This is really going to be just a quick few updates of some of the salient features I spotted in the last few days.
The headline message remains: The risk is low so don’t be concerned, but do be vigilent.
Illness & Precautions
- Infection during pregnancy can lead to miscarriage. [1]
- A child’s temperature is likely to be higher with monkeypox, and they may complain of backache, lower leg aches, chills, and very tender glands around their neck. The blisters are bigger with monkeypox (cf. chickenpox). [2]
- People with monkeypox have been told to avoid contact with their pets for three weeks amid concerns the animals could become infected and pass the virus on to other people. However the risk of someone passing monkeypox to their pet is low and no cases of monkeypox have ever been suspected or reported in pets in the UK. [3]
- People who have tested positive for the virus and their close contacts are being told to isolate at home for 21 days. They should avoid contact with other people until all lesions – or blisters – have healed and scabs have dried off. [4]
- Anyone testing positive is being told to abstain from sex while they have symptoms, and then use condoms for 8 weeks as a precaution. [4]
- Confirmed cases and their close contacts should take extra care if they need to leave the house to see a doctor or other health worker. [4]
Epidemiology
- Health officials are reporting that the current monkeypox outbreak is mostly affecting younger men in London. Although anyone can contract the virus, 111 of 183 cases** in England are in men who have sex with men. In England, 86% of those infected live in London and only two are women. Most are aged 20 to 49. [5]
(** This was a couple of days ago and the numbers have increased since then. The UK government regularly publishes the latest figures etc. [11]) - People aged 50 and above are likely to be immune (they’re more likely to have had a smallpox vaccination) but the under-50s are more susceptible. [7]
- The recent outbreak of monkeypox is being linked to events taking place in Spain and Belgium, according to a leading advisor to the WHO. And the authorities are investigating possible links between a recent Gay Pride event in the Canary Islands, which drew 80,000 people, and cases at a Madrid sauna. [6]
- Experts in Africa have warned that monkeypox could change from a regionally widespread zoonosis to a globally relevant infectious disease. The virus may be filling the ecological and immunological niche once occupied by the smallpox virus now that smallpox vaccination has ceased. [1]
- Which means this was an outbreak waiting to happen after the end of global smallpox vaccination more than 40 years ago. [7]
- There’s unlikely to be the same “explosive growth” of infections into the general population that was witnessed with Covid. However the outbreak could continue for several months as contact tracing slows but does not stop transmission. [7]
- Scientists are working through how the disease came to flare up in so many countries in such a short space of time. Many suspect that monkeypox was circulating at low levels, undetected, in the UK or Europe for several years before it reached the MSM community and flared up. [8]
- Genetic studies on monkeypox viruses taken from people in the ongoing outbreak show a close resemblance to the virus that reached the UK, Israel and Singapore from Africa in 2018 and 2019. They all have a common ancestor which probably dates back to 2019. [8]
- Data from the Democratic Republic of the Congo in the early-1980s and mid-2010s suggest the effective reproduction numbers at those times were 0.3 and 0.6, respectively – meaning each infected person passed the virus to fewer than one person in those populations, on average. [1]
- DNA viruses like these are a lot larger and more complicated than RNA viruses like Coronaviruses. Coronaviruses are among the largest RNA viruses known, at about 30,000 base pairs, but things like monkeypox are up over 200,000 bp. [9]
Zoonotic Concerns
- The infection can be spread by animals, and pet owners have been urged to “manage exposed pets and prevent the disease from being transmitted to wildlife”. [10]
- The EU has warned that the zoonotic transfer to humans could spill over yet again from humans to other mammals, potentially making monkeypox endemic in Europe. That’s a real concern, since we know the disease can be carried by a variety of small mammals. But what we don’t know is the likelihood of humans passing it on to animals, or the disease getting established among those animal populations in the wild. [9]
- Some of our most troublesome infectious disease threats – think Ebola, or Nipah, or coronaviruses, and now monkeypox – are disproportionately zoonotic diseases. [1]
References
[1] https://www.scientificamerican.com/article/what-we-know-about-the-rise-in-monkeypox-cases-worldwide/ [£££]
[2] https://www.thisislocallondon.co.uk/news/national/uk-today/20163472.uk-monkeypox-outbreak-tell-difference-chickenpox-monkeypox/
[3] https://www.theguardian.com/science/2022/may/27/monkeypox-patients-contact-pets-uk
[4] https://www.bbc.co.uk/news/health-61640196
[5] https://www.bbc.co.uk/news/health-61660180
[6] https://www.thisislocallondon.co.uk/news/national/uk-today/20160206.monkeypox-outbreak-sex-raves-spain-belgium-may-blame/
[7] https://www.theguardian.com/world/2022/may/24/monkeypox-outbreak-was-waiting-to-happen-say-scientists
[8] https://www.theguardian.com/world/2022/may/25/monkeypox-may-have-been-circulating-in-uk-for-years-scientists-say
[9] https://www.science.org/content/blog-post/now-monkeypox
[10] https://www.thisislocallondon.co.uk/news/national/uk-today/20162530.monkeypox-pet-owners-urged-manage-exposed-pets-uk-cases-rise/
[11] https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates