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What is a notifiable disease? Here are the facts about monkeypox

As monkeypox is declared a notifiable disease in Northern Ireland, we take a look at the virus and what you need to know.

Q: What is monkeypox?

A: Monkeypox is a viral zoonosis — a virus transmitted to humans from animals, with symptoms very similar to those seen in the past in smallpox patients.

However, while smallpox was one of the most devastating diseases known to humanity and caused millions of deaths before it was eradicated in May 1980, monkeypox is clinically less severe.

Monkeypox is caused by the monkeypox virus and the name originates from the initial discovery of the virus in monkeys in a Danish laboratory in 1958.

The first human case was identified in a child in the Democratic Republic of Congo in 1970.

Q: Why is it now a notifiable disease and what does that mean?

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A: It means medical practitioners will have to share information with the Public Health Agency (PHA) if they are aware that a person they are attending has monkeypox or if they have reasonable grounds for suspecting so.

This step is often taken to interrupt transmission of a disease and prevent any further transmission. It also helps the relevant health authorities to gather data on any potential outbreaks of the disease. 

Q: Can people die from monkeypox?

A: In most cases, the symptoms of monkeypox go away on their own within a few weeks, but in some individuals, they can lead to medical complications and even death.

Newborns, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.

Complications from severe cases of monkeypox include skin infections, pneumonia, confusion and eye infections which can lead to loss of vision.

Q: How is monkeypox transmitted?

A: Monkeypox is spread from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials, such as bedding.

The incubation period of monkeypox is usually from six to 13 days but can range from five to 21 days.

Monkeypox is usually associated with travel to Central or West Africa, but some of the cases that have been occurring outside these countries have had no travel link and it is now known it is spreading through community transmission in the UK.

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Image issued by the UK Health Security Agency of the stages of monkeypox (Credit: UK Health Security Agency/PA)

Image issued by the UK Health Security Agency of the stages of monkeypox (Credit: UK Health Security Agency/PA)

PA

Image issued by the UK Health Security Agency of the stages of monkeypox (Credit: UK Health Security Agency/PA)

Q: Is monkeypox a sexually transmitted infection (STI)?

A: According to the World Health Organization (WHO), it is not yet known if monkeypox can be passed on directly through sex.

WHO has said more studies are needed to understand the risk — but it’s likely that it is simply passed on through close contact.

This means a person could still contract the virus while having sex with somebody who is carrying it, but that does not make it an STI.

Q: Health authorities are asking gay and bisexual men to be particularly vigilant. Why is this?

A: The Public Health Agency (PHA) has said “a notable proportion of recent cases in England and Europe have been found in gay, bisexual and other men who have had sex with men”.

The WHO has said several of the community transmission cases have been identified in men who have sex with men (MSM) and these cases were identified at sexual health clinics.

It has explained the reason why there may be more reports of cases of monkeypox in the MSM community may be because of positive health-seeking behaviour in this demographic.

Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may explain why these cases are being picked up at sexual health clinics.

It continued: “Anyone who has close physical contact of any kind with someone who has monkeypox is at risk, regardless of who they are, what they do, who they choose to have sex with or any other factor.”

Q: What should people look out for?

A: Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

A rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals.

The rash changes and goes through different stages — it can look like chickenpox or syphilis, before finally forming a scab which later falls off.

Q: How can I protect myself from monkeypox?

A: According to the WHO, you can reduce your risk by limiting contact with people who have suspected or confirmed monkeypox.

If you do need to have physical contact with someone who has monkeypox because you are a health worker or live together, encourage the infected person to self-isolate and cover any skin lesion if they can, by wearing clothing over the rash.

When physically close to a person with monkeypox, you should wear a medical mask, especially if they are coughing or have lesions in their mouth. You should wear one also.

Avoid skin-to-skin contact whenever possible and use disposable gloves if you have any direct contact with lesions. Wear a mask when handling any clothes or bedding if the person cannot do it themselves.

Regularly clean your hands with soap and water or an alcohol-based hand rub, especially after contact with the person who is infected, their clothes, bed sheets, towels and other items or surfaces they have touched or that might have come into contact with their rash or respiratory secretions.

Wash the person’s clothes, towels and bedsheets and eating utensils with warm water and detergent. Clean and disinfect any contaminated surfaces and dispose of contaminated waste appropriately.

Q: Is there a vaccine against monkeypox?

A: The PHA was unable to provide information on vaccination for monkeypox, however, the WHO has said there are several vaccines available for prevention of smallpox that also provide some protection against monkeypox.

A new vaccine developed for smallpox was approved in 2019 for use in preventing monkeypox and is not yet widely available.

People who have been vaccinated against smallpox in the past will have some protection against monkeypox.

As vaccination against smallpox ended in 1980 after the disease was eradicated, people below the age of 40 to 50 years are unlikely to have been vaccinated.

Q: Can children get monkeypox?

A: Children are typically more prone to have severe symptoms than adolescents and adults. The virus can also be passed to a foetus or to a newborn through birth or early physical contact.


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