Arranz Izquierdo Javier, Molero García José María, Gutiérrez Pérez María Isabel
Instituto de Investigación Sanitaria de Illes Balears (Idisba), Illes Balears, España; Centro de Salud Escola Graduada, Ibsalut, Palma de Mallorca, Illes Balears, España; Grupo de trabajo de enfermedades infecciosas de SemFYC, Madrid, España.
Grupo de trabajo de enfermedades infecciosas de SemFYC, Madrid, España; Centro de Salud San Andrés, DA Centro (SERMAS), Madrid, España.
Aten Primaria. 2023 Oct;55(10):102680. doi: 10.1016/j.aprim.2023.102680. Epub 2023 Jun 19.
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.
猴痘是一种病毒性人畜共患病,在西非或中非国家流行,偶尔会传播到其他地区。2022年5月,猴痘在欧洲和北美的几个国家开始全球暴发。报告的大多数病例在门诊确诊,主要影响男男性行为者(MSM)。传播途径是与感染者或感染动物的损伤部位、体液、呼吸道分泌物或受污染物质密切接触。临床表现与人类天花相似,但症状较轻。2至4周后,以轻度、自限性的皮肤病变为主。在男男性行为者中,由于感染方式会出现非典型皮肤病变。某些风险群体可能会出现严重形式或并发症。病死率因相关进化枝而异,为3%至6%。疑似病例通过常规或实时PCR核酸扩增技术,从损伤部位渗出液或痂皮中检测到病毒来确诊。大多数情况下,在初级保健机构通过监测主要症状进行临床管理。5%至10%的病例需要住院治疗,并且有一些特定的抗病毒治疗选择。人类天花疫苗可预防猴痘,用作有风险人群的暴露前和暴露后预防。减少接触病毒的措施是主要的猴痘预防策略。此外,家庭医生的作用对于通过主动监测和疾病早期诊断来控制猴痘传播至关重要。