France - Monkeypox outbreak 2022-2025

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Source: https://www.msn.com/fr-fr/sante/othe...ce/ar-AA1x3T9j

Mpox: the new clade 1b variant detected for the first time in France
Article by Tom Kerkour
• 1 h

A first. A person has been diagnosed in France as carrying the clade 1b sub-variant of the mpox virus, considered more contagious and more dangerous, which is unprecedented, announced the health authorities on Monday, January 6, confirming information from Ouest-France.

Mpox is a viral disease that spreads from animals to humans, but is also transmitted by close physical contact with a person infected with the virus. In 2022, the global epidemic, carried by clade 2, had spread to around a hundred countries where the disease was not endemic.
United Kingdom, Germany...

Currently, the clade 1b variant has been experiencing a resurgence in the Democratic Republic of Congo since September 2023. But other cases have been identified outside the continent. First in Sweden on August 15, then in Germany on October 22, but also in the United Kingdom on October 30. These were imported cases, infections that occurred outside the national territory.

This sub-variant is considered at this stage to be more contagious and with a higher fatality rate. It seems to cause rashes all over the body, when previous strains were characterized by rashes and lesions located on the mouth, face or genitals.

Faced with this epidemic, the French health authorities had updated their vaccination recommendations; recommending a booster dose for targeted people (men who have sex with men, sex workers, trans people with multiple partners), who had already been vaccinated during the first epidemic

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Translation Google

Faced with the first case of Mpox clade I b identified in France, health authorities recall the importance of vaccination for target audiences

published on 07.01.25

The Ministry of Labor, Health, Solidarity and Families, and Public Health France, have been informed of a first human case of Mpox clade 1b on the national territory, in Brittany. The recommended management measures have been put in place.

The reported case concerns a person who had not travelled to Central Africa, an area in which the different clades of mpox viruses have been actively circulating for several months, including clade I b. However, this person had been in contact with two people returning from Central Africa; investigations are underway to find the origin of the contamination and identify all the at-risk contact persons around the diagnosed case.

As a reminder, four countries in the European Economic Area (EEA) have recorded cases of clade I b monkeypox since the summer of 2024: Sweden, Germany, the United Kingdom and Belgium. The risk of infection by clade I of Monkeypox for the general population in France and Europe is considered low by the European Centre for Disease Prevention and Control (ECDC). However, sporadic cases, linked to countries with more intense viral circulation, may occur. The occurrence of this case in France was quickly detected thanks to the surveillance system in place.

Since the 2022 epidemic, clade II b of the Monkeypox virus has been circulating quietly in France: in 2024, 215 cases of monkeypox, all due to clade II b, were reported to Public Health France, with an average of 3 cases reported per week at the end of the year. Until now, no cases of clade I had been detected in France.

The detection of this case of clade I b does not change the response strategy.

To deal with this virus, whatever the clade, France has a response strategy, regularly reassessed since 2022, based on surveillance (mandatory declaration of cases and virological analyses by the national reference center for orthopoxviruses), prevention, diagnosis, management of cases and contacts, as well as free vaccination of target audiences and contacts.

Preventive measures for target audiences: vaccination and application of barrier gestures

To protect themselves and others, health authorities are reminding the importance of vaccination for target audiences . In accordance with the opinion of the High Authority for Health (HAS) of August 29, 2024, vaccination is recommended as a preventive measure in pre-exposure for people at high risk of exposure, and as a reactive measure for people at risk of contact around a case of MPOX.

In accordance with the opinion of the High Council for Public Health (HCSP) of September 2, 2024, people with close ties to Central African countries where the MPOX virus is actively circulating, including people regularly visiting their family or humanitarian workers, can also be vaccinated against MPOX before their trip.
As a reminder, people at high risk of exposure are:

• Men who have sex with men (MSM) reporting multiple partners and trans people reporting multiple partners;
• Sex workers / people in prostitution;
• Professionals in places of sexual consumption;
• Partners or people sharing the same living space as those at high risk of exposure mentioned above.

The contact details for Mpox virus vaccination centres are available on the Santé.fr website

For travelers coming from or going to Central Africa, it is recommended to apply barrier gestures:

• Wash your hands frequently
• Avoid contact with people infected with MPOX or with skin rashes that may suggest MPOX, with objects potentially contaminated by these people (clothing, household linen or dishes), as well as with animals and particularly rodents.

For any request for information on symptoms, treatments, prevention measures and vaccination, call:

“Mpox info service” toll-free number: 0 801 90 80 69
Every day from 8 a.m. to 11 p.m. (free and anonymous call and chat)

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https://sante.gouv.fr/actualites/presse/communiques-de-presse/article/face-au-premier-cas-de-mpox-de-clade-i-b-identifie-en-france-les-autorites

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Mpox cases in France. January 1 - January 8, 2025.


Published on January 8, 2025
Updated on January 8, 2025
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Key points

• In total, 222 cases of MPOX have been reported to Public Health France since January 1, 2024, including 7 since the last report on December 19 and diagnosed in 2024.
• A first case of clade Ib was confirmed by the Orthopoxvirus CNR in January 2025.
• The reported cases all concern adults, 213 men and 9 women.

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PDF 0.31 MB

https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-transmissibles-de-l-animal-a-l-homme/mpox/documents/bulletin-national/cas-de-mpox-en-france.-1er-janvier-8-janvier-2025

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From the PDF link above:

Epidemiological assessment of cases of mpox in France

January 1, 2024 - January 7, 2025

Key points as of January 7, 2025

• A total of 222 cases of mpox have been reported to Public Health France since January 1, 2024,
including 7 since the last assessment on December 19 and diagnosed in 2024.
• A first case of clade Ib was confirmed by the Orthopoxvirus CNR in January 2025.
• The reported cases all concern adults, 213 men and 9 women.

Cases reported since the beginning of 2024

From January 1, 2024 to January 7, 2025, a total of 222 cases of mpox were reported to Public Health France via mandatory reporting (DO). Among these cases, 10 were not biologically confirmed
(Figure 1).
...

Socio-demographic characteristics

All cases concerned adults aged between 18 and 70 years (median age of 36 years). Nine cases concerned women.

Nearly half of the cases (n=104, 47%) resided in the Ile-de-France region, 33 in Auvergne-Rhône-Alpes, 32 in Occitanie, 13 in Provence-Alpes-Côte d’Azur and 12 in Nouvelle-Aquitaine (figure 2).
...

Risk exposures and notion of travel

Nearly half of the cases (n=104; 47%) reported not knowing whether they had had a risky contact with a case of mpox in the 3 weeks preceding the first symptoms.

Among the 172 cases reported, a trip to a foreign country in the three weeks preceding the onset of symptoms was reported by 46 of them (27%). The most frequently visited country was Spain.
Only four cases had traveled to a sub-Saharan African country (Côte d'Ivoire, Senegal and Madagascar).

Regarding the 8 cases of clade IIb diagnosed in women, none had traveled in the 3 weeks preceding the onset of symptoms. Four of them reported having had contact within the 3 weeks before the onset of symptoms with:

- a confirmed case of mpox for two of them (a sexual partner for one and a family member for the other);
- a case not biologically confirmed (sexual partner);
- a sexual partner from a southern African country, not known as a case of mpox.

The case of clade Ib confirmed in January 2025 concerns a woman who has not traveled to Africa recently but who reports contact with two people who have stayed in Central Africa in an area where the clade I virus is circulating. Investigations are underway to determine the origin of the contamination and identify all the contact persons at risk, in order to offer them vaccination in particular.

Severity of cases

Among the 213 cases for which information was available, 12 (6%) were hospitalized, mainly due to severe pain, associated or not with a concomitant pathology or complications.

Vaccination history

Among the 145 cases whose smallpox vaccination status was known both in childhood and since 2022, 110 had received no vaccination, 24 had been vaccinated only since 2022, 6 had been vaccinated only before 1984, and 5 had been vaccinated since 2022 even though they had been vaccinated before 1984. In addition, 44 cases had been vaccinated since 2022, with no information on possible vaccination in childhood.

Virological analyses

The Orthopoxvirus CNR (Army Health Service, IRBA) received samples concerning 181 cases of monkeypox diagnosed since January 1, 2024. The determination of the clade was performed for 175 cases and highlighted 174 cases of clade II monkeypox virus and 1 case of clade I monkeypox virus. Sequencing was carried out for 62 of these 175 cases and highlighted the exclusive circulation of subclade b for both clades.

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