OK guys, so here’s another (not quite new) zoonotic disease for us to get our heads round and which piques my forensic nature: Monkeypox.
As of writing there are now 20 cases reported in the UK [1], with over 100 across mainland Europe [5] – where there seems to be a hotspot in Spain – and cases in the US, Canada and Australia. It is being suggested [2] that a number of cases will be being missed due to a similarity with chickenpox.
Monkeypox is a viral disease which is thought to be carried mostly by rodents and is prevalent in remote central and western areas Africa. Cases outside Africa are almost always associated with travel to that continent. That makes the current outbreak in the UK and beyond especially interesting. Although the first reported UK case in early May was in someone recently returned from west Africa, many of the more recent cases apparently do not have an obvious connection to African travel. Perhaps even more interesting is that a significant number of the UK cases are in men who have sex with men (MSM).
The virus is not transmitted in the same way as Covid or flu, but through close bodily contact with an infected person; it can enter the body through broken skin, the airways, eyes, nose or mouth [3]. However it has not previously been described as a sexually transmitted infection – although sex tends to involve close bodily contact! Spread is also possible from infected animals (eg. monkeys, rodents) or from virus-contaminated objects (eg. bedding and clothing).
Unfortunately the initial symptoms are very much like most viral illnesses: fever, headaches, swollen glands, back pain, aching muscles and a general listlessness. Only later does the rash develop; it often begins on the face, and then spreads to other parts of the body, most commonly the palms of the hands and soles of the feet. The rash, which can be extremely itchy, goes through several stages before forming a scab, which later falls off. Although there is no treatment for monkeypox, and no specific vaccine, most cases resolve within 2-3 weeks.
As the name implies, monkeypox is an Orthopoxvirus very closely related to smallpox (also cowpox). The smallpox vaccine is reportedly highly effective protection [3], so anyone who has been vaccinated against smallpox should have some protecton. Have you been vaccinated against smallpox? Smallpox vaccination was compulsory in the UK between 1853 and 1971 [4] so many people over 50 will have been vaccinated, although apparently compliance was falling before the vaccination requirement was removed.
Should we be worried? Current advice is NO. The risk to the public at large is thought to be very low especially as the virus does not spread easily. But then we originally thought that about Covid-19. So no, don’t panic or be alarmed; but do remain alert and if in any doubt about symptoms talk to your GP.
References
[1] https://www.bbc.co.uk/news/health-61506562
[2] https://www.thisislocallondon.co.uk/news/national/uk-today/20154025.monkeypox-cases-uk-double-20/
[3] https://www.bbc.co.uk/news/health-45665821
[4] https://www.ncbi.nlm.nih.gov/books/NBK545998/
[5] https://www.independent.co.uk/news/health/monkeypox-virus-infection-case-symptoms-live-uk-b2083515.html