Letter to editor:human monkeypox and the atypical outbreak

Rujittika Mungmunpuntipantip,Viroj Wiwanitkit

(1.Private Academic Consultant Center,Bangkok,Thailand;2.Joseph Ayobabalola University,Ikeji-Arakeji,Nigeria)

Dear editor, we would like to share ideas on the publication in your journal "Learning from the past:the history of human monkeypox and the atypical multi-country outbreak in 2022"[1]. To better understand the risk assessment and potential clinical and public health impacts of this outbreak in the future, Yao[1]provides a thought-provoking history of the 64-year interaction between the monkeypox virus and humans. He also provides a variety of information and viewpoints on the human monkeypox outbreak.

The current outbreak is very different from that in Africa. The discrepancy is associated with many factors, in which the environment and the human host have a crucial impact in addition to genetics and evolution. Typically, the patient has a cutaneous lesion in addition to a fever.However,the presence of neither a fever nor a skin lesion is more common in the current outbreak[2]. Some people may just have bizarre symptoms, such as neurological and digestive symptoms[3-6]. Occasionally, under certain circumstances, atypical skin lesions may occur.Hemorrhagic vesicles may also develop[2].

Yao[1]provides a history of the 64-year interaction between the monkeypox virus and humans and offers a variety of information and viewpoints on the monkeypox outbreak, which is useful for understanding the risk assessment and potential future clinical and public health impacts of this outbreak.Monkeypox is becoming rare again, mostly due to zoonosis[2-3]. The possibility of human-to-human transmission is currently being examined[2-3]. There is no doubt that past evolution and mutation could have had an impact on the recent change.

All professionals working in this new industry need to continue their education. Atypical symptoms of the disease must be considered. Last but not least,Isaacs[7]pointed out that cases of men who have sex with men (MSM) make up the majority of contemporary cases.MSM cases may not have a great awareness of their health condition to seek medical attention early. As previously indicated, the disease can manifest itself in a variety of ways, some of which may be mild and unnoticed. It could be the main factor in the eventual spread of the disease. It is vitally important to restore infection control, as we have just successfully done during the COVID-19 epidemic.

以下是對(duì)應(yīng)的中文翻譯。

致編輯的信：人感染猴痘和非典型暴發(fā)

編輯：我們想分享一下閱讀貴刊刊發(fā)的論文“知往鑒今：人感染猴痘史及其非同尋常的2022年多國(guó)暴發(fā)疫情”［1］的體會(huì)。為了更好地理解風(fēng)險(xiǎn)評(píng)估及此次疫情對(duì)未來(lái)臨床和公共衛(wèi)生的潛在影響，該文作者姚開(kāi)虎［1］梳理了發(fā)人深省的猴痘病毒與人類之間64 年的相互作用史。他同時(shí)提供了關(guān)于人感染猴痘暴發(fā)的各種信息和觀點(diǎn)。

當(dāng)前的疫情與非洲疫情有很大的不同。導(dǎo)致差異的原因與許多因素有關(guān)，除了遺傳和進(jìn)化之外，環(huán)境和人類宿主也具有至關(guān)重要的影響。典型人感染猴痘患者除了發(fā)熱外還有皮膚病變，然而此次疫情中患者既無(wú)發(fā)熱，也無(wú)皮膚病變的情況很普遍［2］。有些患者可能只是有非特異的癥狀，例如神經(jīng)和消化問(wèn)題［3-6］；特定情況下偶爾會(huì)出現(xiàn)不典型的皮膚病變，也可能出現(xiàn)出血性囊皰［2］。

姚開(kāi)虎［1］撰寫(xiě)的這一篇關(guān)于猴痘病毒與人類相互作用的64 年歷史，以及關(guān)于猴痘暴發(fā)的各種信息和觀點(diǎn)，有助于理解猴痘暴發(fā)的風(fēng)險(xiǎn)評(píng)估及對(duì)臨床和公眾健康的潛在影響。由于猴痘是人畜共患病，暴發(fā)后通常會(huì)重新變得罕見(jiàn)［2-3］。人傳人的可能性正在進(jìn)行評(píng)估［2-3］。毫無(wú)疑問(wèn)，過(guò)去的進(jìn)化和突變可能對(duì)最近觀察到的變化已產(chǎn)生了影響。

所有目前從事于這個(gè)行業(yè)的專業(yè)人士都必須不斷學(xué)習(xí)，更新知識(shí)，工作中警惕該病的非典型癥狀。最后但同樣重要的是，Isaacs［7］指出，男男性行為者占此次疫情病例的大部分。男男性行為患者可能不會(huì)明顯意識(shí)到自己的健康問(wèn)題而盡早就診。正如以上所述，這種疾病的臨床表現(xiàn)多樣，其中一些可能表現(xiàn)輕微，易被忽視，這可能是該疾病最終傳播的主要因素。恢復(fù)那些我們剛剛在新型冠狀病毒肺炎流行期間成功實(shí)施的感染控制措施至關(guān)重要。