What is monkeypox? Signs, symptoms and risks as cases confirmed in UK

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What is monkeypox? Signs, symptoms and risks as cases confirmed in UK

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Health officials have confirmed two cases of the rare monkeypox virus in Wales.

Public Health Wales said it is monitoring two cases of imported monkeypox alongside Public Health England after their discovery. The statement is here. The virus is said to have been acquired overseas, and the two cases are members of the same household. Both individuals were admitted to a hospital in England where one remains.

Monkeypox is a rare disease caused by infection that usually causes mild illness that will get better on its own without treatment. Some people can develop more serious symptoms, so patients with monkeypox in the UK are cared for in specialist hospitals.

Here is what the World Health Organisation has to say about the virus:

What do we know about the virus?

It is one that is transmitted to humans from animals and has symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe.

It occurs primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions.

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo (then known as Zaire) in a nine-year-old boy in a region where smallpox had been eliminated in 1968. Since then, most cases have been reported from rural, rainforest regions of the Congo Basin, particularly in the Democratic Republic of the Congo, where it is considered to be endemic.

Since 1970, human cases of monkeypox have been reported from 11 African countries. The virus has been exported from Africa a few times. In the spring of 2003, monkeypox cases were confirmed in the United States of America.

Recently, monkeypox was carried to Israel in September 2018, to the United Kingdom in September 2018 and December 2019 and to Singapore in May 2019 by travellers from Nigeria who fell ill with monkeypox after arrival. A health worker was infected and became ill.

How is it transmitted?

It is mostly transmitted to people from wild animals such as rodents and primates, but human-to-human transmission also occurs. It can be transferred from one person to another by contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.

Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor.

Human-to-human transmission is relatively limited. Infection can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects.

Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health workers and household members of active cases at greater risk.

What are the signs and symptoms?

The incubation period of monkeypox is usually from six to 13 days but can range from five to 21 days.

The World Health Organisation says the first phase is characterised by fever, intense headache, swelling of the lymph nodes, back pain, muscle aches and an intense lack of energy.

A rash can then develop which tends to be more concentrated on the face, hands and soles of feet.

Symptoms last between two and four weeks. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications. Complications of monkeypox can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision.

How dangerous is it?

Typically, up to a tenth of persons ill with monkeypox may die, with most deaths occurring in younger age groups.

The case fatality ratio of monkeypox has varied between 0 and 11 % in the general population, and has been higher among young children. In addition, persons younger than 40 or 50 years of age (depending on the country) may be more susceptible to monkeypox as a result of the termination of routine smallpox vaccination worldwide after the eradication of smallpox.

Is there a vaccine?

There is currently no specific treatment recommended for monkeypox.

Vaccination against smallpox with vaccinia vaccine was demonstrated through several observational studies to be about 85% effective in preventing monkeypox.

However at the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. A newer vaccinia-based vaccine was approved for the prevention of smallpox and monkeypox in 2019 and is also not yet widely available in the public sector.

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