How do you catch monkeypox?
Until this global outbreak, monkeypox was mostly spread by infected rodents — including rats, mice and even squirrels — in western and central Africa.
People can get the disease — which comes from the same family as smallpox — if they are bitten by infected animals, touch their blood, body fluids or scabs, or eat game or bushmeat.
The orthopox virus, which causes monkey pox, can enter the body through broken skin – even if it is not visible, as well as the eyes, nose and mouth.
Despite being mainly spread by wild animals, monkeypox was known to be able to be transmitted between humans. However, health leaders insist it was very rare until the current outbreak.
Person-to-person spread can occur if someone touches clothing or bedding that has been used by an infected person, or through direct contact with the virus’s tell-tale scabs. The virus can also spread through coughing and sneezing.
In the continuing rise in the number of cases, experts think the virus passes skin-to-skin contact during sex – although this exact mechanism has never been seen until now.
How deadly is it?
Monkeypox is usually mild and most patients recover without treatment within a few weeks.
Yet the disease kills up to 10 percent of cases. But this high rate is thought to be in part due to a historical lack of testing, meaning a tenth of known cases have died rather than a tenth of all infections.
However, in milder species, the death rate is closer to one in 100 — similar to when Covid first struck.
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 as part of the ongoing outbreak.
How is it tested?
It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox.
Monkeypox is confirmed by a clinical assessment by a health professional and a test in the UK specialist laboratory – the UKHSA’s Rare and Imported Pathogens Laboratory.
The test involves taking samples of skin lesions, such as a portion of the scab, moisture from the lesions, or pieces of dry scab.
What are the symptoms?
It can take up to three weeks for monkeypox infected patients to develop any of the tell-tale symptoms.
Early signs 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.
But the most unusual feature is a rash that often starts on the face and then spreads to other parts of the body, usually the hands and feet.
The rash changes and goes through several stages before finally forming a scab, which later falls off.
How long is someone contagious?
A person is contagious from the time their rash appears until all the scabs have fallen off and there is intact skin underneath.
The scabs may also contain infectious virus material.
The contagious period is thought to last three weeks, but it can vary from person to person.
What should I do if I have symptoms?
The UK Health Security Agency advises 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 monkey pox or have been in West or Central Africa in the past three weeks been.
Britons are being asked to contact clinics prior to their visit and to avoid contact with others until seen by a medic.
Gay and bisexual men have been asked to be extra vigilant for symptoms, as most cases have been identified in men who have sex with men.
What is even monkey pox?
Monkeypox was first discovered in 1958 when an outbreak of a smallpox-like disease occurred in monkeys kept for research.
The first human case was recorded in 1970 in the Democratic Republic of the Congo and the infection has since been reported in a number of Central and West African countries.
Only a handful of cases have been reported outside of Africa and these have been limited to those 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 kills up to one in ten of those infected, but does not spread easily between people. The tropical disease is endemic to parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)
Nurses and physicians are advised to remain alert to patients presenting with a new rash or scabby lesions (as above)
Does it have to do with chickenpox?
Despite causing a similar rash, chickenpox is not related to monkeypox.
The infection, which usually affects children, is caused by the varicella-zoster virus.
In comparison, monkeypox – like smallpox – is an orthopox virus. Due to this link, smallpox vaccines also provide protection against monkeypox.
Are young people more vulnerable?
According to the World Health Organization, Britons under the age of 50 may be more susceptible to monkey pox.
This is because children in the UK were routinely offered the smallpox shot until 1971, which protects against monkeypox.
The WHO also warns that the mortality rate among young children has been higher.
Does it spread as easily as Covid?
Leading experts insist we won’t see Covid-like transmission levels in the monkeypox outbreak.
A report from the World Health Organization last year suggested that the virus’s natural R rate — the number of people each patient would infect if they lived normally while sick — is two.
This is lower than the original Wuhan variant of Covid and about a third of the R percentage of the Indian ‘Delta’ strain.
But the actual rate is likely much lower because “distinguishing symptoms greatly aid early detection and containment,” the team said, meaning it’s easy to spot and isolate cases.
Covid is mainly spread through droplets that an infected person gives off when he breathes, speaks, coughs or sneezes.
How is the UK coping with the outbreak?
MailOnline revealed that monkeypox patients and their close contacts, including NHS staff, are being offered the Imvanex smallpox vaccine.
The strategy, known as ring vaccination, involves pricking and monitoring everyone around an infected person to form a buffer of immune people to limit the spread of a disease.
In addition, close contacts of people with a confirmed monkeypox infection are told to stay at home for 21 days and to avoid contact under the age of 12, people with suppressed immune systems and pregnant women.
The government said unprotected direct or high-risk contact in the environment includes living in the same house as someone with monkey pox, having sexual contact with them or even simply changing their bedding ‘without appropriate PPE’.
As with Covid, anyone who has come within three feet of an infected person is classified as having monkeypox contact.
This lower category of contact, which also includes sitting next to a person with monkey pox on an airplane, means that a tracer will call the person every day for three weeks and advise them not to work for 21 days if their jobs are children or immunocompromised colleagues.
The UK has stopped legally requiring people to go into quarantine if they develop monkey pox, but ministers are considering a public health campaign to warn gay and bisexual men, due to the number of cases in this group.
What if it continues to spread?
Experts told MailOnline they could ‘see a role’ for a targeted rollout for gay men in the UK ‘if not brought under control soon’.
Close contacts of known cases in the UK are already being offered the shot, which was originally designed for smallpox. The two viruses that cause a rash are very similar.
A health source told MailOnline that “there would be a number of strategies we would look at” if the number of cases continued to rise.
Professor Kevin Fenton, regional director of public health in London, said that if the outbreak continues to grow in the capital, the roll-out of vaccines and treatments could be expanded 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 discovered cases of monkey pox.
Most cases have been detected in the UK, Spain, Portugal, Canada and Germany.
There are a handful of antivirals and therapies for smallpox that seem to work against 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, may protect against monkeypox because the viruses behind the diseases are closely related.
Data shows that it occurs in about 85 percent of cases and has been used ‘off-label’ in the UK since 2018.
The shot, thought to cost £20 per dose, contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in humans.
Due to its similarity to the poxviruses, antibodies produced against this virus provide cross protection.
Are there medications to treat it?
There are a handful of antivirals and therapies for smallpox that seem to work on monkeypox.
This includes the drug tecovirimat, which was approved in the EU for monkey pox in January.
Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus in the body.
According to the U.S. Centers for Disease Control and Prevention (CDC), an injectable antiviral drug used to treat AIDS called cidofovir can be used to control the infection.
It also works by stopping the growth of the virus.