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HEALTH

Monkeypox in Denmark: what causes it, and is it serious?

Denmark reported its first case of the monkeypox virus on May 23rd. What causes the virus, and should we be worried?

An electron microscopic (EM) image shows mature, oval-shaped monkeypox virus particles
An electron microscopic (EM) image shows mature, oval-shaped monkeypox virus particles. File photo: Russell Regnery/cdc Cynthia S. Goldsmith/Reuters/Ritzau Scanpix

What is monkeypox?

Monkeypox, abekopper in Danish, is a zoonotic virus (a virus spread from animals to humans) which most often occurs in areas of tropical rainforest in Central and West Africa. It is occasionally found in other regions, and cases have recently been discovered in Europe, North America and Australia.

“We’ve known about this virus in apes since the 1950s,” Fredrik Elgh, consultant and professor of virology at the University Hospital of Umeå in Sweden, told Swedish news wire TT.

“Every type of animal has its own type of pox, us humans had closely-related smallpox which was wiped out in the 1980s. Smallpox were an enormous issue throughout the history of humanity, we can see that on old mummies.”

“In more recent times, like the 1700s, we know that in every family, multiple children died of smallpox.”

There is no vaccine for monkeypox approved in Europe, but vaccines for smallpox are effective against the virus, as the two viruses are members of the same family.

“The vaccine used against smallpox also has an effect on monkeypox,” Elgh told TT. “That means that those born in the mid-70s or earlier will have a degree of immunologic memory. Young people have no immunity. There’s also a new, sophisticated vaccine which gives good coverage after two doses.”

“What’s good about poxes is that even if you take the vaccine after you’ve been infected, it has an effect on the progress of the illness. There are also antiviral medicines,” Elgh explained to TT.

What causes it?

Monkeypox is spread via close contact with an animal or human with the monkeypox virus. It can be transmitted via bodily fluids, lesions, respiratory droplets or through contaminated materials, such as bedding.

Recent cases of the virus in Europe are thought to have been spread through sexual activity, Bolette Søborg, head of section with the Danish Health Authority, said via a statement on Monday.

“There are indications that the infection is particularly found among men who have sex with men,” Søborg said.

“We were therefore last week in contact with the (organisations) AIDS-fondet and LGBT+ Danmark and asked them to help us create awareness in those groups that there is currently a need to be aware of guidelines relating to hygiene and use of protection during sex,” she said.

Denmark is not the only European country to have detected cases of monkeypox. Cases have also been reported in the United Kingdom, Spain, Netherlands, Germany and Sweden.

READ ALSO: Denmark registers first case of monkeypox

What are the symptoms?

The Danish health ministry describes the symptoms of monkeypox as including fever, shivering and a rash with blisters that can leave wounds when they heal.

Monkeypox typically has an incubation period of six to 16 days, but it can be as long as 21 days. Once lesions have scabbed over and fallen off, the person with the virus is no longer infectious.

Why is it in the news now?

Although cases of monkeypox have been reported outside of affected areas of Central and West Africa previously, the virus is making headlines in parts of Europe now because this is the first time cases have been identified in persons with no recent history of travel to affected areas and no history of contact with previous imported cases.

Danish infectious disease control agency State Serum Institute (SSI) states that 83 cases have been reported across Europe including 23 in Spain. The man who tested positive in Denmark recently visited Gran Canaria, according to SSI.

Is it dangerous?

The type of monkeypox seen in affected areas of Central and West Africa can be serious and, occasionally, deadly. However, it appears that the cases detected so far in Europe have been relatively mild.

“In those countries where it is more prevalent, which is in Central and West Africa, a fatality rate between one and ten percent has been reported,” Elgh told TT. “But then, you have to remember that that’s in an African context where people are not as well-nourished and there isn’t the same access to healthcare, so it can’t be directly translated.”

“There’s not that much data, especially not on how it behaves in our part of the world. There are also different genetic variants of the virus with different levels of severity, so it’s not possible to comment on [how dangerous it is] before we know more,” he further told TT.

Could this cause a new pandemic?

It’s unlikely, Elgh believes. He told TT that “this is not a new pandemic”.

“The general public do not need to be worried about monkeypox,” he added. “But my belief and hope is that this will not be a pandemic like corona. The most likely scenario is that as long as we contact trace properly, it will ebb out,” he told TT.

He explained that the two viruses are different types of viruses, meaning that monkeypox cannot adapt as easily as the Covid-19 virus.

“Monkeypox is a DNA virus, while coronavirus is a RNA virus,” he explained to TT. “DNA viruses are much more stable, which means that you don’t need to be worried that they will adapt as quickly. It would take a lot and a long time before they adapt to humans.”

The Danish Patient Safety Authority said on Monday that contact tracing for monkeypox was being undertaken.

“The Danish Patient Safety Authority is now contact tracing so that close contacts to the patient can be given guidance as to how they should respond,” Health Minister Magnus Heunicke said in a statement.

“Health authorities do not expect broad community infections in Denmark, but we are following the situation closely so we can be as well prepared as possible for any development in the situation,” he said.

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HEALTH

‘Live Danish, die young’: How unhealthy are young people in Denmark?

'Live Danish, die young' - is the new phrase from a movement to promote better health among young people in Denmark. But what does the latest data reveal about health issues among young Danes?

'Live Danish, die young': How unhealthy are young people in Denmark?

Health and lifestyle issues among young Danish people have long been documented.

For example binge drinking and heavy smoking have been highlighted as a major problem among young Danes for years.

In 2019, a study by the European School Survey Project on Alcohol and Other Drugs (ESPAD) found that 40 percent of young Danes aged 15-16 had been drunk in the past 30 days.

This was the highest rate in Europe at the time, where the average was just 13 percent.

On a broader level, multiple studies have also shown that Danes struggle when it comes to physical activity levels.

That’s why a new alliance of over 20 patient organisations, medical guilds, and insurance companies is now calling for better preventative health in Denmark.

A new call to action

The alliance believes Danes smoke and drink too much, do insufficient exercise, and have shorter average life spans than their Scandinavian counterparts.

“The Danes have an incredibly unhealthy lifestyle compared to other Nordic countries. We smoke and drink significantly more, and our diet and exercise could also be better. Live Danish, die young, I usually say,” Jes Søgaard, professor emeritus in health economics at the University of Southern Denmark, told the TV2 broadcaster.

The alliance, led by the insurance company Danica, has prepared ten proposals for targets it wants the government to commit to achieving by 2035, including a 2.5-year increase in longevity, an increase in physical activity, and a halving of young people’s binge drinking.

However, while obesity and physical inactivity are both singled out as significant issues plaguing the Danish population frequently, alcohol consumption has emerged as the most notable lifestyle-related health challenge.

Troubling statistics

Young people aged 16 to 24 in the country have topped survey findings as the age category that consumed the most alcohol for more than a decade, from 2010 to 2021.

However, according to the most recent National Health Profile survey, which gathered responses from thousands of Danes about their health, illness, and well-being, it is now the older population (those over 65) that leads when it comes to alcohol consumption.

The National Health Profile survey shows that more than one in five Danes aged 65 or older drink more than ten alcoholic beverages in a typical week.

In comparison, only 10.4 percent of Danes aged 35 to 44 reported drinking at that level.

Anette Søgaard Nielsen, a professor at the Unit for Clinical Alcohol Research at the University of Southern Denmark, told DR that the older generation grew up in a prosperous society where alcohol was a significant part of the social culture.

As they transition into retirement, many continue or even increase their alcohol consumption due to more free time and disposable income, and some seniors also use alcohol as a form of self-medication or to cope with loneliness and other psychological issues, Søgaard Nielsen explained.

However, while seniors have overtaken the young on the top of the findings, the level of consumption among Danish youth is still troublingly high, as 19 per cent reported drinking more than ten alcoholic beverages in a typical week (which is roughly the same percentage as the one among 55-64-year-olds). 

Unhealthy habits: How does Denmark fare at the EU level?

Several things stand out when comparing Denmark’s population to that of its European Union (EU) peers.

According to the European Commission’s latest Country Health Profile Report for 2023, behavioural risk factors accounted for at least 40 percent of deaths in Denmark in 2019.

While tobacco smoking rates in Denmark have significantly decreased over the past two decades, they remained higher than those in other Nordic countries.

In 2019, over one in three Danes (38 percent) engaged in regular heavy drinking, the highest proportion in the EU.

Adult obesity rates also increased to 16 percent in 2019, aligning with the EU average.

Efforts to address these issues

National efforts to reduce smoking have focused on younger generations, as outlined in Denmark’s 2019 National Action Plan against Children and Young People Smoking.

One of the key objectives of this plan is to create a smoke-free youth generation by 2030. To help achieve this goal, a smoking ban in schools was implemented in 2021.

Given Denmark’s history of being Europe’s heaviest drinkers, the government has launched several initiatives to strengthen alcohol control policies.

In March 2022, the Danish Health Authority tightened national guidelines on low-risk drinking for both young people and adults.

The main recommendation is that children under 18 should not drink alcohol, and adults should limit their intake to no more than 10 drinks per week, with no more than 4 drinks per day.

In November 2023, the Danish Ministry of Health announced new measures to restrict alcohol sales to minors and increase the price of nicotine pouches.

“Children and young people are starting to drink far too early and they are drinking too much,” said Health Minister Sophie Løhde at the time.

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