The probability that the smallpox virus will appear in Turkey …

The probability that the smallpox virus will appear in Turkey ...

Yasemin Artunc / Mynet Special The smallpox virus continues to spread worldwide. The number of cases of simian pox virus, which is transmitted from animals to humans and has become human-to-human in recent years, is increasing every day. Developments regarding the smallpox virus, which is not visible in our country, are being closely monitored. Acıbadem Taksim Hospital specialist in infectious diseases and clinical microbiology Prof. Dr. Çağrı Büke answered questions from Mynet.


The causative agent of monkeypox is a DNA virus and belongs to the Ortopoxvirus species belonging to the Poxvirus family. This species especially likes to engage the skin. Unlike smallpox of the same species, the smallpox virus has an animal reservoir. Therefore, it causes zoonotic infectious diseases transmissible from animals to humans. The name “monkey pox” was given because the virus was first isolated from primates in Denmark in 1958, but the main reservoir is a squirrel or a rodent. The disease was first observed in people in 1970 in a nine-year-old child in the Democratic Republic of the Congo.

Today, there are two different strains of monkeypox virus. The first is the “West African” tribe; It is common in Nigeria, Liberia, Sierra Leone and Côte d’Ivoire. This is a strain that currently occurs in Europe and is mild. The mortality rate for infections that develop with it is 1%. The second tribe, the “Congo Basin”, is detected in the Democratic Republic of the Congo, the Republic of the Congo, the Central African Republic, Gabon and also Cameroon. With this, more severe clinical pictures appear and mortality from related infections reaches 10%.


Although the Congo Basin tribe has not yet been transferred outside Africa, the West African tribe entered the United States in 2003 due to imports of infected animals. None of the monkeypox diseases observed in humans during this period were transmitted from human to human. In 2017, there was an epidemic in Nigeria, in which a large number of cases were recorded after 40 years. The peculiarity of this epidemic was that the disease was previously observed in settlements near forest areas, but with this epidemic, the disease began to occur in urban areas of Nigeria. This situation has also been seen in Singapore, Israel and England, through those who returned from Nigeria in 2018. A hospital cleaning lady in England contracted chickenpox after cleaning a patient’s bed. In 2021, cases involving passengers returning from Nigeria and the United States were again identified.


Although the last case found in England on May 7, 2022 was a person from Nigeria, none of the cases that occurred later could be in contact with this case or with any other traveler. This recent situation recalls that smallpox disease has different transmission routes. countries that reported cases outside the United Kingdom between that date and 22 May 2022; Canada, Spain, Sweden, Portugal, Austria, Belgium, France, Germany, Italy, the Netherlands, the United States, Israel and Switzerland.


No case of monkeypox has been reported from our country so far. In today’s world, where the number of cases and countries reporting cases is increasing every day, it should be borne in mind that there may be a possibility of disease in Turkey if there are known that there are different ways of transmitting the disease. .


The time from infection to the onset of the first symptoms is relatively long. This period can range between 5 and 21 days. The first symptoms are high fever, headache, enlarged lymph nodes, back, muscle and joint pain, weakness and fatigue. With the onset of these symptoms, the disease becomes contagious. These complaints usually last for two days. Then the skin rashes begin. Skin rashes appear on the face first. Then it gradually spreads throughout the body. Skin rashes called macules, papules, vesicles and pustules can also develop on the mucous membranes of the mouth and genital tract. Skin rashes are painful and even itchy. The disease lasts on average 2-4 weeks. This will usually resolve itself. The disease continues to be transmitted through contact with lesions on the skin and mucous membranes until the rashes on the skin and mucous membranes dry out and turn into crusts.


Various complications can occur during smallpox. In cases where skin lesions are numerous and widespread, fluid loss causes dehydration. In addition, secondary bacterial infections of the skin with itchy lesions may develop. In addition to bacterial superinfection of lesions and septicemia, lesions of the eye and cornea can develop, which can lead to vision loss. Encephalitis (inflammation of the brain) has also been reported.

Although the infectious disease caused by the monkeypox virus is generally mild, it is serious and life-threatening in children and in cases with underlying immunosuppressive disease or those receiving such treatment. The West African tribe is the current tribe in Europe, with a mortality rate of 1% from infections with it. Mortality is 10% for infections caused by the Congo Basin.


The disease is transmitted to humans mainly from wild animals such as monkeys, rats and squirrels, rodents and primates. Direct contact with the skin, mucous membranes, blood and other body fluids of infected animals plays a role in transmission. It should be borne in mind that there is a low probability of contamination by consuming undercooked meat products from infected animals.

Respiratory droplets play an important role in the transmission of disease from person to person. Prolonged exposure to these drops poses a risk of contamination. In addition, contact with lesions on the skin and mucous membranes also plays a major role in disease transmission. In this regard, it should be borne in mind that the disease can be transmitted sexually. Wearing clothing that has come into contact with the patient’s body and mucous membranes and using someone else’s blankets and sheets also play a role in transmitting the disease to humans.

It is estimated that the cases that have occurred today in Spain and Italy may be due to a festival that brought together 80,000 people in the Canary Islands between 5 May and 15 May. Again, it is considered that the sauna may play a role in the emergence of cases in Spain.

What needs to be done now is to curb the spread of the virus, detect all cases quickly and trace contacts; To inform and raise the awareness of society and people about the disease, ways of its transmission and ways of prevention. Another such important situation is the updating of doctors’ knowledge about the diagnosis and differential diagnosis of this new disease. Prompt identification and identification of people with the disease and isolation of these cases for an average of three weeks are essential to prevent the spread of the disease.

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