Literature review

MONKEYPOX AND ITS POSSIBLE MEDICAL AND LEGAL CONSEQUENCES

How to cite: Gomes CH, Miziara CSMG. Monkeypox and its possible medical and legal consequences. Persp Med Legal Pericia Med. 2023; 8: e230411

https://dx.doi.org/10.47005/230411

The authors inform there is no conflict of interest.

MONKEYPOX E SUAS POSSÍVEIS REPERCUSSÕES MÉDICO LEGAIS

Carlos Henri Gomes(1)

http://lattes.cnpq.br/7704819555772823https://orcid.org/0000-0001-6079-3848

Carmen Silvia Molleis Galego Miziara(1)

http://lattes.cnpq.br/6916238042273197https://orcid.org/0000-0002-4266-0117

(1) Universidade de São Paulo, Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação. São Paulo-SP, Brasil

E-mail: carloshenri_gf@hotmail.com

ABSTRACT

Introduction: Monkeypox is a disease caused by a virus of the genus Orthopoxvirus of the Poxviridae family, transmitted from animals to humans or between humans. On July 23, 2022, the WHO designated Monkeypox as a Public Health Emergency of International Concern. The consequences of this virus are of medico-legal interest. Objective: To describe and discuss the main health consequences that are of medico-legal interest arising from the Monkeypox disease. Methodology: Narrative review of the literature on Monkeypox in the freely accessible databases Google Scholar, MEDLINE and SciELO without temporal delimitation and including scientific articles obtained in full or from official health websites of the World Health Organization, the Control Center and Disease Prevention from the United States Department of Health and Human Services, as well as from the Brazilian Ministry of Health, followed by a discussion on repercussions of interest to Legal Medicine and Medical Expertise. Conceptual framework: Forensic Medicine lacks understanding of the possible consequences of Monkeypox in their practice, so that studies like this are necessary to aid in their work in favor of social justice. Results: Monkeypox is self-limited in most cases, the main manifestations being fever; chill; adenomegaly; myalgia; and skin rashes. There may also be oral, genital or rectal lesions, from a few to thousands. Common sequelae are permanent scarring in cases of superinfection. Although symptoms of anxiety and depression have been reported, the prevalence of these conditions has not been confirmed. Blindness and varioliform scars are possible sequelae described, but the effects of Monkeypox in the medium and long term still need to be studied. Discussion: The main sequelae found in the literature were scars and blindness. Cases in which there is death or sequelae may generate an allegation of medical malpractice, requiring expert evaluation. Also, in such situations, the patient or his family members may resort to insurance to pay for contracted coverage. The medical expertise will characterize the situation and correlate it with the expected coverage. In order to formalize leave of absence of workers affected by the disease with payment of the corresponding social security benefits, medical expertise will be required. In the event of a disease with a causal link with work, the illness can be equated to an accident at work. The occurrence of blindness can generate sensory impairment compatible with the benefit of continued provision of social assistance. Final considerations: Forensic Medicine and Medical Expertise can provide technical-scientific support for granting benefits or establishing damage and causality in Monkeypox cases. Therefore, expertise can be requested within the criminal, civil, insurance, social security, administrative and labor areas, each with its particularities. Other works that address the possible medico-legal consequences of Monkeypox can contribute to the construction of detailed and specific knowledge for each claim of justice that may arise related to this infection.

Keywords: Forensic Medicine, Monkeypox, Outcomes, Sequelae, Civil Law, Criminal Law;


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