on the toll-free number 0 801 90 80 69 (free call and services, anonymous and confidential) This system is responsible for supporting prevention messages and protective measures, providing information on symptoms, treatments and vaccination, advising and directing people to treatment systems.
What is monkey pox (Monkeypox)?
Monkeypox is an infectious disease caused by an Orthopoxvirus. This zoonotic disease is usually transmitted to humans in forest areas of Central and West Africa by wild rodents or primates, but human-to-human transmission is also possible, particularly within the family home or in the care setting.
How is it transmitted?
The monkeypox virus can be transmitted by direct contact with lesions on the skin or mucous membranes of a sick person, as well as by droplets (saliva, sneezing, sputter, etc.). Sexual intercourse, with or without penetration, meets these conditions for contamination, and having several partners increases the risk of being exposed to the virus.
Contamination can also occur through contact with the patient’s environment (bedding, clothing, dishes, bath linen, etc.). It is therefore important that the patients observe isolation throughout the duration of the disease (until the disappearance of the last scabs, most often 3 weeks).
In Central or West Africa, humans can also become infected through contact with animals, wild or in captivity, dead or alive, such as rodents or monkeys.
Infection with the monkeypox virus is not known as an STI, but direct contact with damaged skin during sexual intercourse facilitates transmission.
What are the symptoms ?
Infection with monkeypox virus can cause a blistering rash, made up of fluid-filled blisters that progress to drying, crusting and then scarring. Itching may occur. The vesicles are more concentrated on the face, in the ano-genital area, the palms of the hands and soles of the feet, can be present but also on the trunk and the limbs. The mucous membranes are also affected, in the mouth and the genital area. This rash can be accompanied by fever, headache, body aches and asthenia. Lymph nodes may be swollen and painful, under the jaw, in the neck or in the fold of the groin. Sore throats are also reported.
The incubation of the disease can range from 5 to 21 days. The fever phase lasts about 1 to 3 days. The disease most often heals spontaneously, after 2 to 3 weeks but sometimes 4 weeks.
Is monkeypox serious?
The disease is more severe in children and in immunocompromised people. It can be complicated by superinfection of skin lesions or by respiratory, digestive, ophthalmological or neurological disorders.
In Europe, and in particular in France, no deaths have been reported.