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expert reaction to first monkeypox-related deaths reported outside of Africa

Monkeypox deaths have recently been reported in Brazil and Spain.


Prof Paul Hunter, Professor in Medicine, UEA, said:

“Sadly we were always going to see some deaths with this pandemic. Historically, in Africa we saw mortality rates of about 3% with the West African variant. Overall of about 22,000 cases reported world-wide, so far we know of 4 deaths outside of Africa (about 0.02%) dramatically lower than in African cases, though it is likely that this number will rise over coming weeks. So the risk of death from a Monkeypox infection outside of endemic countries is substantially lower.

“Historically, monkeypox can be more severe in children, the immune compromised and pregnant women and so risk of death in these groups following an infection would be higher. In Africa it used to be the case that most deaths were in children but in the past 2/3 decades deaths in adults have become more common. This may partly be due to fewer adults ever having had the smallpox vaccine but could also be due to the rise in HIV/AIDS over the past 40 years. It is reported that the death in Brazil was in someone with lymphoma which would mean they were immune compromised. But no details are available on the other deaths.  The much lower death rate seen in countries outside of Africa is probably due in part to the availability of better health care in wealthier countries, though better control of HIV infections may also play a role.

“The risk of death outside of Africa remains low though not zero, but these reports reinforce the need to roll out vaccination as soon as possible to those people who are most at risk of catching Monkeypox. The big issue for me remains how do we reduce the mortality rate in endemic African countries.”



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