Monkeypox

Adresse

Rue Gabrielle-Perret-Gentil 4
1205 Geneva
Switzerland

Isabella Eckerle
Pre
Isabella Eckerle
Médecin responsable du Centre
Laurent Kaiser
Pr
Laurent Kaiser
Chef de service
Pascal Cherpillod
Docteur
Pascal Cherpillod
Biologiste responsable du CRIVE
Docteur
Pauline Vetter
Médecin du Centre
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In view of the very unusual confirmation of cases of Monkeypox (monkey pox) in several European countries and in the United States in the last week, this page is intended to confirm that the virology laboratory at HUG has a PCR allowing the diagnosis to be made if necessary at the National Reference Center for Emerging Viral Infections (CRIVE).

Below you can find a brief summary of the current epidemiological situation as of 27.07.2022, as well as the case definition and contact persons at HUG in the event of suspicion. Given the clinical presentation, it is possible that affected patients may first consult on an outpatient basis. More information on the disease and specimen collection is available in this Monkeypox summary.

Epidemiological situation

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This disease is caused by a virus similar to that of smallpox, the monkeypox virus, an orthopoxvirus (DNA virus). It is a zoonosis endemic in West Africa and Central Africa. Cases are regularly reported in some African countries, for example in Nigeria. Imported cases diagnosed outside Africa have been rare but regular since 2018.

The number of cases diagnosed outside Africa in the past week is unusual, as is the geographic distribution of cases in multiple countries at the same time, acquired out of Africa. Since the initial reports in the UK, numerous cases of monkey pox (Monkeypox) have been confirmed in several European (England, Belgium, Sweden, Spain, Portugal, Germany, Switzerland, etc), North American (USA, Canada), and Australia countries. Case numbers have risen considerably since the first reports in the UK, and the WHO has declared the outbreak a public health emergency of international concern.

Epidemiological investigations are in progress, and only one case seems for the moment linked to a return from Africa, the others having apparently been acquired in Europe or North America. The epidemiological links remain to be investigated, but the first available data do not indicate a clear chain of transmission. The UK, Portuguese, and Spanish cases have been described as occurring mainly in young men who have sex with men.

 

PCR results for Monkeypox, from the CRIVE:

Diagnostic monkeypox PCR CRIVE Geneva last4weeks Diagnostic monkeypox PCR CRIVE Geneva activity

Diagnostic monkeypox PCR CRIVE Geneva Diagnostic monkeypox PCR CRIVE Geneva activity

 

The top graph shows the number of samples tested for Monkeypox in Geneva by the CRIVE. Dark orange indicates positive results, while light orange indicates negative results.

 

Clinic and case definition

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The usual clinical manifestations are a fever with lymphadenopathy (cervical, inguinal), followed within 1-2 days by a first macular rash then evolving into vesicles/pustules in the mouth, on the face, the torso, and then towards the extremities (including the palms of the hands and soles of the feet).

The WHO suspected case definition is: febrile with lymphadenopathy followed by rash.

Diagnostic

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In case of suspicion, the national reference center for emerging viral infections, has a PCR for diagnosis (ideally skin lesions swab (to be stored in VTM), or throat swab (before the appearance of lesions). 

Please fill the analysis request form and send it with the speciment to the laboratory. Pleas note that there is no longer a need to call the lab first.

Specimens are to be transported as category B for confirmations and for suspicions.

This disease must be reported within 24 hours in after case confirmation to the cantonal physician.

Transmission occurs through the respiratory route as well as through direct contact with a lesion (infected fluid). The preventive measures are therefore the AIR + CONTACT measures.

Traitement

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Plusieurs antiviraux ont montré un effet in vitro contre le virus de la variole du singe, ou chez des animaux infectés. Il existe peu de données chez l’être humain. Un résumé des évidences existantes est disponible ici. 

La Société Suisse d’Infectiologie (SSI), en collaboration avec la Commission Fédérale pour la Santé Sexuelle élabore des recommandations de prise en charge, qui seront régulièrement mises à jour.
 

More information

Last update : 22/11/2022