ZAGREB, 25 July 2022 - Croatia has so far registered ten cases of monkeypox, all the patients are men aged between 30 and 50, and in two cases it was established that they contracted the disease abroad, epidemiologist Goranka Petrović said on Sunday.

Croatia expects the first batches of vaccines against this rare infectious disease in the coming weeks.

Doctor Petrović said that each member-state of the European Union would prepare its plan for containing this disease.

The European Commission has organised joint public procurement of the vaccines. The distributed amount of doses will be in proportion with the number of citizens in each member-state, Petrović said.

Croatia can expect 1,400 doses for immunisation of persons who have been in close contact with monkeypox patients.

According to the explanation given by the World health Organisation (WHO), monkeypox is usually a self-limited disease with symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.

Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.

Until 23 July this year, 3040 cases of monkeypox had been reported to WHO, from 47 countries.

This prompted WHO Director-General Tedros Adhanom Ghebreyesus to decide to declare that the global monkeypox outbreak represents a public health emergency of international concern.

"Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners," said Ghebreyesus.

"That means that this is an outbreak that can be stopped with the right strategies in the right groups," reads a press release on the WHO website.

It’s therefore essential that all countries work closely with communities of men who have sex with men, to design and deliver effective information and services, and to adopt measures that protect the health, human rights, and dignity of affected communities.

Stigma and discrimination can be as dangerous as any virus, the WHO underscores.

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June 24, 2022 - The first case of monkeypox in Croatia has been confirmed by the "Dr. Fran Mihaljević" Clinic for Infectious Diseases.

The suspicion of the disease was confirmed during the evening by PCR test, reports Index.hr. 

A man who was in Italy and Spain was infected
He is a man who has lived in Italy and Spain. He has milder monkeypox and is not hospitalized but in home isolation. Last week the first case of infection was confirmed in Serbia.

What is monkeypox?
Monkeypox is not a sexually transmitted disease but can be transmitted through direct contact during sexual intercourse. It can also spread through clothing, bedding, or towels used by an infected person, by touching lesions, or by droplet transmission.

It was first discovered in 1958 when it appeared in monkeys used in research. However, the first case of transmission to humans was recorded in 1970 in the Democratic Republic of Congo.

Markotić: There is a possibility of transmission from person to person
The director of the "Dr. Fran Mihaljević" Clinic for Infectious Diseases, Alemka Markotić, explained the infection's symptoms.

"It is a viral disease. These are DNA viruses, most often small, small rodents, including mice, rats and squirrels, and numerous primates," Markotić explained, adding that there is a possibility of transmission from human to human, from animal to human, but also from man to animal.

What are the symptoms of monkeypox?
When it comes to symptoms, Markotić said that the disease starts with a high temperature, like most other infectious diseases, with a generally bad condition, exhaustion, and a severe headache.

"It is common for many diseases, but on the third or fourth day, a rash appears, first at the site of the initial entrance, then spreads further from the face, extremities, and finally on the palms and soles. The symptoms themselves resemble smallpox. Fortunately, there is no smallpox in circulation. This disease has been completely eradicated by vaccination. In monkeypox, we also have very swollen lymph nodes," Markotić explained.

Who can get monkeypox?
When asked who gets monkeypox, Markotić said all categories of people get sick.

"We can say that now in this phenomenon of some kind of epidemic in Europe, it is mostly men who have had relationships with men. But, further, the disease can spread to other groups. Immunocompromised people, pregnant women, and young children are particularly vulnerable. They are at the greatest risk. This disease is much easier than smallpox. Mortality is somewhere up to 10 or 11 percent. Again more in vulnerable populations," Markotić concluded.

HZJZ: The disease is not very contagious
HZJZ pointed out that the disease is not highly contagious, i.e., in most cases, very close contact with the patient is required. The causative agent is a virus similar to the smallpox virus, and its natural reservoir is most likely some species of squirrels and other rodents in the wilds of Central and West Africa.

Although the disease is called monkeypox, it seems that monkeys are not a reservoir of the virus but accidentally become infected, like humans, in contact with other animals and their secretions. The disease can be transmitted from person to person by droplets and contact with skin changes in patients.

Occasionally, monkeypox occurred outside of Africa, most commonly in travelers who became infected in Africa and in persons who came in close contact with them. For example, in the United States, an epidemic was reported in 2003 among children and young people who became infected through contact with prairie dogs, infected by rodents imported from Ghana.

It passes in two to four weeks
Monkeypox manifests as fever, headache, chills, exhaustion, fatigue, muscle and back pain, swollen lymph nodes, and rash, as in chickenpox. Vaccination against smallpox is thought to provide solid protection, but it is unknown how long protection lasts after immunization.

In addition, smallpox vaccination was abolished worldwide in the late 1970s, after smallpox was declared eradicated. Treatment is symptomatic, and in most cases, the disease passes in two to four weeks.

There is a difference between smallpox and monkeypox
The HZJZ also mentioned a big difference between smallpox and monkeypox because smallpox is anthroponosis, i.e., the man was the sole host and reservoir of the virus. Thanks to this fact, the disease could be eradicated. On the other hand, monkeypox is a zoonosis, i.e., the natural host and reservoir of the virus are wild animals, and therefore it is impossible to eradicate the disease even if there is an effective vaccine.

Most importantly, they pointed out that the transmission of apes from man to man is much less efficient than the transmission of smallpox, i.e., monkeypox is less contagious. 

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