MONKEYPOX is a rare disease that causes outbreaks in Africa.
But unusually, it has started spreading across a number of untouched countries in Europe and the Americas.
The mystery outbreaks, starting in May 2022, are concerning health leaders.
But the threat to the public is still considered low.
While monkeypox is a mild illness which gets better with time, in very rare cases it can lead to death. About six per cent of cases are fatal, the World Health Organization (WHO) says.
What is monkeypox?
Monkeypox is a viral infectious disease.
This particular virus is a rare zoonosis, this means that it is transmitted to humans from an animal.
It primarily occurs in remote parts of Central and West Africa, near tropical rain forests.
It spreads between humans only through close contact.
What are the monkeypox symptoms?
Monkeypox causes symptoms between five and 21 days after exposure.
The symptoms of monkeypox start off similar to flu. But then a rash breaks out, starting on the face.
Initial symptoms include:
An itchy and sometimes painful rash slowly appears one to three days into illness, starting with the face, palms of the hands and soles of the feet.
What starts as a seemingly harmless red rash – which looks like chickenpox – evolves into angry blisters that can last several days.
The inside of the mouth, genitals and lining of the eyes can also be affected by the nasty rash.
If the rash spreads to the eyes it can cause blindness.
While some patients may have only a few lesions, others will have thousands, the WHO says.
Symptoms generally last from 14 to 21 days, with severe cases relating to age, the extent of virus exposure, the patient’s health and the severity of complications.
Doctors and the public have been warned to keep an eye out for unexplained rashes.
Is monkeypox in the UK?
On May 7, 2022, a case of Monkeypox case was confirmed to arrive from Nigeria by the UK Health Security Agency (UKHSA).
The patient was treated at Guy’s Hospital in London and the UKHSA scrambled to get through to those who might have been in close contact with the infected person.
Following that initial case, a bunch more were reported – with no links to travel.
As of May 24, there have been 56 cases detected in England and one in Scotland.
Most do not have travel links or have been in contact with someone who does, meaning there is community transmission of the virus.
Monkeypox has been seen just six other times in the past in the UK, with cases dating back to 2018 and always in travellers from other countries.
However an NHS nurse once caught the virus in 2018 while changing the bedsheets of a patient in hospital, blaming “pathetically small” protective gloves.
Another case was seen in South West England in December 2019 in someone who had visited Nigeria.
The former Health Secretary Matt Hancock announced there had been an outbreak of the monkeypox virus in June 2021, although few details were given.
How can you catch monkeypox?
Infection usually occurs after direct contact with the blood, bodily fluids or skin lesions of an infected animal.
In Africa, human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels.
Eating the inadequately cooked meat of an infected animal could trigger infection.
Monkeypox does not usually spread easily between people.
Human-to-human transmission can result from close contact with the skin lesions of an infected person.
The UKHSA says: “An individual is contagious until all the scabs have fallen off and there is intact skin underneath. The scabs may also contain infectious virus material.”
A person can also catch monkeypox from objects recently contaminated by the patient, such as their bedsheets, clothing or utensils.
A large proportion of cases identified are gay, bisexual or men who have sex with other men – although it is early days, and there could be a reason why only these people are presenting with symptoms.
Monkeypox is not normally a “sexually transmitted infection” (STI), but it can be passed on by direct contact during sex or very close physical touch.
Transmission can also occur via the placenta, known as congenital monkeypox.
Is monkeypox deadly?
According to WHO, the monkeypox virus is similar to human smallpox.
Monkeypox is much milder than smallpox, but it can still be fatal.
It has a mortality rate of between one and 10 per cent, depending on the strain, with most deaths occurring in younger age groups.
Dr Michael Skinner, a reader in virology, Imperial College London, said: “Virologists recognise two strains of monkeypox virus.
“The Congo strain is more severe (up to 10 per cent mortality) and probably more transmissible in humans than the West African strain, the source of these latest cases, for which mortality is estimated at about one per cent.
“Most UK cases of monkeypox are likely to be the West African strain due to the UK receiving more travelers from this region than the Congo.”
The WHO states: “In recent times, the case fatality ratio has been around three to six per cent.”
How to treat monkeypox
Monkeypox symptoms last between two and four weeks. There is no treatment for it – it gets better on its own.
There are no specific vaccines available for monkeypox, either.
But outbreaks can be controlled using contact tracing.
A vaccine developed for smallpox – which was declared eradicated in 1980 – is also licensed for monkeypox.
This jab has been proven to be 85 per cent effective in preventing monkeypox. However, most people in the UK will not be vaccinated against smallpox given that it is no longer in circulation.
The Government has stocks of the smallpox vaccine which is being offered to very close contacts of those affected. These people also have to isolate for 21 days.
Dr Carlos Maluquer de Motes, Reader in Molecular Virology, University of Surrey, said: “Isolation is one of the most effective measures to contain the spread of a disease, particularly a viral disease, because it limits the number of susceptible individuals that can be exposed to the virus.
“Isolation of confirmed cases and the identification and vaccination of all their close contacts creates a circle of protected people around a positive case that is very effective in breaking chains of transmission.
“This ‘ring vaccination’ strategy was successfully used to eradicate smallpox, so it is a proven strategy to contain poxvirus disease.”