Monkeypox: German health expert calls for isolation measures

People infected with monkeypox should go into isolation, according to the President of the German Medical Association.

An ambulance drives in the grounds of Freiburg University Hospital where one patient with monkeypox is being treated.
An ambulance drives in the grounds of Freiburg University Hospital where one patient with monkeypox is being treated. Photo: picture alliance/dpa | Philipp von Ditfurth

Klaus Reinhardt said he believed there should be an isolation period for those who contract monkeypox, a rare virus, which is normally found in West Africa, but which has recently emerged in Europe, Canada and Australia.

Reinhardt said the incubation period for the virus is three weeks. “That means that already a number of infected people don’t know it yet and so can spread the disease further,” Reinhardt told Südwestrundfunk radio on Tuesday.

In the UK and Belgium, people who have monkeypox are being asked to isolate for 21 days.

Six cases of monkeypox have been registered in Germany so far. The Health Ministry said it expects more cases to surface. 

READ ALSO: More cases of monkeypox in Germany expected, says Health Ministry

According to authorities, the virus usually causes only mild symptoms such as fever, headache, muscle pain and skin rash, although severe cases can occur. People who notice any skin lesions – a key symptom of monkeypox – are advised to see their doctor straight away. 

One patient with the virus is being treated in isolation at Freiburg University Hospital. Authorities said the patient had recently returned from Spain and his condition is stable.  

Cases have also been detected elsewhere in the country, including Munich and Berlin. 

Reinhardt, who is the head of the German Medical Association, said he believed vulnerable groups should be vaccinated. Smallpox vaccinations are said to be very effective against monkeypox. 

The German government said it was looking at options for vaccinations.

However, Reinhardt said there was no reason for people in Germany to panic. Unlike coronavirus, which spreads via airborne particles and droplets, monkeypox is transmitted primarily through close physical contact. 

Health Minister Karl Lauterbach (SPD), together with Reinhardt and the President of the Robert Koch Institute, Lothar Wieler, were set to give an update on the situation on Monday. It’s expected that guidelines on how to deal with the virus will be released. 

Experts say that many of the individuals who were confirmed to have the virus in Europe said they had recently had sexual contact with a new partner, which raises the likelihood that the recent monkeypox cases were transmitted sexually.

The World Health Organisation (WHO) says it believes there is no need for mass vaccinations against monkeypox.

The most important measures to combat the outbreak are tracing contacts and isolating infected people, said Richard Pebody, head of the pathogens team at WHO Europe. He added that vaccine stocks are relatively limited.

Measures such as “safe sexual behaviour, good hygiene, regular hand washing – all these sorts of things will help to limit the transmission of this virus” added Pebody.

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‘Breaking point’: Why German pediatric wards are filling to capacity

Overcrowded patient rooms, days-long stays in the ER, transfer of sick babies to hospitals more than 100 kilometers away: the current wave of respiratory syncytial virus (RSV) infections in Germany is pushing children's hospitals to their limits. 

'Breaking point': Why German pediatric wards are filling to capacity

The German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) said on Thursday that there was a “catastrophic situation” in children’s intensive care units. 

According to the physicians, a wave of respiratory syncytial virus (RSV) infections can be expected every year starting in the autumn. 

Yet this year “there are fewer and fewer pediatric hospital beds available overall” as well as a lack of nursing staff, Divi Secretary General Florian Hoffmann explained Wednesday on ZDF’s Morgenmagazin.

Because all beds were full in one case, a child was transferred from the Hannover Medical School (MHH) to Magdeburg on Friday night, a distance of around 150 kilometers. 

“My colleagues had called 21 clinics,” said Gesine Hansen, Medical Director of the MHH Clinic for Pediatric Pneumology, Allergology and Neonatology, told DPA. 

The child, who was about one-year old, had an RSV infection, which can be life-threatening, especially for babies and children with pre-existing conditions.

READ ALSO: 7 things to know about visiting a doctor in Germany

‘Catching up’

Some health experts have said that hospitals are now filled to capacity because children had minimal social contact during the pandemic and are now catching up on infections.

According to the Robert Koch Institute (RKI), an estimated 5.6 severe cases of RSV respiratory illness occur worldwide per 1,000 children in the twelve months after birth. 

Within the first year of life, 50 to 70 percent would typically have experienced at least one infection with RSV, and by the end of the second year of life, nearly all children should have experienced at least one infection. 

In the wake of protective measures against Covid-19, however, many such infections had temporarily failed to materialise. 

‘Breaking point’

According to Divi, hardly any clinics had a free crib or free pediatric intensive care bed in the past few days.

“Children have to lie in the emergency room for days,” Hoffmann said.

Yet the peak of the current wave of respiratory infections in children has by no means been reached, Hoffmann said. “The situation in practices and clinics will get even worse in the coming weeks.”

“We are at the breaking point,” said Matthias Keller, head of the Children’s Hospital Dritter Orden Passau already. The rooms are often double-occupied, he said. In some cases, there were too few monitors and not enough equipment for respiratory support.

READ ALSO: Flu season makes a comeback in Germany

A child with RSV being treated at the Olgahospital in Stuttgart. Photo: picture alliance/dpa | Marijan Murat

“Some patient rooms are like bed storage areas, where you really have to crawl over the beds to get to the sick child, because the parent bed is lined up with the patient bed,” said Keller, who is also chairman of the South German Society for Pediatric and Adolescent Medicine.

This has far-reaching consequences for other young children who need treatment. When an infant who has just been resuscitated is admitted to a children’s hospital that is actually fully occupied, a three-year-old has to wait there for the third day in a row for his urgently needed heart operation.

‘Responsibility of politicians’

A wave of infections usually lasts six to eight weeks. In Bavaria, Lower Saxony and Berlin, as well as North Rhine-Westphalia, clinics are reporting a “maximally tense situation,” reported Divi on Thursday.

The Düsseldorf University Hospital, for example, is experiencing a wave of influenza among its young patients in addition to the RSV wave, which is “causing massive problems primarily for children up to elementary school age,” said University Hospital spokesman Tobias Pott.

In the Rhineland, “all beds are completely full” at times, said Jörg Dötsch, president of the German Society for Pediatric and Adolescent Medicine. An ER waiting time of six to seven hours is not uncommon, he says. 

“It is very unpleasant when children and their families have to virtually camp out in the emergency room,” says Dötsch, who is also director of the Clinic for Pediatric and Adolescent Medicine at the University Hospital in Cologne. 

READ ALSO: Healthcare in Germany: How to get a faster appointment with a specialist doctor

What are the solutions?

At their meeting on Thursday in Hamburg, intensive care physicians and intensive care nurses will discuss approaches to solving the crisis. 

One solution may be to temporarily bring nursing staff from adult facilities into the children’s hospitals, says Hoffmann, who is also a senior physician at Dr. von Hauner’s Children’s Hospital at the University of Munich. 

But above all, he says, many more pediatric nursing staff need to be trained. “We need to strengthen nursing,” he explained. “Only then do we have a chance.”

Others said more money needed to be invested in pediatric medicine and vaccines, even if it is less profitable.

“The fact that children’s lives are currently in danger is the responsibility of politicians,” said Jakob Maske, spokesman for the Professional Association of Pediatricians and Adolescents.

“Nowadays medicine has to be profitable – not cure diseases, but make money.”

READ ALSO: How private investors are buying up healthcare practices in Germany