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HEALTH

UPDATED: Monkeypox in Austria: What causes it and is it serious?

After Austria confirmed its first case of monkeypox in Vienna at the weekend, the Ministry of Health has now recommended quarantine rules for close contacts with symptoms. Here is what you need to know about the disease.

UPDATED: Monkeypox in Austria: What causes it and is it serious?
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions. Photo: Cynthia S. Goldsmith, Russell Regner/CDC/AP

A 35-year-old man was confirmed as the first case of monkeypox in Austria this Sunday, 22nd, according to Viennese medical authorities.

The man is isolated in a clinic in the Favoriten district and “is doing well under the circumstances”, health authorities said. On Sunday, the patient went to the clinic with a slight fever and isolated skin lesions.

This is the first case in Austria of a “multi-country monkeypox outbreak in non-endemic countries”, as the World Health Organisation (WHO) says.

READ ALSO: EXPLAINED: How Austria’s compulsory vaccine mandate could be back in June

The monkeypox virus is well known but endemic to isolated regions in Africa. Experts are still unsure why the disease has been spreading outside of Africa in people with no connection to the affected areas.

What is monkeypox?

Monkeypox, Affenpocken in German, is a zoonotic virus (a virus spread from animals to humans) that most often occurs in areas of tropical rainforest in Central and West Africa. However, it is occasionally found in other regions, and cases have recently been discovered in Europe, North America, and Australia.

The name monkeypox originates from the initial discovery of the virus in monkeys in a Danish laboratory in 1958, according to WHO. The first human case was identified in a child in the Democratic Republic of the Congo in 1970.

READ ALSO: Everything foreigners need to know about the Austrian healthcare system

How is it transmitted?

Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.

People can also be infected through contact with the lesions of the skin, blood, tissues, or excretions of infected animals (mainly rodents) and by handling the meat of sick animals.

The disease is not known to be sexually transmitted. Still, close contact between people during sex can make the transmission of the virus easier.

READ ALSO: EXPLAINED: What is Austria’s ‘tick vaccine’, and should you take it?

Many of the cases presented are in men who have sexual relations with other men and health authorities have asked for extra care and are studying current cases.

What are the symptoms?

The symptoms of monkeypox include fever, headache, muscle aches, swollen lymph nodes, chills, and exhaustion. In addition, a rash similar to chickenpox typically develops, often starting on the face and spreading to other parts of the body, including the genitals.

Monkeypox typically has an incubation period of six to 16 days, but it can be as long as 21 days. Once lesions have scabbed over and fallen off, the person with the virus is no longer infectious.

READ ALSO: ‘Mysterious hepatitis’: Everything we know so far about the new cases in Austria

Monkeypox is usually self-limiting, and people recover in a few weeks, but it may be severe in some individuals, such as children, pregnant women, or persons with immune suppression due to other health conditions.

What are the guidelines from the Ministry of Health?

On Tuesday May 24th, Austria’s Ministry of Health published a set of guidelines, including a three-week quarantine for close contacts of positive cases that are showing symptoms.

The isolation period can be completed at home or at hospital, depending on the state of health of the patient.

Furthermore, contacts of a positive case will be treated as either Type I or Type II in a move similar to the management of Covid-19 contacts.

Type I contacts are considered as high-risk and include those who have had direct contact with skin lesions of an infected person, such as sexual partners, but also close passengers on planes, buses or trains for a period of at least eight hours. 

High-risk contacts do not have to isolate straight away but must monitor their condition for 21 days through a daily phone call with the health authorities. If symptoms occur, then the person has to quarantine for three weeks and a PCR test has to be carried out.

Type II contacts are short social contacts, such as work colleagues (not in the same office), or fleeting contacts in gyms, saunas or bathrooms. These contacts must monitor their health for 21 days.

How can I protect myself and others?

There is no specific vaccine against this virus that would be widely available, but the common smallpox vaccine already offers high protection and is recommended for close contacts and health workers.

“Historically, vaccination against smallpox had been shown to be protective against monkeypox. While one vaccine (MVA-BN) and one specific treatment (tecovirimat) were approved for monkeypox, in 2019 and 2022 respectively, these countermeasures are not yet widely available.”, according to the World Health Organisation.

READ ALSO: More pay and longer holidays: How Austria hopes to attract 75,000 new nurses

For now, there are no large vaccination campaigns for smallpox, and WHO is convening experts to discuss recommendations on vaccination.

“Steps for self-protection include avoiding skin to skin or face to face contact with anyone who has symptoms, practising safer sex, keeping hands clean with water and soap or alcohol-based hand rub, and maintaining respiratory etiquette”, according to the World Health Organisation.

If people develop a rash, accompanied by fever or a feeling of discomfort or illness, they should contact their health care provider and get tested for monkeypox, the organisation added.

READ ALSO: Reader question: Do I need to wear a mask on flights to/from Austria?

If someone is suspected or confirmed as having monkeypox, they should isolate until the scabs have fallen off and abstain from sex, including oral sex.

During this period, patients can get supportive treatment to ease monkeypox symptoms.

Anyone caring for a person sick with monkeypox should use appropriate personal protective measures, including wearing a mask and cleaning objects and surfaces that have been touched.

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HEALTH

WHO says European festivals should go ahead despite monkeypox risk

Most new cases of monkeypox are currently detected in Western Europe. The World Health Organisation says this is no reason to cancel more than 800 festivals scheduled to take place on the continent this summer.

WHO says European festivals should go ahead despite monkeypox risk

The World Health Organization said Friday that European summer festivals should not be cancelled due to the monkeypox outbreak but should instead manage the risk of amplifying the virus.

A surge of monkeypox cases has been detected since May outside of the West and Central African countries where the disease has long been endemic.

Most of the new cases have been in Western Europe.

More than 3,200 confirmed cases and one death have now been reported to the WHO from 48 countries in total this year.

“We have all the summer festivals, concerts and many other events just starting in the northern hemisphere,” Amaia Artazcoz, the WHO’s mass gatherings technical officer, told a webinar entitled “Monkeypox outbreak and mass gatherings: Protecting yourself at festivals and parties”.

The events “may represent a conducive environment for transmission”, she said.

“These gatherings have really close proximity and usually for a prolonged period of time, and also a lot of frequent interactions among people,” Artazcoz explained.

“Nevertheless… we are not recommending postponing or cancelling any of the events in the areas where monkeypox cases have been identified.”

Sarah Tyler, the senior communications consultant on health emergencies at WHO Europe, said there were going to be more than 800 festivals in the region, bringing together hundreds of thousands of people from different countries.

“Most attendees are highly mobile and sexually active and a number of them will have intimate skin-to-skin contact at or around these events,” she said.

“Some may also have multiple sexual contacts, including new or anonymous partners. Without action, we risk seeing a surge in monkeypox cases in Europe this summer.”

Risk awareness

The UN health agency recommends that countries identify events most likely to be associated with the risk of monkeypox transmission.

The WHO urged festival organisers to raise awareness through effective communication, detect cases early, stop transmission and protect people at risk.

The outbreak in newly-affected countries is primarily among men who have sex with men, and who have reported recent sex with new or multiple partners, according to the WHO.

People with symptoms are advised to avoid attending gatherings, while people in communities among whom monkeypox has been found to occur more frequently than in the general population should exercise particular caution, it says.

The normal initial symptoms of monkeypox include a high fever, swollen lymph nodes and a blistery chickenpox-like rash.

Meg Doherty, from the global HIV, hepatitis and sexually-transmitted infection programmes at WHO, said: “We are not calling this a sexually-transmitted infection.

“Stigmatising never helps in a disease outbreak,” she added.

“This is not a gay disease. However, we want people to be aware of what the risks are.”

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