Doctors understand that the first patient in the US global epidemic was diagnosed with monkey disease


When Dr. Nesli Basgoz met her patient for the first time in May, and she was admitted to a Massachusetts hospital with symptoms common to many infectious diseases — fever, rash, fatigue, and sweating.

Basgoz and his colleagues at the hospital examined the patient for smallpox. It was negative. They tested him for syphilis. It was negative.

Doctors were still treating him with antibiotics and antiviral drugs, who were waiting for the results of various tests, but his condition did not improve with this treatment.

With each passing day, Basgoz noticed that the patient’s rash changed. At that moment, he learned that he had no general illness.

His mind exploded, uniting parts of a medical puzzle.

“Some of the skin lesions, called pustules, have started to develop ulcers, a feature that can be seen in smallpox viruses,” Basgoz, the hospital’s chief assistant and clinical director of the infectious diseases department, told CNN.

“It’s a combination, not an improvement when it comes to things in common; negative test results for common infections; and a slight change in the appearance of the rash has increased the likelihood that it may be the smallpox virus, ”he said. It was his ah-ha moment.

Patient Basgoz, described as a “relatively young and healthy person,” traveled to Canada this year before becoming the first person in the United States to be diagnosed with smallpox. To date, global health officials have identified more than 1,200 patients in at least 31 countries as of Friday.

Monkey smallpox “wasn’t on our radar screen in the beginning,” Basgoz said of treating the U.S. first case.

As the monkey smallpox virus spread, some doctors and public health officials noticed that patients presented with mild symptoms that could be mistaken for other illnesses. According to Basgoz, two factors can help explain why the disease sometimes occurs covertly.

“One of the main reasons is that the main strain associated with the epidemic is the West African class and it is associated with a milder disease,” said Basgoz, compared to the other in Central Africa.

“The second is that so far there are a lot of relatively young and healthy people among the reported patients,” Basgoz said. “When you see an infection in relatively young and healthy people, it’s easier than in people who are elderly or have other medical conditions.”

Smallpox spreads through direct contact with body fluids or wounds on the body of an infected person, or through direct contact with body fluids or materials that come in contact with wounds, such as sheets or clothing, according to the CDC.

A CDC report released on Thursday said the spread of smallpox in the air by tiny virus particles in the air was “not reported.” It can be spread through “saliva or respiratory tract” contact, but these secretions “fall quickly from the air” and this method of infection is rarely seen.

The CDC said the risk to the general public remains low, but health care providers should be vigilant for patients with rashes or diseases similar to monkey smallpox.

“Historically, people with smallpox have symptoms similar to the flu, such as fever, body aches, and swollen glands, before common rashes appear on several parts of the body, most commonly on the face, arms, and hands. However, during the current epidemic, some patients developed rashes around the genitals or anus before they noticed flu-like symptoms, while others did not develop flu-like symptoms, “said Dr. Rochelle, CDC Director. Valensky said.

He added that for some patients, rashes do not always spread to other parts of the body or may occur in several parts of the body.

“It can be similar to different things – the fever, chills, body aches we talked about with Covid-19 can also occur as the first signs or symptoms of monkey smallpox prodrome,” the doctor said. Christina Vozheva, chairwoman of the microbiology committee at the American College of Pathologists and director of clinical microbiology at the University of Vermont, who is not a member of the CDC, told CNN.

“The lesions themselves can be confused with herpes or smallpox or syphilis, so sexually transmitted disease clinics may see more of these patients because they may be similar to those diseases,” Vojevada said. “So I think it’s important for both patients and clinics to give a complete history of your potential effects, if appropriate, to test for monkeys.”

In the United States, 45 patients with monkeys have been identified so far in 15 states and Washington, D.C., and the virus does not appear to be spreading “in the same area” of the country, a CDC official said in a news release Friday. briefing.

“Currently, we do not have an urban epidemic in the United States, as in Montreal and elsewhere. We don’t have an area where the community seems to have a lot of infections, ”he said. Jennifer McQueiston, a veterinarian and deputy director of the CDC’s Highly Dangerous Pathogens and Pathology Division, said at a briefing.

Most cases in the United States – 75% or more – report that they may have been infected during an international trip, McQueen said. Some other patients reported being associated with a known ape disease and they were identified by contact search.

But there are also patients who don’t know how some monkeys contracted smallpox, “and that shows that there is some kind of infection in the community to the extent that it attracts the attention of public health workers,” Mackwiston said.

“There are such rare cases where they don’t know how the monkey got the smallpox,” he added. “Maybe they got it from someone who recently traveled, but they’re not sure – and we’re in the United States now. This may change. We can start spreading the community, and I think we need to make sure that testing is on the rise and that we can catch it when it happens. ”

CDC researchers and health officials last week released a report stating that of the 17 cases described in the report in nine states, rash was a symptom of the disease, and most were diagnosed in gay, bisexual or male. having sex with men (MSM).

“The high proportion of early cases detected in people identified as gay, bisexual or other MSM in this epidemic may reflect the early introduction of smallpox into interconnected social networks; The findings may also reflect the fact that some MSMs and clinical providers have strong, established relationships and a broad knowledge of infectious diseases, including rare conditions, ”the CDC researchers said in a statement.

“However, infections are often not limited to specific geographies or groups of people; Intimate physical contact with infected people can spread smallpox, because anyone, regardless of gender or sexual orientation, can be infected with smallpox. ”

Basgoz, of Massachusetts General Hospital, hopes that even though people know what the symptoms of smallpox may be in this epidemic, they understand that the risk is low and does not stigmatize the disease.

According to him, viruses in our environment live in our bodies trillions of microorganisms, we do not notice it, viruses are more than bacteria.

“They’re everywhere,” Basgoz said. “Most of them don’t hurt us, but sometimes they do, so I like to put it in context for people.”


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