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Monkeypox

An Italian greyhound belonging to a gay couple in Paris catches monkeypox

Monkeypox is a rare viral infection that causes unusual rashes or lesions (shown in a flyer provided by the Centers for Disease Control and Prevention (CDC) in the U.S.

How do you catch monkey pox?

Until this global epidemic, monkeypox was usually spread by infected rodents – including rats, mice and even squirrels – in West and Central Africa.

People can contract the disease, which is in the same family as smallpox, by being bitten by infected animals, touching their blood, body fluids or scabs, or eating wild game or weed meat.

Orthopoxvirus, which causes monkeypox, can enter the body through broken skin—even if it can’t be seen—as well as through the eyes, nose, and mouth.

Although monkeypox is mainly spread by wild animals, it has been known to be transmitted between humans. But health chiefs insist it was very rare until the current epidemic.

Person-to-person transmission can occur if someone touches clothing or bedding used by an infected person or by direct contact with virus scabs. The virus can also be spread by coughing and sneezing.

In the continuing rise in cases, experts believe the virus is transmitted through skin-to-skin contact during sex – although this exact mechanism has never been observed.

How deadly is that?

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment.

Still a disease kills up to 10 percent of the time. However, this high rate is thought to be partly due to a historical lack of testing, meaning that a tenth of known cases died rather than a tenth of all infections.

However, with milder strains, the death rate is closer to one in 100 – similar to the first hit with Covid.

The West African version of the virus, which is mild compared to the Central African strain, is behind the current spread. No deaths have been reported in the ongoing outbreak.

How is it tested?

Monkeypox can be difficult to diagnose because it is often confused with other infections such as chickenpox.

Monkeypox is confirmed by clinical assessment by a healthcare professional and a test at a specialist UK laboratory – the UKHSA Rare and Imported Pathogens Laboratory.

The test involves taking samples from skin lesions, such as part of a scab, fluid from the lesions, or pieces of dry crusts.

What are the symptoms?

Patients infected with monkeypox can take up to three weeks to develop any of its symptoms.

Early symptoms of the virus include fever, headache, muscle aches, back pain, swollen lymph nodes, chills and exhaustion – meaning it could theoretically be mistaken for other common illnesses.

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But its most unusual feature is a rash that often starts on the face, then spreads to other parts of the body, usually the hands and feet.

The rash changes and goes through different stages before eventually forming a scab that later falls off.

How long is someone contagious?

An individual is contagious from the time the rash appears until all the scabs have fallen off and there is intact skin underneath.

Scabs may also contain infectious viral material.

The infectious period is thought to last three weeks, but it can vary between individuals.

What should I do if I have symptoms?

The UK’s Health Safety Agency is advising Britons to contact their sexual health clinic if they have a blistering rash and have been in close contact with a suspected or confirmed case of monkeypox, or have been in West or Central Africa in the last three weeks.

Britons are asked to contact clinics before visiting and to avoid contact with others until they have been seen by a doctor.

Gay and bisexual men have been asked to be particularly alert to the symptoms, as most cases have been found in men who have sex with men.

What is monkey pox anyway?

Monkeypox was first discovered when a smallpox-like disease broke out in monkeys kept for research in 1958.

The first human case was recorded in 1970 in the Democratic Republic of the Congo, and since then infection has been reported in a number of countries in Central and West Africa.

Only a handful of cases have been reported outside of Africa, and they have been limited to people with travel connections to the continent.

The UK, US, Israel and Singapore are the only countries to have detected the virus before May 2022.

Monkeypox is a rare viral infection that causes unusual rashes or lesions (shown in a flyer provided by the Centers for Disease Control and Prevention (CDC) in the U.S.

Monkey pox is a rare viral infection that kills up to one in 10 people, but it does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)

Nurses and doctors are advised to remain alert to patients who have a new rash or scab (as above).

Nurses and doctors are advised to remain alert to patients who have a new rash or scab (as above).

Is it related to chicken pox?

Although it causes a similar rash, chickenpox is not related to monkeypox.

The infection, which mostly affects children, is caused by the varicella-zoster virus.

By comparison, monkeypox—like chickenpox—is an orthopoxvirus. Because of this association, smallpox vaccines also provide protection against monkeypox.

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Are young people more vulnerable?

Britons under the age of 50 may be more susceptible to monkeypox, according to the World Health Organisation.

Until 1971, children in the UK were routinely offered the smallpox jab to protect against monkeypox.

The WHO also warns that mortality is higher among young children.

Does it spread as easily as Covid?

Leading experts insist we won’t see Covid-style levels of transmission in a monkeypox outbreak.

A World Health Organization report last year suggested that the natural rate of the R virus – the number of people each patient would have infected if they were living normally when they were sick – is two.

This is lower than the original Wuhan variant of Covid and about a third the R rate of the Indian “Delta” strain.

But the true rate is likely much lower because “distinctive symptoms are very helpful in its early detection and containment,” the team said, meaning it’s easy to detect and isolate cases.

Covid is mainly spread by droplets released by an infected person whenever they breathe, talk, cough or sneeze.

How is the UK handling the epidemic?

MailOnline has revealed that monkeypox patients and their close contacts, including NHS workers, are being offered the Imvanex smallpox vaccine.

The strategy, known as circular vaccination, involves jabbing and watching anyone around an infected person to create a buffer of immune people to limit the spread of the disease.

In addition, close contacts of people with confirmed monkeypox infection are told to stay at home for 21 days and avoid contact with people under 12, immunosuppressed people and pregnant women.

The government said unprotected direct contact, or high-risk environmental contact, includes living in the same house as a person with monkeypox, having sex with them, or even just changing bed linen “without appropriate PPE.”

As with Covid, someone who has come within one meter of an infected person is classified as having come into contact with monkeypox.

This lower category of contact, which also includes sitting next to a person with monkeypox on a plane, means that a tracker will call that person every day for three weeks and they will be advised to stay off work for 21 days if their work involves children or immunosuppressed colleagues.

The UK has stopped requiring people to be quarantined by law if they come down with monkeypox, but ministers are considering a public health campaign to alert gay and bisexual men because of the number of cases in that group.

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What if it continues to spread?

Experts told MailOnline that they “could see a role” in introducing targeted stabbing of gay people in the UK “if it is not brought under control quickly”.

Close contacts of known UK cases are already being offered a jab originally designed for smallpox. The two viruses that cause the rash are very similar.

A health source told MailOnline “there would be a number of strategies we would look at” if cases continued to rise.

Professor Kevin Fenton, regional director of public health in London, said if the epidemic continued to grow in the capital, then the introduction of vaccines and treatment could be extended to more groups.

He said there are “plans” to have more antivirals if the outbreak continues to grow.

Which other countries have reported cases?

More than 40 countries – including the US, Spain and Italy – have reported cases of monkeypox.

The most cases were found in the United Kingdom, Spain, Portugal, Canada and Germany.

There are several antivirals and therapies for smallpox that appear to work for monkeypox, including the drug tecovirimat, which was approved in the EU for monkeypox in January

There are several antivirals and therapies for smallpox that appear to work for monkeypox, including the drug tecovirimat, which was approved in the EU for monkeypox in January

Is there a vaccine for it?

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses behind the diseases are closely related.

Figures show it prevents around 85 per cent of cases and as of 2018 it is being used ‘off-label’ in the UK.

The jab, which is believed to cost £20 a dose, contains a modified vaccinia virus that is similar to both smallpox and monkeypox but does not cause disease in humans.

Because of their similarity to smallpox viruses, antibodies produced against this virus provide cross-protection.

Are there any medicines to treat it?

There are several antivirals and smallpox therapies that seem to work for monkeypox.

This includes the drug tecovirimat, which was approved for monkeypox in the EU in January.

Tecovirimat prevents the virus from leaving the infected cell, thus preventing the virus from spreading in the body.

According to the US Centers for Disease Control and Prevention (CDC), an injectable antiviral drug used to treat AIDS called cidofovir can be used to treat the infection.

It also works by stopping the growth of the virus.

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