Monkeypox is a rare disease caused by infection with the monkeypox virus and occurs primarily in Africa.
Both animals and humans can be infected with the monkeypox virus and it can transfer through animal to human and human to human contact.
Despite the name (which it was given because the disease was first identified in monkey colonies in 1958) rodents and other small animals are disease hosts. The first cases in humans were identified in 1970. (1)
Symptoms
Although usually a mild illness that will get better without treatment there is a risk of serious complications including septicaemia, encephalitis and blindness. The illness begins with flu-like symptoms followed between 1 to 5 days later by a red, bumpy rash which changes into fluid filled spots which eventually scab over.
It can be confused with chickenpox and specialist testing is needed to confirm the diagnosis. It does not pass easily from person to person and close contact with the infected person is needed to transmit the infection.
Treatment
There is no specific treatment for monkeypox and no vaccine.
However, it is thought that vaccination against smallpox also provides protection against monkeypox. The eradication of smallpox means the vaccine is no longer in regular use which may account for the increased frequency of monkeypox outbreaks in Africa. (2)
Current Situation
Nigeria has an ongoing outbreak of monkeypox that began in September 2017. Since then there have been 558 cases and 8 deaths across the country. (3)
Unusually, monkeypox is currently spreading across Europe, the Americas, and other regions such as Israel and Singapore. Scientists have said that the long running outbreak in Nigeria should have served as a warning that it was only a matter of time before spread outside of the country began to happen.
Monkeypox has always occasionally been diagnosed outside of Africa but until 2022 the infected person always had a history of recent travel or link to one of the African countries where monkeypox is known to be endemic.
In the UK in May 2022 a case of monkeypox was confirmed in someone who had neither travelled to Africa nor been in contact with someone who had. Since then more cases in people with no travel history have been confirmed.
The WHO estimates that 16 non-endemic countries currently have cases of monkeypox but at the time of writing there have been no deaths in these countries. (2)
People with the infection pass it on to others through very close skin contact. In this recent outbreak people often presented with lesions on the genitals but, rather than being transmitted specifically though sex, it seems likely that it is the close skin contact that is the mode of transmission. The virus is not thought to spread via body fluids such as semen or vaginal fluids.
Unlike COVID-19 this is not an airborne virus and it is therefore far less transmissible.
Currently the outbreak appears to be primarily amongst men who have sex with men, probably through close skin to skin contact with each other rather than by the sexual act itself. (4)
Summary
It is always a concern when any disease starts to behave differently to its norm, be that in terms of how it is spreading or a change in its severity or outcomes. It is therefore vital that scientists are given the resources to investigate this outbreak thoroughly so that it can be contained and our knowledge about monkeypox expanded.
However, unlike COVID-19, the monkeypox virus is not a new virus, we have known about it for more than half a century. Although the media enjoys publishing doom ridden headlines such as “Monkeypox sweeping across the country” and “Scientists racing to contain the outbreak” that is not the reality. (5) (6)
The reality is that scientists are working calmly to establish why an infectious disease we already knew about is behaving a little differently. Monkeypox is not the new COVID-19 - but it is one of many diseases we should always take seriously.
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