The whole world’s eyes are on Africa, where monkeypox is taking its toll. And the danger of the disease spreading globally is causing concern especially in Europe. Although health officials have decided not to take additional preventive measures, countries such as Spain and France have increased their vigilance. How things could be in Romania, when the vaccination centers will open for the population and who can be vaccinated from now on, several specialist doctors explained to us.
In Romania there is no case of monkeypox. Photo source: archive
“The increase in the number of cases of the disease in Africa is something that we, as a public health institution, must take very seriously,” Dr. Gindrovel Dumitra, coordinator of the vaccinology group within the National Society of Family Medicine, told Adevărul.
“However, we cannot make a comparison with the SARS-CoV-2 virus, when we had vaccination centers open. And this, because the characteristics of the two diseases are completely different. In the case of monkeypox, the spread is not as easy as in the case of Covid. Close contact over a longer period of time is needed between people who can transmit the virus. Mpox is not transmitted by going to school, work or traveling on public transport. For example, we can travel by plane and among the passengers there is also a sick person. The risk of getting the virus is practically non-existent. The transmission route is more demanding,” the doctor also explained.
“At Matei Balș vaccination can start even from tomorrow”
Dr. Gindrovel Dumitra told us that the population of Romania will be vaccinated “only if a large number of cases of infection”. At the moment, there is no sick person. “Everything depends on what will happen in Europe as well. If we are going to import this disease, it is possible that at some point certain vaccination centers in public hospitals or in family doctors’ offices will be involved. But I don’t think it will be a phenomenon like Covid-19. I’m really sure that won’t happen.”
Dr. Adrian Marinescu, infectious disease doctor and medical director of the “Matei Balș” Institute of Infectious Diseases, told Adevărul that the vaccination center within the hospital can open at any time. “Even tomorrow if needed. The anti-Covid vaccination centers, which are already working, like the one in Matei Balș, can take over and vaccinate against monkey pox at any time”.
As for opening centers in buildings independent of hospitals, this idea does not make sense. “There are bigger emergencies in Romania, with other things, with treatments for Covid and to start discussing now about independent centers… that means allocating staff too”, says the infectious disease doctor.
Who can currently be vaccinated against monkeypox?
Although vaccination is not possible on a large scale, there are people who, if they want, can immunize themselves against mpox. “It is about those who go abroad, to Africa, to be exact. But I do it with money from my own pocket. The vaccine costs around 40-50 euros. We have vaccines against monkey pox, but we have them in small doses”explains Dr. Marinescu. The doctor announced, in this context, the opening of a Traveler’s Medicine Center at the Matei Balș hospital. “In a week, two, we’ll have one too.”
For now, however, such a center operates only at the “Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases. Dr. Simin Florescu, the medical director of the institution, confirmed that the hospital currently has the vaccine against monkey pox. “We have the vaccine, we administered it since last year, when those cases were also registered in our country. The vaccine is administered in a single dose. In cases of high risk, a second dose can be administered, and the immunization is recommended to be done one month before leaving the country. It depends on the level of risk we anticipate. Travelers should consider travel medicine counseling anyway. Because, once that person comes to us, we will also think about this disease: monkey pox”, he stated this for the Truth.
People who present themselves at the Traveller’s Medicine Center within the “Victor Babeș” Hospital are advised individually by doctors. “Depending on the risk that we assess individually in that patient, we will tell him to get the mpox vaccine or not. Nothing is left to the patient’s decision. He may not immunize himself, but once he gets to us, he will vaccinate with what he needs, not what he wants. It is the individual counseling of each person who travels that determines the establishment of prophylactic conduct”, said Dr. Simin Fliorescu.
Homosexuals are among the people in the risk groups
The vaccine is dedicated, that is, specially designed for monkeypox. “Part of the adults are vaccinated against smallpox, an eradicated disease. However, there is quite a lot of evidence, but not enough, as if those people were also protected against monkey pox. But, because nothing is certain for now, once it is decided to vaccinate people who are part of the risk groups, their immunization will be done with the dedicated vaccine”, continued Dr. Gindrovel Dumitra.
People from risk groups, the specialist also says, are “homosexual people or those who are in groups that function for a long time in close contact. Not the elderly, not the chronically ill, not children, not those with weak immunity”.
But, the specialist points out, this disease is not a disease of homosexuals, as it is not a sexually transmitted disease, in the classical sense of the word. Monkey pox is transmitted by direct and prolonged contact between a healthy person and a sick person, regardless of how this contact manifests itself; sexual contact, kissing, hugging, open wounds, injuries, etc. Therefore, we must take care to observe some measures to limit the spread of the virus so that the risk of infection is reduced as much as possible, warns Dr. Gindrovel Dumitra. “It is very difficult to tell you now that we must be quiet. Obviously, the hygiene rules remain valid, especially since during this period the summer Covid circulates intensively. But it is true that if you come into direct and long-term contact with a sick person, washing your hands or wearing a protective mask does not prevent the disease. Because the other ways of transmission must also be taken into account”.
France has opened its vaccination centers. Dr. Marinescu: “Excessive zeal”
European health authorities have decided that they will not impose any additional measures against the new mpox variant because the risk it poses to the population is “low”. Following an online meeting held the other day, representatives of the European Commission’s Health Security Committee, the European Center for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) decided that there is still no need of border controls nor to initiate community block vaccination against the virus.
Even so, Monica García, Spain’s health minister, said in a post on X that while it won’t be implementing any border measures, the Spanish government will work with airport authorities and airlines to increase the information available to travelers in Spain. And France does not remain indifferent to the situation in Africa, which can escalate at any time in Europe. The authorities decided to open more than 232 vaccination centers to deal with a possible mpox epidemic. However, everything depends only on prevention, believes the infectious disease doctor Adrian Marinescu. “If you have cases of smallpox and you don’t have anything to specifically treat them with, you don’t have rapid intervention, what do you do? Everything would be solved only by vaccination. How do you deal with vaccination? Through vaccination centers. But one important thing must be mentioned here: the fact that they have opened these centers does not mean that they have started to stock up on a large number of vaccine doses. They are now thinking about logistics. To a situation that can be more complicated at a given time. They physically opened the centers, they did not start any mass immunization. There are those places where the centers could, in a sense, work. They didn’t stock up on vaccine, they don’t vaccinate. It’s more of an excess of zeal.”
The doctor is of the opinion that the French have not opened new vaccination centers in new buildings, but it is all about those in hospitals. The specialist also explained that a vaccination at the population level is not and will not be discussed, as the disease spreads very hard. Therefore, a pandemic is unlikely to occur.
The first case of illness in 1970
The first human case of the disease was reported in 1970. But now the virus has become endemic in the countries of central and western Africa. This is the second time a global health emergency has been declared over the virus. The first was in 2022, after a global outbreak in countries that had not previously reported cases, such as Europe. This time the outbreak is caused by the subtype of the virus known as “clade I”, which causes more severe symptoms.
