- James Gallagher
- BBC science and health correspondent
1 hour ago
If you are still suffering from the Covid pandemic, I am sorry to tell you that there is another virus, which we must control before the situation escalates and spreads further.
It’s monkeypox, and there are about 80 confirmed cases in 11 countries, including the United Kingdom, where no such disease was expected.
What’s going on and is it time for us to worry or be glad we finally got through covid?
Let’s be clear: This is not a new type of Covid and we are not at the gates of a general closure of monkeypox, but it is an unusual and unprecedented spread of this disease.
This disease has surprised disease scientists, and it always becomes a source of concern when the virus changes its behaviour.
The emergence of monkeypox was largely expected.
The natural habitat of the virus is wild animals, thought to be rodents, not monkeys.
The disease spreads most often in remote areas of Central and West African countries near tropical rainforests. Where a person from these areas touches an animal carrying the virus, the virus is transmitted from one type to another, which appears in the form of a rash first, and then turns into blisters and cracks.
The virus is currently spreading outside its natural habitat and there must be close, long-term contact to continue, so outbreaks tend to be small and go away on their own.
A few cases have appeared in other parts of the world previously, including the United Kingdom, but all of them can be directly linked to a person who traveled to a country where they were infected, and brought the virus with him to his country. But that does not apply to the current cases.
The virus was first detected in people with no apparent connection to West and Central Africa.
It’s not clear who is most likely to contract the infection.
picture released, Science Photo Library
Symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and fatigue
Monkeypox is spread through sexual contact and in most cases causes a rash on their genitals and the surrounding area.
Many of those affected are homosexual and bisexual.
Professor Sir Peter Horby, director of the Institute of Epidemiology at the University of Oxford, told me: “We are faced with a very new case, which is surprising and alarming.”
It is true that he says this is not a second type of Covid, but we “need to act” to prevent the virus from gaining a foothold and we should “avoid something like this” entirely.
Doctor Hugh Adler, who treated monkeypox patients, agreed: “We’ve never seen this pattern before, it’s surprising.”
What is monkeypox?
Symptoms of monkeypox include fever, headache, bloating, backache, muscle aches, and lethargy.
Once the temperature rises, a rash appears beginning on the face and then moves to other parts of the body, but it is most often on the palms of the hands and soles of the feet.
The infection goes away without medical intervention after symptoms last between two to three weeks.
The disease is transmitted to a person when they come into contact with people with the virus. The virus may enter the body through cracks in the skin, the respiratory tract, or through the eyes, nose, or mouth.
It can also be transmitted from an infected animal, such as monkeys, rats and squirrels, to humans or from surfaces and objects contaminated with the virus such as bedding and clothing.
There is no cure for monkeypox, but its spread can be curbed by some restrictions that prevent transmission.
There is a vaccine against chickenpox that has been proven to be 85 percent effective in preventing infection, and it is still used occasionally.
So, what’s going on?
picture released, UKHSA
The rash changes and goes through different stages, and it can look like chickenpox or syphilis, before eventually turning into a scab that later disappears.
We know this disease is different, but we don’t know why.
There are two possible explanations: either the virus has changed, or the old virus has found itself in the right place and time to thrive.
Monkeypox is a DNA virus, so it does not mutate as quickly as Covid or influenza.
Very early genetic analysis indicates that the current cases are closely related to the forms of the virus seen in 2018 and 2019.
It is too early to be certain, but at present there is no evidence that this is a new mutated variant.
However, as we have learned from our experience with the Ebola and Zika virus pandemics in the past decade. The virus does not have to change in order to take advantage of an opportunity.
Prof Adam Kucharski, from the London School of Hygiene and Tropical Medicine, said: “We thought for a long time that Ebola was easy to contain, only to realize that it was not.”
It is not clear why gay and bisexual men are disproportionately affected by this disease.
Does sexual behavior facilitate the spread of disease? Is it just a coincidence? Is it because this group is more sexually health conscious and gets checked regularly?
Perhaps the reason is that monkeypox has become easier to spread.
Previous large-scale smallpox vaccinations gave older people some protection against monkeypox, which is closely related to chickenpox.
“It’s possible that it’s transmitting more effectively than smallpox did in the past, but we’re not seeing any sign that it might spread,” said Adler, who still expects the disease to clear up on its own.
Understanding how the outbreak began will help predict what happens next. We know that this is only the tip of the iceberg, because the cases that are detected do not fit the image of an elegant person transmitting the disease to another person and so on.
Instead, many of the cases appear to be unrelated, so there are no links between the cases but rather a chain of cases spreading across Europe and beyond.
One explanation for the current cases of infection is that a large number of people recently gathered at a big event such as a festival, and the attendees got monkeypox in that place and transmitted the disease to different countries.
An alternative explanation for infecting so many unrelated people is that the virus has already been circulating for some time without anyone noticing and infecting many people.
Either way, we can expect to continue uncovering more cases.
Prof Jamie Whitworth, from the London School of Hygiene and Tropical Medicine, said: “I don’t think the general public needs to be concerned at this point, but I don’t think we’ve detected all these cases and we can’t control them.”
“But remember, we are not in the same situation we were in with Covid.
Monkeypox is a well-known and not new virus, and it is often mild, and we already have vaccines and treatments in place although it can be more dangerous in young children, pregnant women and people with weakened immune systems.
But it spreads more slowly than Covid, and the characteristic, painful rash makes it hard to go unnoticed, like a cough. This makes the task of finding people who may have it and vaccinating those at risk of contracting it easier.
But the World Health Organization’s regional director for Europe, Hans Kluge, warned: “As we enter the summer season, gatherings, festivals and parties, I am concerned that the rate of transmission will increase.”