Costa del Sol hospital in Marbella admits patient with mpox

The regional ministry of health confirmed to SUR on Thursday that there is a case of mpox in Marbella. The patient is in the Costa del Sol hospital, where he arrived post-diagnosis.

The hospital has activated a strict protol with measures to protect the health of other patients and the staff.

The Andalusian surveillance and response protocol drawn up during the 2022 international outbreak states that this is a rare viral zoonotic disease (transmitted from animals to humans) which, until 2022, was endemic to certain countries in West and Central Africa.

"All cases of mpox outside endemic areas up to May 2022 had been imported or linked to an imported case or to animals brought in from endemic areas," the regional government states.

The main path of transmission in humans is "through direct or indirect contact with live or dead mammals, mainly rodents or primates from endemic areas".

During the 2022 outbreak, there was person-to-person transmission. This can happen through close, direct physical contact with lesions or bodily fluids, particularly during sexual intercourse or prolonged contact.

Chemist and virologist Margarita del Val from the CSIC (Spanish national research council) told SUR in 2025: "The disease that keeps me awake at night more than any other is mpox."

"In 2022, it was a multi-country epidemic which, outside Africa, was actually transmitted through very promiscuous and active sexual contact. But now, in Central Africa, it is spreading throughout the entire population of all ages, men and women, children and adults, and no longer solely through sexual contact, but also through close household contact," Del Val said.

Babies are at the highest risk, she warned.

"I'm concerned because we know where its weakness lies: we have safe and effective vaccines. We know that what needs to be done is to vaccinate the entire vulnerable population, first healthcare workers, those most at risk, their contacts and immunocompromised individuals, and then gradually expand the programme. But we do not have enough vaccines. What's more, the vaccines are not reaching the area. It is a region rife with conflict. I am concerned that something we should be vaccinating against and controlling is getting out of hand," she said.

The period of transmission extends from the onset of the first symptoms or from the day before the rash appears, if the rash is the first symptom, until all the lesions have healed, the scabs have fallen off and new skin has formed.

The document warns that this may take several weeks.

The condition may be self-limiting and the majority of patients recover within a few weeks, but complications such as proctitis, corneal ulcers, bacterial superinfections, pneumonia, sepsis, encephalitis and airway involvement may occur.

The incubation period could range from five to 21 days, although the cases studied in Spain suggested an average of seven to ten days.

It initially presents with fever, headache, muscle aches, fatigue and swollen lymph nodes. Between one and five days after the onset of fever, lesions appear.

In the 2022 outbreak, lesions were frequently found in the genital, perianal and perioral areas. The lesions progress from macules to papules, vesicles, pustules and finally scabs.

What is a close contact? Those who have had unprotected physical contact with lesions or bodily fluids; sexual contact with a confirmed case; regular contact with a household member; direct and prolonged contact with clothing, bed linen or objects used by a patient; prolonged unprotected exposure at a distance of less than one metre, which must be assessed on a case-by-case basis; healthcare workers exposed without appropriate PPE.

In 2022, close contacts were not required to self-isolate, but were advised to take extra precautions for 21 days, minimise social contact, wear a face mask and refrain from having sex during that period.

The test that detects the virus takes a sample from the lesion itself. Samples from the oral or pharyngeal mucosa or anal swabs may also be used.

The reference centres for samples where PCR testing is not available are San Cecilio hospital in Granada for eastern Andalucía and the Virgen del Rocío hospital in Seville for western Andalucía.

If a case is under investigation, the doctor must report it immediately to public health. Probable and confirmed cases must enter the alert network and subsequently the national surveillance system.

Furthermore, certain serious cases, such as those involving pneumonia, encephalitis, meningoencephalitis or airway compromise, must be reported as a matter of urgency.

As a precaution, do not share towels, bed linen, clothing, cutlery or glasses; wash clothes at 60 degrees; do not shake out dirty laundry; and disinfect contaminated surfaces.

The protocol notes that, historically, the smallpox vaccine provides protection against mpox. A third-generation vaccine was approved in 2019. It also points out that a specific antiviral was approved in 2022, although its availability in Spain is limited.

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