They are in a battle with monkeypox, with 491 new cases reported in July
In June, 106 new confirmed cases of monkeypox were reported in mainland China, and 491 new cases were reported in July. In August, the Chinese Center for Disease Control and Prevention and the General Administration of Customs successively released information on the monkeypox epidemic, indicating an upward trend in recent times
This summer, monkeypox seems to have made a comeback, and the domestic battle against this disease has also begun.
Infection: People who face monkeypox directly
According to the China National Center for Disease Control and Prevention, 491 new confirmed cases of monkeypox were reported in mainland China in July, which is more than four times the number reported in June.
Sun Kai from Guangdong is one of these 491. On July 12th, he suddenly felt pain in his back, and at that time he didn't pay attention. About 3 days later, he found ulcerated surfaces at the roots of his genitals, followed by a low fever. Two days later, another acne appeared on the back, and the symptoms did not disappear after a few days of receiving penicillin injections at the hospital. "Because I had high-risk same-sex sexual activity before, I realized it might be monkeypox, so I went to the Shenzhen Chronic Disease Prevention and Control Center, which can be tested. After testing positive, I started hospitalization and isolation."
Unlike the widely circulated cases of monkeypox on the internet, Sun Kai's symptoms are milder, with a total of three "pimples" growing. After 3 days of hospitalization, acne begins to scab and fall off, and the entire process takes less than two weeks. "My doctor said that some people who came recently had slightly more severe symptoms, while the recent wave has been milder."
Since June, Shenzhen Third People's Hospital has started admitting cases of monkeypox. Lu Hongzhou, president of the hospital and director of the National Clinical Medical Research Center for infectious diseases, introduced to chinanews. com that the main symptoms of the patients admitted to the hospital were mainly monkeypox herpes, which was mainly distributed on the head, face, trunk and limb skin. Herpes in external genitalia were also more common. Some patients complained of mild pain or itching, some accompanied by fever, and swollen lymph nodes. At present, all cases are mild, with no severe cases or deaths.
Pan Yuejun also felt the recent increase in monkeypox cases. He is the director of the Love Walk Red Ribbon Service Center in Shibei District, Qingdao, and has been a volunteer for AIDS prevention and control for 15 years. The Sixth People's Hospital of Qingdao, which is a public welfare organization, has been receiving cases of monkeypox since June.
Entering July, related consultations have become increasingly frequent. They began to take on more science popularization work related to monkeypox. "Everyone is concerned about a few issues, whether there are many cases? What are the symptoms? Is there a vaccine to prevent them?" Pan Yuejun said.
Spread: The risk of large-scale spread is extremely low
The sudden increase in cases has raised concerns about whether monkeypox will spread more widely in China, and some people have posted photos of local rashes on social media, asking if it means they have been infected.
Monkeypox has been continuously spreading in non endemic countries such as Europe and America for the first time since May 2022. Last September, the first imported case of monkeypox was reported in China. However, the global monkeypox epidemic has previously shown a downward trend. On May 11th of this year, the World Health Organization announced that the monkeypox epidemic no longer constitutes a public health emergency of international concern.
According to the "Monkeypox Prevention and Control Plan" issued by the National Bureau of Disease Control and Prevention and the National Health Commission in July, monkeypox is a self limiting disease, and the virus is mainly transmitted through direct contact with the diseased skin or mucous membranes of the case. It can also be transmitted through contact with items contaminated with the virus or long-term close inhalation of respiratory droplets from the case. The incubation period of the virus is 5-21 days, mostly 6-13 days, with symptoms such as fever, headache, back pain, muscle pain, swollen lymph nodes, rash, etc.
The plan points out that the outbreaks of COVID-19 in multiple countries around the world since May 2022 have mainly been transmitted through sexual contact among men who have sex with men, with the majority of cases being young and middle-aged men, spreading through large-scale gatherings and subsequent MSM in communities. Lu Hongzhou stated that most of the monkeypox patients treated at the hospital are male homosexual, but there are also cases of close contact with monkeypox patients and frequent sharing of their clothing and towels. At present, all cases admitted to the hospital are mild, with no severe cases or deaths. The death cases reported abroad are all people with immunodeficiency, such as untreated AIDS patients.
Lu Hongzhou does not agree with the suggestion to disclose the patient's itinerary. He pointed out that based on the current situation of widespread transmission among monkeypox patients, there is no perceived risk of large-scale transmission.
There is currently no vaccine or specific antiviral drug for monkeypox in China. Lu Hongzhou introduced that currently, targeted treatment is mainly adopted for patients, such as fever reduction, and external application of antibacterial ointment for secondary skin infections.
However, according to China Biotech WeChat official account, the replication defective Tiantan strain monkeypox vaccine independently developed by Sinopharm China Biotech Beijing Institute of Biological Products has been officially accepted by the Drug Evaluation Center of the State Drug Administration on July 13.
Battle: Prevention and control have already been initiated
After recovering from illness, Sun Kai chose to share his experience on social media. Currently, more than 20 cases of monkeypox infection or suspected infection have come to him for consultation. "The symptoms are mild, but there is a more serious one, which may have one or two hundred 'pimples' on the body, but it is the earlier wave."
"The reason why it came out," he said, "is mainly because I rarely see patients talk about their experiences with monkeypox. Many people who come to me for consultation are very panicked, hoping that everyone can understand more and not be completely disoriented. In fact, monkeypox may not be as scary as imagined, and the symptoms may vary from person to person."
Unlike some people's panic, the healthcare system is not very panicked. Over the past year, relevant departments have issued multiple prevention and control measures, including the "Guidelines for Diagnosis and Treatment of Monkeypox", "Technical Guidelines for Monkeypox Prevention and Control", and "Monkeypox Prevention and Control Plan". They have conducted in-depth interpretations from the aspects of transmission characteristics, prevention, and disposal. According to the above documents, diagnosed cases can be directly reported online through the monitoring report management module of the China Disease Control and Prevention Information System.
The hospital also reacted quickly. Lu Hongzhou introduced that currently, the fever clinic of Shenzhen Third Hospital is the department that receives all suspected cases of monkeypox, and all suspected cases are sampled and diagnosed by professional medical staff. The admission ward is a negative pressure ward dedicated to treating infectious diseases, and an independent ward for monkeypox cases has been established. It is managed and treated by experienced medical staff working in professional infectious disease wards.
"If there are suspected monkeypox patients coming to see the doctor, they will be guided to the fever clinic. After routine diagnosis, the doctor will sample herpes fluid, throat swabs and other samples to the CDC of the city for further detection of monkeypox virus nucleic acid for a clear diagnosis, and then disinfection and sterilization the suspected patients in the reception room," Lu Hongzhou said.
He said that if patients in the hospital have home isolation conditions, they can go home for isolation on their own. If they are required to be hospitalized for isolation, they can be admitted to the hospital isolation ward for isolation. Hospitals will require patients to wear masks and gloves, educate on the transmission routes of monkeypox, and require patients to stay at home and reduce going out.
Public welfare organizations and volunteers are also taking action. Pan Yuejun said that after the first imported case of monkeypox occurred in China last year, her organization began conducting science popularization related to monkeypox. After the first case of monkeypox occurred in Qingdao, the efforts to popularize science have been further intensified.
In addition to the publicity on the official account, Tiktok, relevant groups, and the addition of monkeypox science popularization content in the daily consultation, they also held two offline patient activities, where volunteers popularized the knowledge about monkeypox prevention, so that key groups can find, check, and take treatment measures in time to avoid more spread.
Hidden worry: Worried about infection, more worried about "social death"
According to the Monkeypox Prevention and Control Plan, county-level disease control institutions should organize epidemiological investigations in a timely manner after receiving reports of suspected and confirmed cases in their jurisdiction, identify the source of infection, and grasp, track, and manage close contacts.
The plan has repeatedly emphasized that in the process of monkeypox epidemic prevention and control, various regions should pay attention to protecting the personal privacy of cases, close contacts, and key populations.
However, due to the current disclosed information, most of the cases are male sexual behavior, and some patients are hesitant to actively undergo testing and treatment. In the monkeypox patient consultation received by Pan Yuejun, the most frequently asked question was not about symptoms, but "Will privacy be leaked? Will it lead to 'social death'?"
A few days ago, he received a request for help from a patient. The other party has symptoms such as fever, diarrhea, and herpes, and is highly suspected of monkeypox. However, they are concerned that once diagnosed at the hospital, their family and colleagues may be transferred. "Life and work may be affected, and they will not be able to live in the future." In the end, the other party chose to quarantine at home, take medication, and wait for recovery.
The Longgang District Center for Disease Control and Prevention in Shenzhen has also discovered this issue. In their paper on the epidemiological investigation of 16 monkeypox cases released in August, it was pointed out that due to public opinion and secular pressure, infected individuals have low initiative in seeking medical treatment. "The time from onset to seeking medical treatment is relatively long, and the symptoms are mild. There are difficulties in investigating and handling the epidemic, and there are certain difficulties in epidemic prevention and control."
After sharing his symptoms and experiences on social media, Sun Kai also received some attack information, as well as leaked medical records and epidemiological history of acquaintances. Pan Yuejun also noticed that in the past two months, information about multiple infected individuals in at least two places has been leaked, including their home addresses, work units, etc.
Appeal: stigmatized information is not conducive to monkeypox prevention and control
The simultaneous attacks and discriminatory remarks have also raised concerns among Pan Yuejun.
In his view, avoiding stigmatization of infected individuals is crucial. On the one hand, this may make infected individuals feel ashamed to go for testing, medical treatment, and even distrust the public health system; On the other hand, the population is generally susceptible to monkeypox virus, and overemphasizing specific populations may overlook other transmission routes, leading the public to mistakenly believe that monkeypox only affects certain specific groups, causing other groups to take it lightly, which is actually not conducive to monkeypox prevention and control.
Lu Hongzhou believes that although men who have sex with men are a key group of people infected with monkeypox virus, it does not mean that all men who have sex with men are infected with monkeypox. Aggressive and discriminatory remarks are obviously inappropriate. The statement that only gay men need to worry is absolutely incorrect. The monkeypox virus does not distinguish a patient's sexual orientation, and anyone who has close contact with monkeypox patients is at risk of developing monkeypox.
"Avoiding contact with monkeypox patients is an effective preventive measure, and developing good lifestyle habits is also a good preventive measure: such as not sharing towels and clothing with others, reducing direct skin contact with others in daily life, etc. Those with a suspected history of contact should be alert to the possibility of contracting monkeypox once they experience symptoms such as fever, rash, and swollen lymph nodes." Lu Hongzhou reminds.
