Does wearing a mask prevent transmission of smallpox from monkeys?

The monkeypox epidemic in the world puts experts on alert. To date, the virus has been identified in more than 15,000 patients in 74 countries. On Saturday 23, the World Health Organization (SGD) considered the Monkeypox a public health emergency.

With more than 800 people infected, Brazil is now the seventh country in the world with the highest number of confirmed cases, according to data from the Ministry of Health. In turn, the state of São Paulo is the one that registers the most cases of Variola orthopoxvirus (monkey pox), the causative agent of monkeypox.

In an attempt to delay the entry of the virus into Brazil, the National Health Surveillance Agency (a visa) in May recommended the use of masks at airports and on planes. According to neurosurgeon Paulo Porto de Melo, the protective measure did not help stop the transmission of the disease in the country.

“Monkey pox is transmitted by prolonged and direct contact between people and active lesions of the virus, and not by the respiratory route”, explains the member of the Doctors for Life, a group dedicated to the study of Covid-19 since the beginning of the pandemic. “Thus, the effect of masks in reducing the transmission of this disease is negligible.”

Monkey pox spreads around the world | Photo: Reproduction: Irina Starikova/Shutterstock

The mortality rate caused by the monkeypox virus is estimated to be between 2% and 10%, depending on the type of agent. In addition, transmission through sexual contact was observed in 95% of cases, according to a study published by the British scientific journal. The New England Journal of MedicineLast week.

According to the WHO, the monkeypox epidemic in Europe may have been caused by risky sexual habits at electronic music parties, known as delirium, Spain and Belgium. The first cases were recorded in men who had sex with other men.

For doctor Paulo Porto de Melo, instead of recommending the use of masks, there are more effective strategies to contain the spread of the disease, such as encouraging the education of the main groups at risk of contagion (men who have sex with other men), avoid close contact with infected people and follow isolation for 21 days.

Respiratory transmission

There is also discussion about the possibility of disease transmission via droplets or aerosols, which would justify the recommendation to use masks as a preventive measure.

A transmission of infection by exposure to expelled respiratory dropletscontaining the virus, occurs when an infected person coughs or sneezes, especially when they are within one meter of each other.

Me and aerosol transmission occurs through smaller respiratory droplets (aerosols) containing viruses that can remain airborne and be transported over distances greater than 1 meter for longer periods of time (usually hours).

For infectious disease specialist Patricia Rady Muller, contamination by monkey pox respiratory route is not excluded as a possible form of transmission. According to the doctor, although the main form of transmission is “body to body”, droplet contamination by saliva would configure a second degree of contagion.

“Emphasizing the use of masks would not be a strategy to delay the arrival of the virus in its entirety”, pleads the doctor. “But in reality, it would be important to avoid contagion if the infected person is close to many people.” Patricia insists that the most effective recommendation to prevent disease transmission is isolation of the infected patient. “The main way to stop this chain of transmission is to detect as many infected people as possible and isolate these patients,” explains Patricia.

For Roberto Zeballos, general practitioner and doctor in immunology, monkeypox is not a respiratory disease. “Where are the cases that were transmitted by droplets? If the contamination was by aerosols, it would not have this 95% predominance. [referindo-se ao estudo da revista britânica] in cases where intimate sex takes place,” he says.

What can happen, according to the specialist, is contamination by the air when the doctor, for example, carries out the treatment of a person contaminated by the monkey pox. “The disease can be transmitted, yes, when the doctor takes care of the infected patient, by the droplets of the vesicles” [lesões na pele da pessoa infectada]Zeballos explains.

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