Management from Primary Care of monkeypox infection (MPOX) in humans

• Published in: Atención primaria 2023-10, Vol.55 (10), p.102680-102680
• Main Authors: Arranz Izquierdo, Javier, Molero García, José María, Gutiérrez Pérez, María Isabel
• Format: Article
• Language: eng ; spa
• Subjects: Animals; Homosexuality, Male; Humans; Male; Mpox (monkeypox) - diagnosis; Mpox (monkeypox) - epidemiology; Mpox (monkeypox) - therapy; Primary Health Care; Sexual and Gender Minorities; Smallpox - diagnosis; Smallpox - prevention & control
• ISSN: 1578-1275
• DOI: 10.1016/j.aprim.2023.102680

Monkeypox (MPOX) is a viral zoonosis endemic in West or Central African countries that is sporadically exported to another area. In May 2022, a global outbreak of MPOX smallpox began to occur in several countries in Europe and North America. Most of the reported cases are identified at the outpatient level and mainly affect men who have sex with men (MSM). Transmission is by close contact with lesions, body fluids, respiratory secretions or contaminated material from an infected person or animal. The clinical picture is similar to human smallpox, with less severity. Mild, self-limiting skin involvement predominates after 2-4 weeks. In MSM, atypical skin lesions appear due to the mode of infection. Severe forms or complications may appear in certain risk groups. The case fatality rate is 3%-6% depending on the clade responsible. The diagnosis of suspicion is confirmed by detection of the virus from exudates of lesions or scabs, with nucleic acid amplification techniques by conventional or real-time PCR. Clinical management in most cases is performed in primary care (PC), by monitoring the main symptoms. Between 5-10% require hospital management and there are some specific antiviral treatment options. Human smallpox vaccines protect against MPOX and are used as pre- and post-exposure prophylaxis for persons at risk. Measures to reduce exposure to the virus are the main MPOX prevention strategy. In addition, the role of the family physician is key to controlling the spread of MPOX through active surveillance and early diagnosis of the disease.