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Ask An Expert: should we actually be worried about Monkeypox?

A public health expert breaks down everything you need to know about the recent viral outbreak

Although you might have tried to bury your head in the sand, it’s likely that by now you’ve heard about monkeypox. 

Monkeypox isn’t new – it’s been around for years, but you’ve probably never heard of it because the virus has generally stayed around central and west Africa. But on May 7, the UK reported an imported case of monkeypox in a person who had travelled from Nigeria.

It’s not 100 per cent clear why there’s been a rise in cases of monkeypox in non-endemic countries, but professionals have come up with some theories like the possibility that the virus has mutated, that immunity provided by smallpox vaccines is waning, or that there was a superspreader event which led to multiple outbreaks of the virus.

At present, there are 71 cases of monkeypox in the UK and over 100 confirmed cases have been identified in 16 countries worldwide. Given that we’re still technically living through a pandemic, it’s understandable that news of a new viral outbreak has caused considerable alarm.

But much of the reporting on monkeypox has been sensationalist, with red-tops keen to draw in clicks and capitalise on people’s fear. On top of this, much of the reporting on the outbreak has been racist and homophobic, with the UN itself has condemning the discriminatory and inflammatory coverage.

With all this in mind, it’s unsurprising that people are freaking out about monkeypox – but do we really need to go back to bulk-buying toilet roll and stockpiling hand sanitiser? Dazed spoke to public health expert Dr Will Nutland about the recent rise in monkeypox cases.

What is monkeypox and what are the symptoms?

Monkeypox is a zoonotic virus, which means it travels from animals to humans. The first human case was recorded in the Democratic Republic of Congo in 1970.

According to the UK government website, “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.”

How does it spread?

Human-to-human transmission of monkeypox occurs through close contact with the skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through ‘fomites’, which are inanimate objects which can carry infection.

So for example, you could contract monkeypox by touching clothing, bedding or towels used by someone with the monkeypox rash, touching monkeypox skin blisters or scabs, or through the coughs or sneezes of a person with the monkeypox rash. There are also unconfirmed suggestions that the transmission can occur during sexual intercourse.

How dangerous is it?

“Can you die?” is a question on everyone’s lips right now – and thankfully, dying from monkeypox is incredibly rare. According to the World Health Organisation there have been no deaths associated with this outbreak, and most people recover within two to four weeks. 

Monkeypox is also nowhere near as transmissible as COVID-19. As it’s a DNA virus, it can’t evolve as fast as RNA viruses like coronavirus. Plus, because the virus isn’t totally novel, there are ways of treating it. The smallpox vaccine provides around 85 per cent protection against monkeypox, and there are also several antivirals which can help fight infection.  

That doesn’t mean that we don’t need to be mindful of monkeypox. “Monkeypox can cause unpleasant and life-altering impacts,” Dr Will Nutland tells Dazed. “A small number of people who get monkeypox – especially those who are immunocompromised – die; in some instances, people will need treatment in hospital; most people who get monkeypox will need recovery time at home. Some of those who have recently been diagnosed have reported feeling very unwell for a number of weeks.”

Monkeypox can also be particularly dangerous for children and pregnant people.

How will it affect sexual health services?

Dr Claire Dewsnap, the president of the British Association for Sexual Health and HIV, has expressed concerns that the spread of monkeypox could have a “massive impact” on access to UK sexual health services s staff who come into contact with infected sufferers are forced to isolate.

Dr Nutland agrees that this is cause for concern. “NHS sexual health services are already underfunded and under-resourced, with many still dealing with the impact of COVID, including staff being off work,’ he says. “In some instances, clinic staff are having to isolate because of exposure to early cases of monkeypox.”

“It's important that people who have symptoms that could be monkeypox seek medical advice straight away, and should phone their sexual health clinic, rather than just turn up.”

How worried should we be?

“We should always be cautious when we see outbreaks of infections, and monkeypox is causing extra caution and attention because we're seeing it transmitted in ways that have historically been rarely transmitted,” says Dr Nutland. “Should we panic? Absolutely not.”

“But should we be paying special attention to increasing awareness of symptoms? Yes – and especially amongst those groups of people where current cases are being identified. Should we be contacting the close contacts of people who have it? Definitely. Should we be exploring contingency plans in case cases grow rapidly? Yes - as we should with any public health issue.”

He continues: “Importantly, we need to recognise that this is a changing situation – and that means that information and responses might also need to change. However, it's important to remember that MPX is not new – there's a wealth of experience and knowledge to draw upon from across the world.”