More monkeypox cases were reported in China last month than in June, and Shanghai was alert to transmission.

A total of 491 cases of monkeypox were reported on the Chinese mainland in July, compared with only 106 cases in the previous month.

They covered 23 provinces, municipalities and autonomous regions, with no serious cases or deaths, according to the Chinese Center for Disease Control and Prevention.

Guangdong Province is the region with the most cases (115), followed by Beijing and Sichuan. Shanghai ranks No. 7 with 25 cases. There were no monkeypox cases reported in Shanghai in June.

All patients are males, with 96.3 percent confirmed as male who have had sex with a male. The risk of other means of transmission is low. No people who had close contact with patients but did not have sexual interaction were infected.

About 89.2 percent of cases were detected when the patients went to a hospital for diagnosis and treatment, 6.5 percent were found in close contacts and the rest were found by voluntary report or screening. Most cases have symptoms like fever, herpes and enlarged lymph glands.

The reason for the rising cases is because monkeypox is transmitted among males who have sex with other males. Some 80 percent of cases are single cases, imposing difficulty in detecting the source and launching prevention and control. Along with public education, more people in the key target category went to hospital for diagnosis and treatment voluntarily.

In addition to screening among close contacts, more cases are detected through voluntary reporting and screening in key targeted areas. The increase of imported cases also contributed to the rising number.

According to CDC, people who have close contacts with monkeypox patients should avoid sexual behavior with others during self-monitoring period. They should also receive checks from local CDC or health facilities on the 7th, 14th and 21st days and carry out voluntary reporting if displaying suspicious symptoms.

The Chinese CDC said the nation has carried out monitoring for viral mutation. The current cases reported in China are all the mild West African strain, which is mainly prevalent in Europe, North America and some Asian countries.

The team of the National Center for Infectious Diseases in Shanghai, led by leading infectious disease expert Dr Zhang Wenhong, also released the latest version of public guidance on monkeypox prevention and protection.

According to the guidance, the transmission of monkeypox includes animal-to-human infection through contact with infected animals or eating infected animals, which is not fully cooked; human-to-human infection through contacting patients’ skin lesion, mouth secretion, droplets, contaminated items and sexual contact. There is possibility of mother to infant infection.

Vulnerable people include those who have close contact with monkeypox patients, including males who have sex with males, health professionals with contact of monkeypox patients or virus, pregnant women, children and people with low immunity.

The guidance notes that ordinary people should avoid contact with monkeypox patients, avoid contact with animals which may carry monkeypox virus and avoid eating or processing wild animals. There is no need for ordinary people to undergo vaccination at present.


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