The World Health Organisation (WHO) has described the monkeypox outbreak as “atypical” but two leading scientists have claimed it is not the next pandemic. It comes as Scotland’s chief medical officer has told people to “take a breath and calm down” over cases of monkeypox in England.
Professor David Heymann, an expert on infectious disease epidemiology at The London School of Hygiene & Tropical Medicine, said it will not spread in the same manner as coronavirus. He told the PA news agency: “This will not be a pandemic as we know pandemics, but it certainly is possible that this disease has spread in many different parts of the world already and we are just beginning to identify it.
“It is not transmitted by air, we don’t believe, so it’s not a respiratory infection like SARS-Coronavirus-2 (Covid-19), so it will not spread in the same manner.” Prof Heymann, the WHO’s former assistant director-general for health security and environment, added: “It is transmitted from people who have monkeypox to people who don’t have monkeypox by close physical contact with the sore or with the open sore that is causing the disease.
“If there is close contact, physical contact, there is a chance the virus could spread from the lesion on one person to another person and could enter through a break in the skin or through a mucous membrane. This virus doesn’t transmit easily. It is a quite rare disease which has now become more common.”
The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact and is caused by the monkeypox virus. Prof Heymann added: “There are two types of the virus. There is a virus in central Africa which is very lethal, it has 10% fatality and it causes a disease that looks like smallpox.
“Fortunately, that disease has not spread outside of Africa yet, and hopefully it won’t, because people are very sick and they don’t travel. The disease that is occurring in Europe and North America is a west African virus-type-strain which is very moderate, it causes skin rash, maybe one or two lesions on the skin, and it can cause a fever and swollen lymph nodes, swollen glands and muscle aches, but it is not fatal in most cases.
“It can be fatal in very less than one per cent of people, so it is not a fatal disease.” On how people can minimise their chances of catching it, he added: “They need to be protecting themselves from close physical contact and whatever they perceive as physical contact they should modify.
“They should beware that this is spreading and they should be very careful when they have physical contact of any type. A handshake would only be dangerous if there is a pox virus lesion on the hand of one of the people who shakes, so they have to do their own risk assessment.”
He said it is “not known” whether there are asymptomatic infections or if every infection causes skin lesions. Prof Heymann added: “People who have never had a smallpox vaccination would be at a greater risk than those who have, although it is not understood how long protection would last from the smallpox vaccine.”
It comes after WHO regional director for Europe Dr Hans Kluge said monkeypox cases in multiple European countries, the US, Canada and Australia are “atypical” for “several reasons”. Firstly, the rare viral disease is spreading among people with no relevant travel history to areas where monkeypox is endemic, such as in west or central Africa, Dr Kluge said on Friday.
He added that most initial cases are being detected through sexual health services and are “among men who have had sex with men”, and said “geographically dispersed” outbreaks suggest “transmission may have been ongoing for some time”. Professor Paul Hunter, of the University of East Anglia, an expert in epidemiology of emerging infectious disease, told PA it is “extremely unlikely” monkeypox will become a pandemic.
He added: “The important thing is there is a vaccine that works and it is the same vaccine that we used for smallpox but these days, I believe, the best guess I have heard is that it is 85% effective against monkeypox, even if you give it two or three days after somebody has been exposed. Ultimately, this is not particularly infectious unless you have close contact with somebody.
“This isn’t a Covid situation at all and if we get the vaccination right, we should be able to bring it under control fairly quickly. But this issue is always, is it going to be reintroduced?
“Is this something that is going to be becoming more common in parts of the world where people go for holidays or other reasons, and then we will see it being continually reintroduced into the UK? Because with a disease that’s got an incubation period of typically 12 days, most people will be totally undiagnosable during their return to the UK, so it is not something you could actually pick up on border screening.”
Prof Hunter added that monkeypox can cause scarring to the skin. He said: “Two hundred years ago everybody lusted after milkmaids, and the reason was milkmaids had lovely skin in older times, and that was because they got cowpox so they didn’t catch smallpox, and people who got smallpox often ended up with very scarred skin, scarred faces.
“You can get that with monkeypox as well because the rash tends to affect the face, the hands and the legs. The scarring, probably, is not the monkeypox itself but when these pox lesions start to weep and break down they get secondary bacterial infection that generally causes the scarring, I believe.”
Meanwhile, speaking to STV News on Friday evening, Professor Jason Leitch reassured viewers there are no cases of the virus in Scotland. The infection is a rare virus, spread from dead or diseased animals in west or central Africa. Symptoms including a fever and a rash will develop on day one to five.
Prof Leitch said: “This is a known disease we know quite a lot about. Occasionally they get out of west and central Africa – to the US, to Europe, we’ve had cases here before. Usually if you interrupt the trains of transmission, you can knock this disease on its head.”
The infection, while unpleasant, is often mild and many recover within two to four weeks of having it. Prof Leitch added: “There are no cases in Scotland so the first and most important thing is: everybody just needs to stop, take a breath and calm down. It’s still quite small numbers.
“What happens is, it’s quite an infectious virus, not as infectious or as airborne as Covid and things we’re used to like flu, but it can move from person to person. You need to be pretty close, it’s droplet spread, so it’s families, it’s sexual partners, it’s people who are in very close proximity.
“You get general fever, the kind of viral disease, but you also get a rash. If that happens or if you’re concerned, you should contact a health professional.”
For more stories from where you live, visit InYourArea.
