Monkeypox Is Spreading In The UK Through Unusual Means. Should We Be Worried?

The mysterious cause of transmission has stumped the medical community.
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Monkeypox can trigger fever, headache and chills among other symptoms
milan2099 via Getty Images
Monkeypox can trigger fever, headache and chills among other symptoms

Covid concerns may have subsided and though they’re far from gone, now another virus, Monkeypox, has been making headlines.

Here’s what you need to know.

What is monkeypox?

Monkeypox is a rare viral infection that typically does not spread easily between humans. It’s comparable to smallpox but milder, less infectious, and less deadly.

Most people recover within a week and the virus disappears on its own, prompting no long-term health effects. However, a more severe illness can occur in a few people.

The virus usually spreads through close contact with an infected person, although there’s a low risk of transmission among humans.

The symptoms include:

  • Fever

  • Headache

  • Muscle aches

  • Backache

  • Swollen lymph nodes

  • Chills

  • Exhaustion.

A rash can start too, usually on the face at first before moving to other parts of the body including the genitals. This rash then goes through different changes and can transform to look like chickenpox or syphilis before scabbing. The scabs then fall off, although it can leave a scar behind.

People without symptoms are not considered infectious.

How many UK cases have there been?

The UK Health Security Agency (UKHSA) has so far confirmed 20 cases of monkeypox in this outbreak, and further cases identified over the weekend are due to be announced on Monday.

Dr Susan Hopkins, chief medical adviser of the UKHSA, told the BBC’s Sunday Morning show that the agency was “detecting more cases on a daily basis”, but also stressed that risk to the general population was “extremely low”.

Those needing urgent care have been treated in specialist disease units in hospital, but the “vast majority” are self-isolating at home, according to health officials.

The UKHSA is now advising anyone at high risk of having caught monkeypox – meaning anyone who has had direct or household contact with a confirmed case – to isolate for 21 days.

They are also being encouraged to provide their details for contact tracing, to not travel, and to avoid contact with immunosuppressed and pregnant people, and children under 12.

So, why are people concerned?

Investigations are underway to understand the links between the UK cases and the means by which monkeypox is transmitting in the community.

This is because the recent cases do not have known connections with previous cases announced earlier in May nor those who might have travelled abroad, which is “rare and unusual” according to Dr Hopkins.

“We are finding cases that have no identified contact with an individual from west Africa, which is what we’ve seen previously in this country,” she said.

According to Dr Hopkins, most of the UK cases identified are “in individuals who self-identify as gay or bisexual, or other men who have sex with men.”

As she previously stated: “We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”

She thanked those who have already contacted sexual health clinics or GPs for testing and stressed that the UKHSA is also contacting any potential close contacts of cases with relevant health information and advice.

The UKHSA’s director of clinical and emerging infections Dr Colin Brown also noted: “While investigations remain ongoing to determine the source of infection, it is important to emphasise it does not spread easily between people and requires close personal contact with an infected symptomatic person.

“The overall risk to the general public remains very low.”

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, told the Guardian: “The vast majority of identified cases are isolating at home and do not require hospital admission.”

What about global monkeypox cases?

While the outbreak was first identified in the UK, cases have now been found across Europe in Spain, Portugal, France, Belgium, Germany, the Netherlands, Italy and Sweden – and most recently Austria, Switzerland and also Israel.

The World Health Organisation (WHO) is looking into how the virus is circulating and the risk it poses to both endemic and non-endemic countries.

It also predicted that case numbers and the number of countries monkeypox is in will rise.

. @WHO is working with member states & partners to better understand #monkeypox circulation in endemic & non-endemic countries. We expect # cases/countries reporting to increase.

Monkeypox is a priority pathogen & requires investment in studies for transmission, severity, R&D… pic.twitter.com/aoxpQY6nTj

— Maria Van Kerkhove (@mvankerkhove) May 19, 2022

How is monkeypox usually transmitted?

The infection is usually picked up from infected animals in rainforests. Minor outbreaks usually occur in West and Central Africa, but transmission is low because it can only happen through direct contact with lesions or respiratory sections.

Infectious disease epidemiologist Mateo Prochazka explained on Twitter last week just why the new findings were so surprising.

He wrote: “Close contact between two people (such as during sex) could also facilitate transmission – but this has never been described before.”

He continued: “What is even more bizarre is finding cases that appear to have acquired the infection via sexual contact. This is a novel route of transmission that will have implications for outbreak response and control.”

He also pointed out that work is ongoing, especially when it comes to protecting health workers, a sexual health service response and preventing an increase in stigma and inequalities.

Yesterday, @UKHSA reported four cases of monkeypox (MPX) in gay and bisexual men in England, making a total of 7 cases nationally.

So what's going on with monkeypox (MPX)?https://t.co/lpefCO16uV

— Mateo Prochazka (@teozka) May 17, 2022

Is this the first time it’s been identified in the UK?

No – three people were diagnosed in September 2018 and an additional person was named in December 2019 after flying back from Nigeria. Another three cases were reported from within the same family in May and June 2021, after the person who initially caught it travelled back from Nigeria.

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