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HEALTH

Monkeypox in Germany: Two teens ‘among new infections’

Two teenage boys between the ages of 15-17 have reportedly been infected by monkeypox, as the number of cases in Germany continues to grow.

An employee at a Munich clinic with a dose of the vaccine from Bavarian Nordic.
An employee at a Munich clinic with a dose of the vaccine from Bavarian Nordic. Photo: picture alliance/dpa | Sven Hoppe

German news site Spiegel Online first reported the new cases – which are an anomaly for a virus as it has mostly affected gay men – following an inquiry to the Robert Koch Institute (RKI). 

They are among a total of 2,677 people who are confirmed to have contracted the virus in Germany to date. There have not been any fatalities.

Out of these, only five cases were women, according to the RKI. The public health institute said that it does not release information on individual cases.

READ ALSO: EXPLAINED: How Germany wants to contain the monkeypox

The disease – which is not usually fatal – often manifests itself through fever, muscle aches, swollen lymph nodes, chills, exhaustion and a chickenpox-like rash on the hands and face.

The virus can be transmitted through contact with skin lesions and droplets of a contaminated person, as well as through shared items such as bedding and towels.

Many of the cases known so far concern homosexual and bisexual men. However, affected people and experts have repeatedly warned against stigmatising gay communities.

How fatal is the disease?

The first monkeypox cases were reported in Germany on May 20th, as the disease continued to spread in West Europe.

At the weekend, the first two deaths outside of West Africa were reported in Spain.

READ ALSO: WHO warns ‘high’ risk of monkeypox in Europe as it declares health emergency

The RKI has urged people returning from West Africa and in particular gay men, to see their doctors quickly if they notice any chances on their skin.

According to the latest estimates, there are 23,000 monkeypox cases worldwide, and Europe is particularly affected with 14,000 cases.

There have been 2,677 monkeypox cases in Germany as of August 2, 2022. Photo: CDC handout

About eight percent of patients in Europe have been hospitalised so far, reported the World Health Association on Monday, mostly due to severe pain or additional infections.

In general, the mortality of the variant currently circulating in Europe is estimated to be low.

READ ALSO: More cases of monkeypox ‘expected’ in Germany

Will a vaccine make a difference?

Since July, a vaccine has been authorised in 27 EU member states and in Iceland, Liechtenstein and Norway. 

The Standing Committee on Vaccination (STIKO) recommends vaccination against monkeypox in Germany for certain risk groups and people who have had close contact with infected people.

So far, the German government has ordered 240,000 vaccine doses, of which 40,000 had been delivered by Friday. 

Around 200,000 doses are set to follow by the end of September. 

The German Aids Federation (DAH) on Friday called for one million vaccine doses, stressing that the current supplies will fall short of meeting need.

“The goal must be to reduce the number of infections as quickly as possible and to get the epidemic permanently under control,” explained Ulf Kristal of the DAH board in Berlin on Friday.

But this is only possible, he said, if as many people at risk of infection as possible are vaccinated.

“We don’t assume the epidemic will be over when the doses available so far have been vaccinated,” Axel Jeremias Schmidt, Epidemiologist and DAH Consultant for Medicine and Health Policy, wrote in a press release.

As long as there are monkeypox infections, he said, people who are at risk must be offered vaccination. 

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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