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Health
Simon Meechan

Monkeypox: How is it treated, vaccines and should we be worried about the 'global emergency'?

Monkeypox has been declared a global emergency having spread to 70 countries worldwide.

The World Health Organisation described the outbreak as an "extraordinary" situation as it made the announcement. But the UK Health Security Agency (UKHSA)says the risk to people in the UK is the same as before, while its latest update suggests transmission may have slowed down in the UK. A leading expert at the London School of Hygiene and Tropical Medicine says the Monkeypox outbreak is not something to "unduly worry" about.

That said, the vaccination programme is stepping up in the UK, although not everyone will be offered a jab, in contrast to the coronavirus pandemic. In most cases, people recover from monkeypox within a few weeks.

Read next: Monkeypox declared a global health emergency

What is monkeypox?

Usually found in West and Central Africa, monkeypox is a virus related to smallpox. It is usually a mild disease but can cause severe illness and even death, although most recover within a few weeks.

What are the symptoms of monkeypox?

Symptoms include fever, body aches, chills and tiredness. Some are similar to coronavirus, so it may be worth testing for that if you are worried.

Some people also develop a rash and lesions on their face and hands, which can spread. The rash can look a little bit like chickenpox, with scabs that form and fall off.

How does monkeypox spread

Physical contact and touching fabric like clothing or towels used by somebody with the rash, or touching the skin blisters and scabs, are the most likely way monkeypox can spread. There is a smaller risk of it being spread through coughs and sneezes, and as prolonged face-to-face contact would be needed, this is not one of the main routes of transmission for the monkeypox virus.

Sexual contact is thought to heighten the chance of exposure, although it is not certain if monkeypox is sexually transmitted, it's more due to the close physical contact. A majority of the cases seen so far have been in gay and bisexual men and men who have sex with men.

The NHS says: "Anyone can get monkeypox. Though currently most cases have been in men who are gay, bisexual or have sex with other men, so it's particularly important to be aware of the symptoms if you're in these groups."

What is the level of risk of monkeypox is there in the UK?

The type of monkeypox involved in the outbreak is a West African variety said to be fatal in only one per cent of cases. The UKHSA said that, after the WHO declaration of a global emergency, the risk to the UK remains the same.

In an update on July 22, the UKHSA said the most recent data suggested the growth of the outbreak might have slowed – meaning they are continuing to identify new infections but at a more stable rate.

When did monkeypox arrive in the UK?

The first case connected to the current outbreak was recorded in England on May 7 2022. Scotland recorded its first case on May 23, while Wales and Northern Ireland confirmed cases on May 26.

How many monkeypox cases are there in the UK currently?

As of July 21, there were 2,208 confirmed cases in the UK. Of those, 2,115 were in England, and the UK Health Security Agency said a high proportion of cases were in London.

What is the current public health guidance for monkeypox?

UKHSA guidance for close contacts of a confirmed monkeypox case has been updated to advise that close contacts do not need to isolate at home if they do not have symptoms.Close contacts are advised to call NHS 111 or a sexual health clinic if they develop a fever or any monkeypox symptoms, and to avoid skin-to-skin contact with others, avoid international travel if possible and to let health or dental facility staff know they are a close contact before attending appointments.

Because it can take up to three weeks for symptoms to appear after being in contact with someone with monkeypox, people are advised to stay alert for symptoms after having skin-to-skin or sexual contact with someone new.

Should we be worried about monkeypox?

Professor Jimmy Whitworth, of London School of Hygiene and Tropical Medicien, said the continued spread of the disease indicates that measures which have put in place have not been sufficient to control the spread of the infection – but urged people not to worry too much.

He said: “This outbreak is concerning for public health practitioners around the world as it has proved very challenging to prevent onward transmission of infection, but it is not a situation that should unduly worry the general public.

“This is an infection that is transmitted by close contact – touching skin, coughing and sneezing, sharing of utensils, bedding and so on. The vast majority of cases have been in gay, bisexual or other men who have sex with men who have had multiple recent sexual partners.

“Most people, whatever their sexual orientation, do not have close contact of this sort with many people and so the infection is unlikely to spread easily.”

He added that increased attention on the disease might “lead to more focus on control within Africa, the natural home of this virus, where the number of cases has been increasing for the past 20 years”.

Is there a monkeypox vaccine?

Yes. The existing MVA vaccine for smallpox offers a "good level of protection" against monkeypox, the NHS says.

On Tuesday, UKHSA announced that they had procured more than 100,000 additional vaccine doses with the first 20,000 set to be delivered for use by the NHS in August.

The NHS is offering the MVA smallpox vaccination to people who are most likely to be exposed to monkeypox. It will contact those who are eligible. These include:

  • some healthcare workers
  • some men who are gay, bisexual or have sex with other men
  • people who have been in close contact with someone who has monkeypox

Steve Russell, NHS Director of Vaccinations, said: “While the risk of monkeypox remains very low and nearly every case we have seen so far has recovered quickly, over 2,000 people have been affected by the virus.

“On the whole, the cases we are seeing are among gay and bisexual men or men who have sex with men, with a significant number coming from London and so it is vital that those who are most likely to get the virus get vaccinated as quickly as possible.

“The NHS is now scaling up its plans to get people vaccinated, particularly in London, thanks to the efforts of staff who are working hard to help stop onward spread, in line with UKHSA advice.

“Thousands more people will be invited very shortly with the number of clinics expanded too, and as we have done with the most successful covid vaccination programme in history, the NHS will leave no stone unturned in ensuring everyone who is eligible can get protected.

“We will be inviting anyone who we believe is a priority for vaccination and local teams will be working to make sure that anyone who meets the criteria set by UKHSA knows how they can get their jab.

“We are asking people to wait to be contacted and to come forward at the earliest opportunity possible when invited to get vaccinated.”

Do I need to go to a hospital if I get monkeypox?

Anyone who contracts monkeypox is advised to isolate as it is contagious. "Because the infection can be passed on through close contact, it's important to isolate if you're diagnosed with it," the NHS says.

Most people recover in a few weeks at home, without treatment. But those whose symptoms become more severe or get more unwell may need hospital treatment.

Why has the WHO declared a global emergency?

There are now more than 16,000 reported cases from 75 countries and territories, and five deaths, WHO director-general Tedros Adhanom Ghebreyesus said – up from 3,040 cases in 47 countries around a month ago.

He acknowledged that the committee was unable to reach a consensus on whether the outbreak represents a public health emergency of international concern.

But he said this is an outbreak “that has spread around the world rapidly, through new modes of transmission, about which we understand too little, and which meets the criteria in the International Health Regulations” and he had therefore decided that it should be declared a global emergency.

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