Nearly 200 cases now exist across countries where the virus does not naturally circulate.
Ao longo de maio de 2022, um vírus que parecia confinado a regiões endémicas de África emergiu silenciosamente em dezenas de países europeus, lembrando que as fronteiras biológicas raramente coincidem com as políticas. Portugal soma 39 casos confirmados de monkeypox, concentrados sobretudo em Lisboa, enquanto a Europa mobiliza vacinas de terceira geração numa corrida contra a escassez e a incerteza. O episódio convida à reflexão sobre a fragilidade das respostas sanitárias globais quando os recursos protetores existem, mas não abundam.
- Em menos de um mês, o monkeypox passou de curiosidade epidemiológica a presença confirmada em quase 200 casos espalhados por países onde o vírus nunca circulou naturalmente.
- Portugal regista 39 infetados — todos homens, maioritariamente com menos de 40 anos — enquanto Espanha, Reino Unido, Eslovénia e Emirados Árabes Unidos anunciam novos casos no mesmo dia, revelando a velocidade silenciosa da propagação.
- França e Dinamarca lançam campanhas de vacinação pós-exposição com a MVA-BN/Imvanex, a única vacina de terceira geração aprovada pela EMA, mas o acesso limitado ao produto torna-se o principal obstáculo continental.
- Portugal admite ter reservas de vacinas tradicionais contra a varíola e estuda a aquisição de vacinas de terceira geração, enquanto a diretora-geral de saúde sublinha que todos os casos permanecem estáveis e em acompanhamento ambulatório.
- O risco para a população geral é considerado baixo pelas autoridades europeias, mas a janela de quatro dias para vacinação eficaz pós-exposição impõe uma urgência logística que testa a capacidade de resposta dos sistemas de saúde.
Na tarde de terça-feira, a Direção-Geral da Saúde portuguesa confirmou mais dois casos de monkeypox, elevando o total nacional para 39 infetados. A maioria concentra-se na região de Lisboa e Vale do Tejo, embora tenham surgido novos casos no Norte e no Algarve. Todos os doentes são homens, predominantemente com menos de 40 anos, e encontram-se estáveis, sem necessidade de internamento.
O padrão masculino dos casos portugueses não reflete uma vulnerabilidade exclusiva do sexo masculino: Espanha já reportou casos suspeitos em mulheres, e o maior surto fora de África antes deste — nos Estados Unidos, em 2003 — afetou sobretudo mulheres. No mesmo dia, Espanha confirmou 15 novos casos e o Reino Unido anunciou 14, tornando-se o país não endémico com mais infeções no mundo, com 70 no total. Eslovénia, República Checa e Emirados Árabes Unidos registaram os seus primeiros casos, num total global que se aproxima das 200 infeções fora de África.
A resposta europeia ganhou contornos mais concretos quando França recomendou a vacinação de contactos de alto risco e profissionais de saúde expostos, usando a vacina MVA-BN — comercializada como Imvanex e aprovada pela Agência Europeia do Medicamento em 2013 — até quatro dias após a exposição. A Dinamarca anunciou seguir o mesmo modelo. A Alemanha encomendou 40.000 doses preventivamente, e o Reino Unido já havia iniciado a vacinação na semana anterior.
Em Portugal, Graça Freitas confirmou a existência de reservas de vacinas tradicionais contra a varíola, sem precisar quantidades, e indicou que o país estuda a aquisição de vacinas de terceira geração. A eficácia da resposta continental depende, em última análise, da disponibilidade de um produto fabricado por uma única empresa dinamarquesa e ainda escasso à escala global.
Portugal's health authority announced two more confirmed cases of monkeypox on Tuesday afternoon, pushing the country's total to 39 infected people. The virus, also called varíola-dos-macacos or VMPX, has spread unevenly across the country: most cases cluster in the Lisbon and Vale do Tejo region, but new infections have now appeared in the North and the Algarve. All confirmed patients are men, predominantly under 40 years old, and all remain stable, receiving care on an outpatient basis.
The fact that every Portuguese case involves a man does not mean the virus targets only males. Spain has reported suspected cases in women, and the largest outbreak outside Africa before this one—in the United States in 2003—infected mostly women, 25 of 47 cases. On the same Tuesday, Spain confirmed 15 additional cases and the United Kingdom announced 14 more, bringing Britain to 70 total infections, the highest count in any non-endemic country globally. The United Arab Emirates, Slovenia, and the Czech Republic each reported their first cases. Nearly 200 infections now exist across countries where the virus does not naturally circulate.
Both Portugal's health authority and the European Centre for Disease Control assess the risk of transmission to the general population as low, though they acknowledge moderate risk for people with multiple sexual partners. The response, however, is accelerating. France's health authorities recommended on Tuesday that vaccination begin for high-risk contacts and exposed healthcare workers, using third-generation vaccines within four days of exposure. The French plan calls for two doses spaced 28 days apart, or three doses for immunocompromised individuals. Denmark announced the same day that it would follow France's model, vaccinating at-risk contacts with the same third-generation vaccine.
The vaccine in question is MVA-BN, marketed as Imvanex, the only third-generation smallpox vaccine approved by the European Medicines Agency, which cleared it in 2013. It is the sole third-generation vaccine licensed for both human smallpox and monkeypox prevention. Made by the Danish company Bavarian Nordic, it is not widely available, yet multiple countries have moved to secure supplies. Germany's health minister, Karl Lauterbach, confirmed an order for 40,000 doses to deploy if infections spread further; Germany currently has five confirmed cases. The United Kingdom acted first, vaccinating healthcare workers and other exposed individuals the previous week. The United States indicated on Monday that it is preparing to distribute third-generation vaccines, known domestically as Jynneos.
Portugal's director-general of health, Graça Freitas, confirmed that the country holds a reserve of traditional smallpox vaccines, though she did not specify the quantity or whether they can be administered for monkeypox. She stated that Portugal is also studying the purchase of third-generation vaccines. As cases climb across Europe and vaccination campaigns take shape, the availability of the effective vaccine remains the limiting factor in the continent's response.
Notable Quotes
Portugal's health authority and the European Centre for Disease Control assess the risk of transmission to the general population as low, though moderate risk exists for people with multiple sexual partners.— Portuguese health authority and ECDC
Germany's health minister confirmed an order for 40,000 vaccine doses to deploy if infections spread further.— Karl Lauterbach, German health minister
The Hearth Conversation Another angle on the story
Why are all the cases in Portugal men if the virus doesn't target men specifically?
That's the pattern right now, but it's likely circumstantial. The virus spreads through close contact—the 2003 outbreak in the US infected mostly women. What matters is exposure, not sex. The fact that we're seeing men here probably reflects where the virus happened to circulate first.
So the low-risk assessment—does that mean people shouldn't worry?
It means the general population isn't at high risk. But the health authorities are being precise: they're saying moderate risk for people with multiple sexual partners. That's not alarmism; it's epidemiology. The virus spreads through contact, so transmission patterns matter.
Why are France and Denmark vaccinating now when cases are still relatively small?
Because they have the vaccine and they understand the math. Post-exposure vaccination works if you do it within days. It's cheaper and faster than waiting for an outbreak to explode. They're trying to contain it before it becomes a larger problem.
Is there enough vaccine?
No. That's the real constraint. MVA-BN is the only approved third-generation vaccine, and Bavarian Nordic can't produce it at scale overnight. Germany ordered 40,000 doses. The UK is vaccinating. Everyone wants it. Portugal is still figuring out what it has and what it can buy.
What happens if cases keep climbing?
Then the vaccine shortage becomes critical. Right now, nearly 200 cases exist across non-endemic countries. If that number doubles or triples, the post-exposure strategy breaks down. You can't vaccinate everyone if you don't have enough doses.