I’m a monkeypox expert – from how it’s spread to protecting your family, here are the 13 things you need to know
FIRST came Covid, then a mysterious outbreak of hepatitis among kids and now monkeypox.
It’s the latest health scare to send shivers down our spines, with words like “isolation” rearing their ugly heads once more.
Monkeypox is a rare viral disease typically seen in parts of central and west Africa, having been discovered in a colony of monkeys in 1958, and later in humans in 1970.
On May 7, the UK Health Security Agency announced that a case had been detected in a patient who had travelled to Britain from Nigeria.
Since then cases have risen, with community spread and more than 300 cases outside Africa, according to the World Health Organisation.
More than 100 of those cases have been detected in the UK, with one child ending up in intensive care and infections confirmed across Europe and the US among other countries.
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Dr Susan Hopkins, chief medical adviser at UKHSA, said: “We are continuing to promptly detect new monkeypox cases through our extensive surveillance network and NHS services.
“If anyone suspects they have rashes or lesions on any part of their body, particularly if they have recently had a new sexual partner, they should limit their contact with others and contact NHS 111, or their local sexual health service as soon as possible, though phone ahead before attending in person.”
So, what is monkeypox, who is at risk and why are young men making up most of the cases so far?
We asked Dr Amr Bayoumy, a virologist at Coventry University, to share everything you need to know.
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WHAT IS MONKEYPOX?
LIKE coronavirus, monkeypox is what’s known as a zoonotic virus — meaning it can be transmitted from animals to humans.
“Clinical symptoms are similar to those seen in the past in smallpox patients,” Dr Amr says. “But while monkeypox is genetically similar to smallpox, it’s less severe.”
Monkeypox is endemic in parts of Africa, which just means that it’s consistently present, and accounts for some 9,000 cases a year.
There are two strains, one originating from West Africa and most likely to be the one causing the global outbreak, and another from the Congo, which is more deadly.
WHY IS IT CALLED MONKEYPOX?
THE name suggests it originated from monkeys, but scientists can’t be certain. What they do know is where it was first identified.
Dr Amr says: “Monkeypox was first isolated from lab monkeys in 1958, hence the name. However, the natural host is thought to be rodents such as rats, mice and squirrels, not monkeys.”
In the 1970s, not long after the virus was discovered, it was first found in humans.
HOW WILL I KNOW IF I’M AFFECTED?
THE good news is that in most cases monkeypox is a mild disease and clears up on its own.
Symptoms start between five and 21 days after a person is infected and can be mistaken for flu. Dr Amr tells Fab Daily: “Clinical symptoms include fever, headache, lymph node swelling and muscle aches.
“Skin rashes usually start within one to three days after a fever. Symptoms can last two to four weeks, and in most cases a person will typically recover.
“However, severe cases can be seen in children and people with compromised immune systems.”
CAN PEOPLE DIE?
IT’s been referred to as a “cousin” of smallpox, which is enough to instil fear because smallpox killed millions before it was eradicated in the 1980s, thanks to vaccines.
However, monkeypox is less severe and less deadly. Dr Amr says: “The case fatality is three to six per cent, with fatalities higher in young children.” That’s for the Congo strain, the West African strain’s fatality rate is thought to be about one per cent.
HOW WORRIED SHOULD I BE?
MONKEYPOX is “not another Covid”, Dr Amr says, reassuringly.
Unlike Covid, this virus doesn’t spread or mutate as quickly.
And Dr Amr says transmission among humans is “not efficient”, with most people passing it on to less than one other person, meaning its R rate is less than one.
“Transmission requires prolonged direct contact with an infected individual or his or her recently contaminated objects,” Dr Amr says.
“Coronavirus is transmitted by breathing in contaminated droplets.”
HOW DOES IT SPREAD?
IN most cases a person is infected after coming into contact with an infected animal, but it can also be transmitted through close contact with a person which appears to be the main source in this outbreak.
Dr Amr explains this can happen if you touch the skin lesions of an infected person, or objects they have contaminated “such as bedding, towels or clothes”.
IS IT SEXUALLY TRANSMITTED?
MONKEYPOX is not thought to be sexually transmitted in the traditional sense. But, it can be passed through sexual contact.
You are contagious with the disease until scabs that form over a rash fall off. The World Health Organisation (WHO) has said more research is needed to “better understand” if it could spread through sex via semen and vaginal fluid.
WHO IS AT HIGHEST RISK?
ANYONE who comes into close contact with an infected person is most risk.
If you’ve recently travelled to West or Central Africa, you’re deemed higher risk too. But in general, Dr Amr says younger people are more likely to catch it.
“People younger than 40 to 50 years old (depending on the country they live) may be more susceptible due to the end of smallpox vaccination campaigns globally in the 1980s,” he says.
UK health chiefs have warned that so far a disproportionate number of cases have been detected in gay and bisexual men.
That does not mean it’s a “gay disease”, TV doctor Ranj Singh told Attitude Magazine. Dr Ranj said men who have sex with men (MSM) are not at fault, but it might be that the first cases were detected in MSM networks.
“This community should be on increased alert,” he added.
The WHO added that cases in gay and bisexual men might be “because of positive health-seeking behaviour in this demographic”, as lots of cases have been detected at sexual health clinics.
The WHO added: “Anyone who has close physical contact with someone who has monkeypox is at risk, regardless of who they choose to have sex with or any other factor.
“Stigmatising people because of an illness is unacceptable.”
ARE MY KIDS AT RISK?
ONE child in the UK has ended up in intensive care with monkeypox.
Official guidance states there are four groups at risk of severe disease: newborns, children, people who are immunocompromised and health workers. Seek help if you’re worried about your child.
HOW CAN I PROTECT MY FAMILY?
IF you know someone with monkeypox, avoid close contact.
The Government says anyone with direct or household contact with a confirmed case should isolate for 21 days.
Dr Amr says: “Avoid sharing bedding, towels or clothes. Wash your hands with soap and water regularly or use an alcohol-based hand sanitiser. Avoid contact with pet rodents which may have monkeypox.
“In 2003, the first outbreak outside Africa was linked to pet prairie dogs, a type of squirrel.”
WHAT SHOULD I DO IF I THINK I HAVE IT?
DR Amr says: “Contact the NHS or your GP. Stay at home and avoid close contact with other people until you have been told what to do.”
IS THERE A VACCINE?
THE short answer is yes. Studies have shown the smallpox vaccine is around 85 per cent effective against monkeypox.
“The smallpox vaccine is no longer available for the general public,” Dr Amr says. “But prior smallpox vaccination may result in milder illness.”
The Government has stockpiled doses and close contacts of confirmed patients are being jabbed in a strategy known as “ring vaccination”. Dr Amr says: “Everyone who has been exposed to a patient receives the vaccine.
“Ring vaccination requires complete and rapid surveillance and epidemiologic case investigation.”
This strategy has worked for previous outbreaks of monkeypox.
CAN IT BE TREATED?
AN antiviral medicine known as tecovirimat has been shown to reduce the duration of symptoms and infectiousness.
It was licensed for monkeypox in Europe in 2022, but Dr Amr says it is not yet widely available.
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Most people recover by themselves without serious complications.
Dr Amr adds: “The authorities are not powerless against monkeypox. We already have the tools — vaccines and medicines — to control infections.”
