The virus has already been diagnosed in seven people in Great Britain. But that’s no reason to panic.

On May 7, the British Health Security Agency (UKHSA) announced that a patient in England had been diagnosed with monkey pox. A week later, two new patients were added. And yesterday, four more new cases were reported. “This is strange and unusual,” said Susan Hopkins, Chief Medical Advisor at UKHSA.

What is it?
Monkeypox virus is a virus infection that normally only occurs in Africa, but is sometimes also brought to other countries by travelers. Contrary to what the name suggests, the virus mainly occurs among small African animals – such as rodents, for example. However, monkeys can sometimes contract it, just like humans, for example through physical contact with infected animals. The virus is related to the well-known smallpox virus (Variola) which has not been seen since the second half of the 1970s thanks to a worldwide vaccination campaign. Like the smallpox virus, the monkeypox virus is accompanied by a skin rash, after which round blisters filled with pus develop on the skin. Prior to this, patients may develop flu-like symptoms such as fever, headache and fatigue. The monkeypox virus has – as far as we now know – two strains: the Congo strain is quite contagious and pathogenic and leads to death in about 10 percent of cases. In addition, there is the West African strain, which is less contagious and disease-causing and is fatal in about 1 percent of cases. It is currently believed that the latter strain is responsible for the British infections.

The spread

Scientists are currently particularly concerned about how the virus is spreading in Britain. The monkeypox virus does not transfer very easily from person to person and most of the patients diagnosed to date with monkeypox virus have not been in contact with the other British patients who currently have monkeypox virus among them.

Connections

At first it seemed like a pretty straight forward story; the first British patient diagnosed with the virus had recently been in Nigeria. It is therefore assumed that the patient acquired the virus there and then brought it back to England. But a week later things got a bit more complicated; the monkeypox virus was then diagnosed in two people (from the same household) neither of whom had been in contact with the first patient. And the authorities are therefore in the dark about how they contracted the virus. And a few days later, four cases were added in one fell swoop (two of which turned out to have shared contacts). And they too have not been in contact with the British where the virus has been previously diagnosed. Nor have they recently been to Africa.

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What the last four patients do have in common is that they identify themselves as gay, bisexual or as MSM (men who have sex with other men). “The virus does not spread easily among humans and the risk to the UK population is small,” the UKHSA stressed. “But the most recent cases have been seen within gay and bisexual communities and among men who have sex with other men, and since the virus spreads through close contact, we advise these groups to be on the lookout for any unusual rashes or sores on the body and then especially the genitals.”

More research

The fact that the lion’s share of the identified patients have not been in contact with each other and have no shared contacts indicates that the British do not yet have all patients on their radar. There is therefore a feverish investigation into the contacts of the patients to determine whether there might be a common connection. “The UKHSA is hastily investigating the source of this infection as the evidence suggests monkeypox virus is spreading within the community,” Hopkins said.

Do not panic

Yet there is still no reason to panic, according to epidemiologist Michael Head. The fact remains that the monkeypox virus spreads quite difficult from person to person. “It requires very close contact, for example skin-to-skin contact with an individual who is already contagious and has a rash,” explains epidemiologist Michael Head. He therefore does not expect the number of cases to rise explosively in the coming period. “It would be very unusual if we see more than a handful of cases during an outbreak and we certainly won’t see any COVID-like infection numbers.” At the same time, however, it is important that patients are identified and isolated. “Cases must be identified, isolated and treated, either in the hospital or at home,” said Jimmy Whitworth, a professor of international public health at the University of Groningen. London School of Hygiene & Tropical Medicine† “Close contacts also need to be identified and monitored. The monkeypox virus does not spread as easily and with these measures, the outbreak can be controlled quickly.”

As mentioned, the monkeypox virus mainly occurs in Africa. But it’s not all that uncommon for it to pop up out there as well. That first happened in 2003; imported African (rodent) animals then passed the virus on to prairie dogs that were then sold as pets and infect their owners again. It led to a major outbreak; about 47 people contracted the virus at the time. Travelers have also brought the virus to Singapore, Israel and Great Britain in the intervening period. The fact that the virus has appeared regularly in recent years may be partly due to the fact that there has been no vaccination against smallpox since the eradication of the smallpox virus. And because of that, the immunity to the smallpox-related monkeypox virus has probably decreased or even disappeared. In addition, it is also possible that the distribution of the virus among West African animals has changed somewhat; it may now be present in a greater number of animals or among more species, increasing the likelihood of humans coming into contact with it.