2022–2023 mpox outbreak in Belgium
The 2022–2023 mpox outbreak in Belgium is part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus. Belgium was the fifth country, outside of the African countries with endemic mpox, to experience an outbreak in 2022. The first case was documented in Antwerp, Belgium, on May 19, 2022.[1] As of August 10th, Belgium has 546 cases and 1 suspected case.[2]
| 2022–2023 mpox outbreak in Belgium | |
|---|---|
| Disease | Mpox |
| Virus strain | Monkeypox virus (West African clade) |
| Location | Belgium |
| Index case | Antwerp, Belgium[1] |
| Arrival date | May 19, 2022 (11 months, 3 weeks and 6 days ago) |
| Date | March 15, 2023 |
| Confirmed cases | 793[2] |
| Suspected cases‡ | 1 |
Deaths | 2 |
| ‡Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out. | |
Background
Mpox (formerly known as monkeypox)[3] is an infectious viral disease that can occur in humans and some other animals.[4] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes.[4] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks.[5][6] There may be mild symptoms, and it may occur without any symptoms being apparent.[5][7] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.[8]
The disease is caused by the monkeypox virus,[lower-alpha 1] a zoonotic virus in the genus Orthopoxvirus.[9] The variola virus, the causative agent of smallpox, is also in this genus.[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.[4][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.[12] Diagnosis can be confirmed by testing a lesion for the virus's DNA.[13]
There is no known cure.[14] 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.[15] A newer smallpox and mpox 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.[16] Antiviral drugs, cidofovir and tecovirimat, vaccinia immune globulin and the smallpox vaccine may be used during outbreaks.[17][18] The illness is usually mild and most of those infected will recover within a few weeks without treatment.[18] Estimates of the risk of death vary from 1% to 10%, although few deaths as a consequence of mpox have been recorded since 2017.[19]An ongoing outbreak of mpox was confirmed on May 6, 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's index case of the outbreak.[20] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May,[21] but it has been suggested that cases were already spreading in Europe in the previous months.[22]
Transmission
A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox 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.[23]
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 mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[24]
History
The first two known cases were detected in on May 19, 2022. The first infected person was diagnosed in Antwerp, and the second from a region called Flemish Brabant. Both had gone to the same party, and thus began the mpox outbreak in Belgium.[1] It is unknown what hospital they went to, although it is very likely that the first infected person went to an Antwerp hospital, and the second infected person went to a Flemish Brabant region hospital. There, they both tested positive for mpox, becoming the first cases in Belgium.
A day after both tested positive, there was another case reported in a man of unknown age who was relatively healthy but had bullous lesions on his hands.[25] More and more cases were reported in Belgium days later and more continue to be reported. As of August 10, there are 546 cases and 1 suspected case.[2]
Vaccination response
On July 5, the Office of European Commissioner for Health, Stella Kyriakides, told Belga News Agency that 3,040 mpox vaccines were shipped to Belgium on July 7. According to the Cypriot commissioner, these deliveries will "protect Belgian citizens and respond to this outbreak." She also praised the European Health Emergency Response and Preparedness Authority's (HERA) quick response. Kyriakides concluded that more doses will be delivered to Belgium in the following weeks.[26]
Responses and reactions
Hospitals have also begun making their own preparations to help control the current mpox outbreak, including screening patients, increasing decontamination and cleaning procedures,[27] and wearing appropriate safety gear (Personal protective equipment / Medical gown) when interacting with infected patients.
Belgium also introduced a mandatory 21-day quarantine for infected mpox patients in hopes of containing the disease in the country. Close contacts are not required to self-isolate but are encouraged to remain vigilant, especially if in contact with vulnerable people.[28]
See also
Notes
- The World Health Organization (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), who are currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus".[3]
References
- "Belgium detexts first two monkeypox cases". Reuters. May 20, 2022.
- "2022 Monkeypox Outbreak Global Map". USA CDC. Retrieved June 17, 2022.
- "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). November 28, 2022. Retrieved November 29, 2022.
- "Multi-country monkeypox outbreak: situation update". www.who.int. World Health Organization (WHO). June 4, 2022. Archived from the original on June 6, 2022. Retrieved June 7, 2022.
- "WHO Factsheet – Monkeypox". World Health Organization (WHO). May 19, 2022. Retrieved May 28, 2022.
- "Signs and Symptoms Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
- 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.
- "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.
- 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.
- 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.
- "Transmission Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
- 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.
- "2003 U.S. Outbreak Monkeypox". U.S. Centers for Disease Control and Prevention (CDC). May 11, 2015. Archived from the original on October 15, 2017. Retrieved October 15, 2017.
- "Treatment Monkeypox Poxvirus CDC". U.S. Centers for Disease Control and Prevention (CDC). December 28, 2018. Archived from the original on June 15, 2019. Retrieved October 11, 2019.
- 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.
- "Prevention". U.S. Centers for Disease Control and Prevention (CDC). November 29, 2019. Archived from the original on March 14, 2022. Retrieved May 14, 2022.
- "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC". U.S. Centers for Disease Control and Prevention (CDC). May 26, 2022. Archived from the original on June 7, 2022. Retrieved June 8, 2022.
- "Monkeypox". GOV.UK. May 24, 2022. Archived from the original on May 18, 2022. Retrieved May 28, 2022.
- "Multi-country monkeypox outbreak in non-endemic countries: Update" (Press release). World Health Organization (WHO). Retrieved July 2, 2022.
- "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.
- Pinkstone, Joe (May 17, 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on May 17, 2022. Retrieved May 17, 2022.
- Nsofor, Ifeanyi (June 2, 2022). "OPINION: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved June 2, 2022.
- Vargas, Ramon Antonio (June 7, 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved June 9, 2022.
- "Monkeypox update: Where the outbreak stands now".
- "Third case of monkeypox reported in Belgium". Retrieved May 20, 2022.
- "Monkeypox vaccines arrive in Belgium". Retrieved July 7, 2022.
- Kurth, Andreas; Achenbach, John; Miller, Liljia; Mackay, Ian M.; Pauli, Georg; Nitsche, Andreas (January 2008). "Orthopoxvirus Detection in Environmental Specimens during Suspected Bioterror Attacks: Inhibitory Influences of Common Household Products". Applied and Environmental Microbiology. 74 (1): 32–37. doi:10.1128/AEM.01501-07. PMC 2223225. PMID 17965204.
- "Belgium introduces mandatory monkeypox quarantine as global cases rise". Retrieved May 23, 2022.
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