vigilance in the event of a suspicious lesion

Saturday July 23, Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO) said monkey pox “public health emergency of international concern”. And for good reason, the epidemic is spreading rapidly.

As of July 23, more than 16,000 cases have been reported in 75 countries and territories. In all, the disease has led to 5 deaths, all reported in Africa. In France, 1,567 confirmed cases had been identified as of July 21.

“Transmission from one person to another occurs during prolonged face-to-face contact, through droplets (saliva, sneezes, sputters), as well as through bodily fluids, skin lesions or internal mucous membranes such as the mouth, describes the National Medicines Safety Agency (ANSM). It can also take place through objects that the patient has contaminated, such as clothes or bed linen. »

Vigilance in the event of a suspicious lesion

As confirmed by the authors of a recent study conducted among 528 patients, published in the “New England Journal of Medicine”, “sexual activity, largely among homosexual or bisexual men, is by far the most suspected route of transmission of the virus”.

Especially since “the DNA of the virus, detectable by PCR in the seminal fluid in 29 of the 32 cases tested, confirms this hypothesis. »

But it is the skin lesions that are the most typical symptom of the disease. They generally make it possible to diagnose it clinically. This study revealed very varied sites of appearance of these lesions: the anogenital zone in 73% of the cases, the trunk, the arms or the legs (55%), the face (25%), the palms of the hands and the soles of the feet (10%).

Among them, some had never been described, such as wounds inside the mouth and anus, which cause very intense pain.

Therefore, “we recommend vigilance when examining anyone for unusual acute skin rashes, particularly when the rashes are associated with systemic symptoms, to avoid missing the diagnosis. in heterosexual people,” advise the authors. Because “monkey pox can affect anyone,” they point out.

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