With the first case of monkeypox confirmed in Scotland and cases increasing worldwide and on virtually every continent, health agencies everywhere are on the alert
What is it?
Monkeypox is a virus associated with monkeys and usually confined to countries in central and western Africa. It spreads from person to person through close physical contact, including through sexual intercourse. There have been cases in the UK before – in 2018, 2019 and 2021 –but never on this scale and almost always associated with travel to affected areas. The largest previous outbreak was in Nigeria in 2017, when there were 172 suspected cases. In an outbreak in the US in 2003, 81 cases were identified.
How many cases are there now?
To date there are over 80 cases worldwide, identified in countries as far apart as Israel, Austria, Sweden and Canada. The UK Health Security Agency (UKHSA) has confirmed over 20 cases in the UK so far, including one in Scotland.
What do the experts say?
Speaking on BBC One’s Morning Show on Sunday, UKHSA’s chief medical advisor Dr Susan Hopkins warned there would be more cases on a daily basis and that medics are now seeing community transmission. “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. “The community transmission is largely centred in urban areas and we are predominantly seeing it in individuals who self-identify as gay or bisexual, or other men who have sex with men.”
How worried should we be?
There are two strains of monkeypox in circulation, with the West African strain thought to be milder. Symptoms include a fever followed by a rash and lesions similar to chickenpox. The British Medical Journal (BMJ) reports a case fatality rate of around 3%, with deaths higher among children and young adults and those who are immunosuppressed though it is important to stress that most cases are mild. The message from medics is that the danger to the general public is extremely low, particularly as the disease is not particularly transmissible.
Is it treatable?
There is currently no specific treatments or vaccines. However the smallpox vaccine has been shown to be 85% effective and outbreaks can be controlled using antivirals such as cidofovir and tecovirimat. The UK government has reportedly stocked up on vaccine doses and they are being used to treat close contacts of those currently affected.
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