The latest monkeypox outbreak, as of the time of writing, has reached 17 countries with 110 confirmed cases and another 205 suspected. It’s a fast-moving story, so if you need to catch up on the latest, here are answers to some of the most pressing questions.
How does monkeypox spread?
The first patient in the current outbreak has returned to the UK from travel to Nigeria, where monkeypox is endemic. However, cases are now spreading among people who have not traveled to West or Central Africa, indicating that local transmission has occurred.
Monkeypox is usually spread by close contact and breath droplets. However, sexual transmission (by semen and/or vaginal fluid) has been postulated as an additional potential route. The World Health Organization (WHO) says: “Studies are needed to better understand this risk.”
Most cases in the current outbreak have been in young adults, but the virus can spread to anyone.
What are the symptoms?
Early symptoms are similar to the flu, such as fever, headache, muscle aches, and swollen lymph nodes.
Once the fever is gone, a rash can develop, often starting on the face and then spreading to other parts of the body – most often the palms of the hands and the soles of the feet.
How deadly is monkeypox?
Monkeypox is mostly a mild, self-limiting disease that lasts two to three weeks. However, in some cases, it can cause death. According to the World Health Organization, the “recent” mortality rate ranges from 3% to 6%. West African monkeypox virus is considered milder than the Central African virus.
Monkeypox tends to cause more serious illness in immunocompromised people — such as those undergoing chemotherapy — and children. There have been no deaths from monkeypox in the current global outbreak, but according to the Daily Telegraph, there is only one child in the UK in intensive care with the disease.
Why is it called monkeypox?
Monkeypox was first identified in laboratory monkeys (macaques) in Denmark in 1958, hence the name. However, monkeys do not appear to be the natural host for the virus. It is most commonly found in rats, mice, and squirrels. The first case in humans was seen in the 1970s in the Democratic Republic of the Congo.
Is monkeypox related to smallpox and chickenpox?
Monkeypox is related to smallpox – both orthopoxviruses – but it is not related to chickenpox. Despite the name, chickenpox is a herpes virus and not a smallpox virus. (How the word “chicken” got the name is not entirely clear. In his dictionary of 1755, Samuel Johnson speculated that it was so named because it was “not of great danger.”) However, the vesicles (small pus-filled blisters) caused by monkeypox resemble In their appearance those found in chicken pox.
Are cases likely to continue to rise?
Cases will likely continue to rise significantly over the next 2-3 weeks, but this is not another epidemic in the making. Monkeypox is nowhere near as common as the airborne virus SARS-CoV-2 that causes COVID-19.
Did monkeypox evolve to become more virulent?
RNA viruses, such as SARS-CoV-2, do not have the ability to check their genetic code for errors every time they reproduce, so they tend to evolve faster. Monkeypox is a DNA virus, which has the ability to check itself for genetic errors every time it reproduces, so it tends to mutate much slower.
The first genome sequencing of the current outbreak (from a patient in Portugal) indicates that the virus is very similar to the monkeypox strain that was circulating in 2018 and 2019 in the United Kingdom, Singapore and Israel. So it is unlikely that the current outbreak is the result of a mutated virus that is better at spreading.
How is monkeypox diagnosed?
In the UK, swabs samples taken from the patient are sent to a specialized laboratory that handles rare pathogens, where a polymerase chain reaction test is performed to confirm monkeypox. The UK’s Health Security Agency has only one laboratory for rare and imported pathogens.
Is there a vaccine for her?
Smallpox vaccines, which contain laboratory vaccinia virus, can protect against monkeypox. However, the vaccine that was used to eradicate smallpox can have serious side effects, killing about one in every million people vaccinated.
The only vaccine approved specifically for monkeypox, Imvanex, is made by a company called Bavarian Nordic. It uses a non-recurring form of the vaccine, which causes fewer side effects. It was approved by the US Food and Drug Administration and the European Medicines Agency in 2019 – but only for use in people 18 or older.
British Health Minister Sajid Javid said the UK government will stockpile effective monkeypox vaccines. The UK currently has about 5,000 doses of the smallpox vaccine, which is about 85% effective against monkeypox.
Are there medicines to treat it?
There are no specific medicines to treat monkeypox. However, antivirals such as cidofovir and brincidofovir have been shown to be effective against poxviruses in animals and may also be effective against monkeypox infections in humans.
By Ed Fell
Professor of Microbial Evolution at the Milner Center for Evolution, University of Bath