High risk UK contacts of monkeypox cases told to self-isolate and avoid children for three weeks - Daily Mail

High risk contacts of monkeypox cases will be told to self-isolate and avoid children for three weeks in the UK - as 14 countries confirm outbreaks and Belgium becomes first to bring in compulsory quarantine

• High risk close contacts of monkeypox cases were urged to self-isolate and avoid children for three weeks 
• Health chief Dr Claire Dewsnap said she expects to see 'really significant numbers' over the coming weeks
• It comes as a British child in critical condition is among the UK's 20 recorded cases of the lethal disease
• Fourteen countries have confirmed outbreaks, with Belgium also calling for a three-week quarantine
• Public Health England's Dr Susan Hopkins said: 'The risk to the general population remains extremely low' 
• But she urged those who feel ill to 'stay at home' and those with rashes to 'immediately seek medical care'

By Chris Matthews and Jamie Phillips For Mailonline

Published: 18:24 BST, 22 May 2022 | Updated: 19:32 BST, 22 May 2022

High risk close contacts of monkeypox cases in Britain are being urged to self-isolate and avoid children for three weeks. 

Sajid Javid yesterday revealed another 11 Britons had tested positive for the virus, taking the total to 20. 

The cases include a British child currently in a critical condition at a London hospital, while a further 100 infections have been recorded in Europe. 

Government guidance said high risk close contacts should not travel and self-isolate for three weeks, as well as not go to work. 

The Government said unprotected direct contact or high risk environmental contact includes living in the same house as someone with Monkeypox, having sexual contact with them or even just changing their bedding 'without appropriate PPE'. 

It follows Belgium becoming the first country to introduce a compulsory 21-day monkeypox quarantine - as 14 countries now confirm outbreaks of the viral disease and doctors warn of a 'significant rise' in UK cases. 

Those who contract the virus will now have to self-isolate for three weeks, Belgian health authorities have said, after three cases were recorded in the country. 

The infections, the first of which was recorded on Friday, are all linked to a festival in the port city of Antwerp. 

It comes as doctors have warned the UK faces a 'significant' rise in infections and the government's response is 'critical' in containing its spread.

Public Health England's Dr Susan Hopkins said: 'The risk to the general population [from monkeypox] remains extremely low,' but added: 'People need to be alert to it, and we really want clinicians to be alert to it,' when asked about the risk posed to British holidaymakers and festival goers.

Dr Hopkins warned anyone who feels ill with any symptoms to 'stay at home' and urged those with a suspicious rash to 'immediately seek medical care, either by calling your GP or a sexual health clinic' during a BBC interview earlier today.  

WHAT IS MONKEYPOX?

Monkeypox - often caught through handling monkeys - is a rare viral disease that kills around 10 per cent of people it strikes, according to figures.

The virus responsible for the disease is found mainly in the tropical areas of west and central Africa.

Monkeypox was first discovered in 1958, with the first reported human case in the Democratic Republic of Congo in 1970. Human cases were recorded for the first time in the US in 2003 and the UK in September 2018.

It resides in wild animals but humans can catch it through direct contact with animals, such as handling monkeys, or eating inadequately cooked meat. 

The virus can enter the body through broken skin, the respiratory tract, or the eyes, nose or mouth.

It can pass between humans via droplets in the air, and by touching the skin of an infected individual, or touching objects contaminated by them. 

Symptoms usually appear within five and 21 days of infection. These include a fever, headache, muscle aches, swollen lymph nodes, chills and fatigue.

The most obvious symptom is a rash, which usually appears on the face before spreading to other parts of the body. This then forms skin lesions that scab and fall off.

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. Yet, the disease can often prove fatal.

There are no specific treatments or vaccines available for monkeypox infection, according to the World Health Organization. 

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, has also said the outbreak could have a 'massive impact' on access to sexual health services in Britain.

It comes as Dr Hopkins, a chief medical adviser to the UK Health Security Agency, also warned that monkeypox is spreading through community transmission in the UK with more cases being detected daily.

Dr Dewsnap told Sky News: 'Our response is really critical here. 

'There is going to be more diagnoses over the next week. 

'How many is hard to say. What worries me the most is there are infections across Europe, so this has already spread.

'It's already circulating in the general population. 

'Getting on top of all those people's contacts is a massive job.

'It could be really significant numbers over the next two or three weeks.'

She says she expects more cases to be identified around the UK, with a 'significant rise over this next week'.

The rare viral infection, which people usually pick up in the tropical areas of west and central Africa, can be transmitted by very close contact with an infected person.

It is usually mild, with most patients recovering within a few weeks without treatment.

However, the disease can prove fatal with the strain causing the current outbreak killing one in 100 infected.

The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact - as well as sexual intercourse - and is caused by the monkeypox virus.

Dr Hopkins said updated figures for the weekend will be released on Monday as she warned of more cases 'on a daily basis'.

Speaking to BBC One's Morning Show, Dr Hopkins said: 'We will be releasing updated numbers tomorrow - over-the-weekend figures.

'We are detecting more cases on a daily basis and I'd like to thank all of those people who are coming forward for testing to sexual health clinics, to the GPs and emergency department.'

When asked if there is community transmission in the UK, she said: 'Absolutely, we are finding cases that have no identified contact with an individual from west Africa, which is what we've seen previously in this country.

'The community transmission is largely centred in urban areas and we are predominantly seeing it in individuals who self-identify as gay or bisexual, or other men who have sex with men.'

Asked why it is being found in that demographic, she said: 'That's because of the frequent close contacts they may have.

'We would recommend to anyone who's having changes in sex partners regularly, or having close contact with individuals that they don't know, to come forward if they develop a rash.'

And asked to confirm reports that someone is being treated for monkeypox in intensive care, she said: 'We don't confirm individual reports and individual patients.' 

Dr Dewsnap also said she is concerned about the impact of monkeypox on the treatment of other infections as staff are diverted to tackle the outbreak.

She added: 'Some clinics that have had cases have had to advise people not to walk in.

'They've primarily done that because if somebody has symptoms consistent with monkeypox, we don't want people sat in waiting rooms potentially infecting other people.

'They've implemented telephone triage to all of those places.'

In Britain, authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed.

Portugal has 14 confirmed cases and 20 suspected infections. And across the Atlantic, there are two confirmed cases in Canada, with 20 suspected cases. 

There are also cases in Italy, Sweden, Belgium, Germany, The Netherlands, France, Israel, Switzerland and Australia.

The World Health Organisation said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox have been reported from 12 member states that are not endemic for the virus, the UN agency said, adding it will provide further guidance and recommendations in coming days for countries on how to mitigate the spread of monkeypox.

No one has died of the viral disease to date. 

 Professor David Heymann, an expert on infectious disease epidemiology at The London School of Hygiene & Tropical Medicine, said: 'What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world.

He said close contact was the key transmission route, as lesions typical of the disease are very infectious.

For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.

Many of the current cases have been identified at sexual health clinics.

Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.

Heymann said it was 'biologically plausible' the virus had been circulating outside of the countries where it is endemic, but had not led to major outbreaks as a result of COVID-19 lockdowns, social distancing and travel restrictions.  

It comes as it emerged some of the country's top disease experts warned that monkeypox would fill the void left by smallpox three years ago.

 Scientists from leading institutions including the University of Cambridge and the London School of Tropical Hygiene and Medicine argued the viral disease would evolve to fill the 'niche' left behind after smallpox was eradicated.

According to the Sunday Telegraph, the experts attended a seminar in London back in 2019 and discussed how there was a need to develop 'a new generation vaccines and treatments'.

The seminar heard that as smallpox was eradicated in 1980, there has been a cessation of smallpox vaccinations and, as a result, up to 70 per cent of the world's population are no longer protected against smallpox.

This means they are also no longer protected against other viruses in the same family such as monkeypox.

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2022-05-22 17:24:13Z
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Horror moment zoo keeper has FINGER ripped off by lion after sticking his hand into cage... - The Sun

A ZOO keeper ended up getting his finger ripped off by a lion as the beast attacked him in front of terrified visitors.

Video shows the moment the man at Jamaica Zoo is left screaming after sticking his hand into a the beast's cage.

The zoo keeper laughs and jokes as he plays around with the lion

It all goes wrong with the lion bites down

He desperately tries to get away from the creature

And then he is hurled backwards - leaving his finger in the lion's mouth

The zoo keeper ignores the animal's growls and snarls as he foolishly sticks his fingers into his mouth.

Tempting fate, the man then sticks his fingers into the cage again.

And then horrifyingly the lion bites down.

The man is left shouting as he desperately tries to pull back his hand as the lion clamps its jaws around his middle finger.

READ MORE ON ANIMAL ATTACKS

PRIMAL SCREAM

World's worst zoo attacks and miraculous escapes in the face of certain death

He grabs hold of his right arm with his left hand and attempts to wrench himself away from the cage.

Bracing himself with his foot against the concrete block part of the enclosure, he then pulls back - seemingly severing his finger.

"When it happened, I thought it was a joke. I didn’t realise the seriousness of it because it’s their job to put on a show," one witness told The Jamaica Observer.

“Obviously, when he fell on the ground everybody realised that it was serious. Everybody started to panic."

Most read in The Sun

She explained the group had been on a tour of the zoo - with the lions being one of the final stops at the park.

And the witness said despite his injuries, the man managed to walk away and get into a truck before driving off.

The woman added: “The entire skin and about the first joint of his finger was gone.

“I ran away from the whole thing, because me nuh like see blood and it was too graphic for me.

“His facial expression when he was walking is like the pain never kicked in.”

The zoo, located near Santa Cruz, said it was not aware of the incident - but it is being investigated by the  Jamaica Society for the Prevention of Cruelty to Animals.

Managing director Pamela Lawson said: “We will be going down there and I will be communicating with the National Environment and Planning Agency who has oversight over Jamaica Zoo.”

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2022-05-22 14:48:00Z
1431323423

Belgium becomes first country to introduce compulsory monkeypox quarantine - Daily Mail

Belgium become first country to introduce compulsory monkeypox quarantine: Anyone testing positive must isolate for 21 days as 14 countries now confirm outbreaks and doctors warn of 'significant rise' in UK cases

• Dr Claire Dewsnap is president of British Association for Sexual Health and HIV
• She says she expects to see 'really significant numbers' over the coming weeks
• It comes as British child in critical condition is among UK's 20 recorded cases
• Israel and Switzerland are latest countries to confirm they have recorded cases

By Jamie Phillips For Mailonline

Published: 09:36 BST, 22 May 2022 | Updated: 16:04 BST, 22 May 2022

Belgium has become the first country to introduce a compulsory 21-day monkeypox quarantine - as 14 countries now confirm outbreaks o f the viral disease and doctors warn of a 'significant rise' in UK cases

Those who contract the virus will now have to self-isolate for three weeks, Belgian health authorities have said, after three cases were recorded in the country.

The infections, the first of which was recorded on Friday, are all linked to a festival in the port city of Antwerp. 

It comes as doctors have warned that the UK faces a 'significant' rise in infections and the government's response is 'critical' in containing its spread.

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, has also said the outbreak could have a 'massive impact' on access to sexual health services in Britain.

It comes as Dr Susan Hopkins, a chief medical adviser to the UK Health Security Agency, today also warned that monkeypox is spreading through community transmission in the UK with more cases being detected daily.

Sajid Javid yesterday revealed another 11 Britons had tested positive for the virus, taking the total to 20.

The cases include a British child currently in a critical condition at a London hospital, while a further 100 infections have been recorded in Europe.

Dr Dewsnap told Sky News: 'Our response is really critical here. 

'There is going to be more diagnoses over the next week. 

'How many is hard to say. What worries me the most is there are infections across Europe, so this has already spread.

'It's already circulating in the general population. 

'Getting on top of all those people's contacts is a massive job.

'It could be really significant numbers over the next two or three weeks.'

She says she expects more cases to be identified around the UK, with a 'significant rise over this next week'.

WHAT IS MONKEYPOX?

Monkeypox - often caught through handling monkeys - is a rare viral disease that kills around 10 per cent of people it strikes, according to figures.

The virus responsible for the disease is found mainly in the tropical areas of west and central Africa.

Monkeypox was first discovered in 1958, with the first reported human case in the Democratic Republic of Congo in 1970. Human cases were recorded for the first time in the US in 2003 and the UK in September 2018.

It resides in wild animals but humans can catch it through direct contact with animals, such as handling monkeys, or eating inadequately cooked meat. 

The virus can enter the body through broken skin, the respiratory tract, or the eyes, nose or mouth.

It can pass between humans via droplets in the air, and by touching the skin of an infected individual, or touching objects contaminated by them. 

Symptoms usually appear within five and 21 days of infection. These include a fever, headache, muscle aches, swollen lymph nodes, chills and fatigue.

The most obvious symptom is a rash, which usually appears on the face before spreading to other parts of the body. This then forms skin lesions that scab and fall off.

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. Yet, the disease can often prove fatal.

There are no specific treatments or vaccines available for monkeypox infection, according to the World Health Organization. 

The rare viral infection, which people usually pick up in the tropical areas of west and central Africa, can be transmitted by very close contact with an infected person.

It is usually mild, with most patients recovering within a few weeks without treatment.

However, the disease can prove fatal with the strain causing the current outbreak killing one in 100 infected.

The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact - as well as sexual intercourse - and is caused by the monkeypox virus.

Dr Hopkins said updated figures for the weekend will be released on Monday as she warned of more cases 'on a daily basis'.

Speaking to BBC One's Morning Show, Dr Hopkins said: 'We will be releasing updated numbers tomorrow - over-the-weekend figures.

'We are detecting more cases on a daily basis and I'd like to thank all of those people who are coming forward for testing to sexual health clinics, to the GPs and emergency department."

And asked if there is community transmission in the UK, she said: 'Absolutely, we are finding cases that have no identified contact with an individual from west Africa, which is what we've seen previously in this country.

'The community transmission is largely centred in urban areas and we are predominantly seeing it in individuals who self-identify as gay or bisexual, or other men who have sex with men."

Asked why it is being found in that demographic, she said: 'That's because of the frequent close contacts they may have.

'We would recommend to anyone who's having changes in sex partners regularly, or having close contact with individuals that they don't know, to come forward if they develop a rash.'

Dr Dewsnap also said she is concerned about the impact of monkeypox on the treatment of other infections as staff are diverted to tackle the outbreak.

She added: 'Some clinics that have had cases have had to advise people not to walk in.

'They've primarily done that because if somebody has symptoms consistent with monkeypox, we don't want people sat in waiting rooms potentially infecting other people.

'They've implemented telephone triage to all of those places.'

Dr Susan Hopkins, a chief medical adviser of the UK Health Security Agency (UKHSA), said more monkeypox cases are being detected on a daily basis.

Speaking to the BBC's Sunday Morning programme, Dr Hopkins said UKHSA will be releasing updated figures on Monday.

She said: 'We will be releasing updated numbers tomorrow - over-the-weekend figures.

'We are detecting more cases on a daily basis and I'd like to thank all of those people who are coming forward for testing to sexual health clinics, to the GPs and emergency department."

And asked to confirm reports that someone is being treated for monkeypox in intensive care, she said: 'We don't confirm individual reports and individual patients.'

In Britain, authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed.

Portugal has 14 confirmed cases and 20 suspected infections. And across the Atlantic, there are two confirmed cases in Canada, with 20 suspected cases. 

There are also cases in Italy, Sweden, Belgium, Germany, The Netherlands, France, Israel, Switzerland and Australia.

The World Health Organisation said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox have been reported from 12 member states that are not endemic for the virus, the UN agency said, adding it will provide further guidance and recommendations in coming days for countries on how to mitigate the spread of monkeypox.

No one has died of the viral disease to date. 

 Professor David Heymann, an expert on infectious disease epidemiology at The London School of Hygiene & Tropical Medicine, said: 'What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world.

He said close contact was the key transmission route, as lesions typical of the disease are very infectious.

For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.

Many of the current cases have been identified at sexual health clinics.

Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.

Heymann said it was 'biologically plausible' the virus had been circulating outside of the countries where it is endemic, but had not led to major outbreaks as a result of COVID-19 lockdowns, social distancing and travel restrictions.  

It comes as it emerged some of the country's top disease experts warned that monkeypox would fill the void left by smallpox three years ago.

 Scientists from leading institutions including the University of Cambridge and the London School of Tropical Hygiene and Medicine argued the viral disease would evolve to fill the 'niche' left behind after smallpox was eradicated.

According to the Sunday Telegraph, the experts attended a seminar in London back in 2019 and discussed how there was a need to develop 'a new generation vaccines and treatments'.

The seminar heard that as smallpox was eradicated in 1980, there has been a cessation of smallpox vaccinations and, as a result, up to 70 per cent of the world's population are no longer protected against smallpox.

This means they are also no longer protected against other viruses in the same family such as monkeypox.

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2022-05-22 08:36:17Z
1440679760

Russia cuts Finland's gas supply over payment row amid bid to join Nato - iNews

Russia has turned off Finland’s gas supply following Helsinki’s decision to join Nato in the latest escalation of an energy payments dispute with the West.

Gas firm Gazprom said it had completely halted exports to Finland at 4am today, with Finnish state-owned gas wholesaler Gasum on Friday confirming the move.

It followed Russia’s decision to halt power supplies to Finland last week.

Russia has continued to supply gas to Western countries despite being hit by sanctions following its invasion of Ukraine.

i has also revealed Britain has imported £400m of Russian diesel since the invasion of Ukraine despite protests that the trade is funding Vladimir Putin’s war machine.

Energy giant Gazprom has demanded European countries pay for gas supplies in roubles because of the sanctions, but Finland refuses to do so.

Most European supply contracts are paid in euros or dollars.

Last month, Russia cut off gas to Bulgaria and Poland after they refused to pay in roubles, the Russian currency.

The decision to cut Finland’s gas supply comes just three days after the Finnish and Swedish governments submitted applications to join Nato.

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Nato secretary-general Jens Stoltenberg hailed the move as “a historic moment, which we must seize”, with the Nordic countries’ membership bolstering the alliance’s shared security.

Finland, which shares an 810-mile border as well as a difficult past with Russia, had previously maintained a neutral stance and remained outside the alliance.

Russia’s Foreign Ministry said joining Nato was a “radical change” in Finland’s foreign policy, adding Moscow “will be forced to take retaliatory steps, both of a military-technical and other nature, in order to stop threats to its national security arising”.

Kremlin spokesperson Dimitry Peskov warned Finland joining Nato would “definitely” represent a threat to Russia.

Mr Peskov told reporters: “Finland joined the unfriendly steps taken by the European Union towards our country.

“This cannot fail to arouse our regret, and is a reason for corresponding symmetrical responses on our side.”

Last month, Russia’s Security Council, Dmitry Medvedev warned there would be “no more talk of a nuclear-free Baltic” if Sweden and Finland join the alliance.

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2022-05-21 07:02:00Z
1431361029

Australia elections: New PM Anthony Albanese says he wants to unite country after Scott Morrison concedes defeat - Sky News

Australia's Labor Party leader Anthony Albanese has said he wants to unite the country after leading the opposition to power for the first time since 2007.

He made his comments after Scott Morrison conceded defeat in the election, ending almost a decade of conservative rule.

Labor currently remains just shy of the 76 seats needed to form a government and so may have to rely on the support of smaller independent parties, including the Greens or so-called "teal independents", who campaigned on policies of integrity, equality and tackling climate change.

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0:47

Australian PM concedes defeat

Their strong showing at the polls means the makeup of the new parliament looks set to be much less climate-sceptic than the one that supported Morrison's pro-coal mining administration.

Final results could take some time as counting of a record number of postal votes is completed.

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The government changed the rules on Friday to enable people recently infected with COVID-19 to vote over the phone.

Voting is compulsory for adults in Australia.

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Following his victory, Mr Albanese, who is a republican from a working-class background, said: "I want to unite the country.

"I think people want to come together, look for our common interest, look towards that sense of common purpose.

"I think people have had enough of division, what they want is to come together as a nation and I intend to lead that."

During the campaign, Labor had promised more financial assistance and a stronger social safety net as Australia wrestles with the highest inflation since 2001 and soaring housing prices.

On foreign policy, the party proposed to establish a Pacific defence school to train neighbouring armies in response to China's potential military presence on the Solomon Islands, which are on Australia's doorstep.

It also wants to tackle climate change with a more ambitious 43% reduction in greenhouse gas emissions by 2050.

Conceding defeat, Mr Morrison said: "Tonight I have spoken to the leader of the opposition and the incoming prime minister, Anthony Albanese, and I've congratulated him on his election victory this evening.

"I believe it's very important that this country has certainty.

"I think it's very important this country can move forward."

Mr Morrison also said he would stand down as leader of the Liberal party.

His capitulation ends eight years and nine months in power for the conservative coalition.

Mr Morrison became prime minister in 2018 after several leadership changes.

Congratulating Mr Albanese on his election as prime minister, Boris Johnson said: "Our countries have a long history and a bright future together.

"As thriving likeminded democracies we work every day to make the world a better, safer, greener and more prosperous place."

Highlighting the "unmatched closeness" between the two nations, he said that "the only distance between us is geographical".

"I look forward to working with Prime Minister Albanese in the weeks, months and years ahead as, together, we tackle shared challenges and demonstrate the importance of our shared values," Mr Johnson added.

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2022-05-21 13:52:30Z
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How DO you catch monkeypox and what are the symptoms? EVERYTHING you need to know about the virus - Daily Mail

How DO you catch monkeypox and what are the symptoms? EVERYTHING you need to know about tropical virus

• Twenty cases in UK could be tip of iceberg as health chiefs hunt for common link
• First time ever spreading in community and appears to be transmitting via sex
• Can kill one in 10 but milder strain is transmitting in UK, which kills one in 100

By Emily Craig Health Reporter For Mailonline

Published: 15:30 BST, 20 May 2022 | Updated: 18:22 BST, 20 May 2022

Monkeypox is spreading globally for the first time, in an outbreak that has caught health officials off-guard.

The UK's case count today doubled to 20 but the majority of them are not linked — which suggests more are going undetected.

Eleven countries have now detected the tropical virus, which is usually only spotted within Africa.

Germany and Belgium today became the latest nations to declare monkeypox cases, while France and Australia announced patients had tested positive overnight.

A disproportionate number of cases are in gay and bisexual men, authorities have said. Health chiefs say the pattern of transmission is 'highly suggestive of spread in sexual networks'.

Here is everything we know about the monkeypox outbreak so far: 

How do you catch monkeypox?

Until this worldwide outbreak, monkeypox was usually caught from infected animals in west and central Africa.

The tropical virus is thought to be spread by rodents, including rats, mice and even squirrels. 

Humans can catch the illness — which comes from the same family as smallpox — if they're bitten by infected animals, or touch their blood, bodily fluids, or scabs. 

Consuming contaminated wild game or bush meat can also spread the virus.

The orthopoxvirus can enter the body through broken skin — even if it's not visible, as well as the eyes, nose and mouth.

Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people.

However, health chiefs insist it is very rare.

Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus' tell-tale scabs. 

The virus can also spread through coughs and sneezes. 

In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.

How deadly is it?

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. 

Yet, the disease kills up to 10 per cent of cases. But this high rate is thought to be in part due to a historic lack of testing meaning that a tenth of known cases have died rather than a tenth of all infections.

However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.

The UK cases all had the West African version of the virus, which is mild compared to the Central African strain. 

It is thought that cases in Portugal and Spain also have the milder version, though tests are underway.

How is it tested for? 

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's specialist lab - the UKHSA's Rare and Imported Pathogens Laboratory.

The test involves taking samples from skin lesions, such as part of the scab, fluid from the lesions or pieces of dry crusts. 

What are the symptoms?

It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.

Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.

But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.

The rash changes and goes through different stages before finally forming a scab, which later falls off.

How long is someone contagious?

An individual is contagious from the point 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 infectious period is thought to last for three weeks but may vary between individuals.

What do I do if I have symptoms?

Anyone with an unusual rash or lesions on any part of their body, especially their genitalia, should contact NHS 111 or call a sexual health service.

Britons are asked to contact clinics ahead of their visit and avoid close contact with others until they have been seen by a medic.

Gay and bisexual men have been asked to be especially alert to the symptoms as most of the cases have been detected in men who have sex with men. 

What even is monkeypox?

Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.

The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.

Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent. 

The UK, US, Israel and Singapore are the only countries which had detected the virus before May 2022.

Timeline of monkeypox in the UK 

1958: Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research.

1970: The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.

2003: A Monkeypox outbreak occurred in the US after rodents were imported from Africa. Cases were reported in both humans and pet prairie dogs. All the human infections followed contact with an infected pet and all patients recovered.

SEPTEMBER 8, 2018: Monkeypox appeared in the UK for the first time in a Nigerian naval officer who was visiting Cornwall for training. They were treated at the Royal Free Hospital in London.

SEPTEMBER 11, 2018: A second UK monkeypox case is confirmed in Blackpool. There is no link with the first case in Cornwall. Instead, the patient is though to have picked up the infection when travelling in Nigeria. They were treated at Blackpool Victoria Hospital and Royal Liverpool University Hospital.

SEPTEMBER 26, 2018: A third person is diagnosed with monkeypox. The individual worked at Blackpool Victoria Hospital and treated the second Monkeypox case. They received treatment at the Royal Victoria Infirmary in Newcastle.

DECEMBER 3, 2019: A patient was diagnosed with monkeypox in England, marking the fourth ever case.

May 25, 2021: Two cases of monkeypox were identified in north Wales. Both patients had travel links to Nigeria.

A third person living with one of the cases was diagnosed and admitted to hospital, bringing the total number ever to seven. 

MAY 7, 2022: A person was diagnosed with Monkeypox in England after recently travelling to Nigeria. The person received care at the expert infectious disease unit at Guy's and St Thomas' NHS Foundation Trust in London.

MAY 14, 2022: Two more cases were confirmed in London. The infected pair lived in the same household but had not been in contact with the case announced one week earlier.

One of these individuals received care at the expert infectious disease unit at St Mary's Hospital in London. The other isolated at home and did not need hospital treatment.

MAY 16, 2022: Four more cases were announced, bringing the UK total to seven. Three of these cases are in London, while one of their contacts is infected in the north east of England.

The spate of cases was described as 'unusual' and 'surprising' as experts warn gay and bisexual men to look out for new rashes.

MAY 19, 2022: Two more cases were revealed, with no travel links or connections to other cases. The cases were based in the South East and London. Fears began to grow that infections are going undetected.

MAY 20, 2022: Eleven more cases were confirmed, meaning Britain's monkeypox outbreak have doubled. Minsters discuss the possibility of a public health campaign to warn gay men the disease may be more prevalent for them.

Is it related to chickenpox?

Despite causing a similar rash, chickenpox is not related to monkeypox.

The infection, which usually strikes children, is caused by the varicella-zoster virus. 

For comparison, monkeypox — like smallpox — is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.  

Are young people more vulnerable?

Britons aged under 50 may be more susceptible to monkeypox, according to the World Health Organization.

This is because children in the UK were routinely offered the smallpox jab, which protects against monkeypox, until 1971.

The WHO also warns that the fatality rate has been higher among young children. 

Does it spread as easily as Covid?

Leading experts insist we won't be seeing Covid-style levels of transmission in the monkeypox outbreak.

A World Health Organization report last year suggested the natural R rate of the virus – 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 rate of the Indian 'Delta' strain. 

But the real rate is likely much lower because 'distinctive symptoms greatly aid in its early detection and containment,' the team said, meaning it's easy to spot cases and isolate them.

Covid is mainly spread through droplets an infected person releases whenever they breathe, speak, cough or sneeze. 

How is the UK managing the outbreak?

MailOnline this week revealed close contacts of monkeypox cases, including NHS workers, are already being offered the Imvanex smallpox vaccine. 

The strategy, known as ring vaccination, involves jabbing and monitoring anyone around an infected person to form a buffer of immune people to limit the spread of a disease.

A spokesman for the UKHSA did not disclose how many have been vaccinated, but said: 'Those who have required the vaccine have been offered it.'

Health chiefs are also contacting all close contacts of those who have been infected.

What if it continues to spread? 

Experts told MailOnline they 'could see a role' for a targeted jab rollout to gay men in the UK 'if this isn't brought under control quickly'.

Close contacts of the UK's known cases are already being offered the jab, which was originally designed for smallpox. The two rash-causing viruses are very similar.

A health source told MailOnline 'there would be a number of strategies we'd look at' if cases continued to rise.

Professor Kevin Fenton, London's public health regional director, said if the outbreak in the capital continues to grow then the rollout of vaccines and treatments could be broadened to more groups.

He said there are 'plans in place' to have more antivirals if the outbreak keeps growing. 

What other countries have spotted cases?

Twelve countries — including the US, Spain and Italy — have now detected cases of monkeypox.

Spain this morning reported 14 new confirmed cases, bringing the nation's total to 21.

And Belgium detected two cases, one in Antwerp and the other in Flemish Brabant.

Germany subsequently confirmed its first ever monkeypox case in a patient who had 'characteristic skin lesions' — a tell-tale sign of the illness.

France last night confirmed a 29-year-old man in Paris had contracted the virus. He had not recently travelled, suggesting the virus is spreading in the community. 

Meanwhile, Australia last night confirmed two cases, including one man in his thirties who had travelled from Britain to Melbourne with symptoms earlier this week. 

The Netherlands Portugal, Sweden and Canada have also detected cases.

The World Health Organization said it has received reports of 37 confirmed cases and 71 suspected infections. 

Is there a vaccine for it? 

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related. 

 

Data shows it prevents around 85 per cent of cases, and has been used 'off-label' in the UK since 2018. 

The jab, 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 people. 

Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.

Are thre any drugs? 

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox.

This includes the drug tecovirimat, which was approved for monkeypox in the EU in January.

Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus within the body. 

An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).

It also works by stopping the growth of the virus.

What is the situation with the UK outbreak?

Twenty cases were confirmed in the UK between May 6 and 20.

No details about the eleven confirmed on May 20 have been released yet. 

But six of the previous nine confirmed cases were in men who have sex with men — which officials say is 'highly suggestive of spread in sexual networks'.

How worrying is it?

UK health chiefs say the risk of a major outbreak is low.

But experts not that the outbreak is 'concerning' and that it is 'very unusual' to see community transmission in Europe.  

Dr Michael Head, a global health expert at the University of Southampton, said the rise in cases is 'undoubtedly worrying'.

But he noted that 'a big monkeypox outbreak like this is still a very different situation to a Covid pandemic'.

Dr Head added: 'Given 11 further cases have been announced today, it’s likely there will be more cases to come in the UK. 

'There certainly will be further cases confirmed in other countries. The contact tracing efforts by public health teams will be crucial in containing the outbreak.'

Dr Charlotte Hammer, an infectious diseases expert at the University of Cambridge, said: 'It is very unusual to see community transmission in Europe, previous monkeypox cases have been in returning travellers with limited ongoing spread.

'Based on the number of cases that were already discovered across Europe and the UK in the previous days, it is not unexpected that additional cases are now being and will be found, especially with the contact tracing that is now happening.'

What is the situation in the US?

The US has confirmed one case and is investigating more.

A Massachusetts man on May 18 became the first confirmed US case for this outbreak.

On May 19, officials in New York City announced they were probing a suspected monkeypox case as well.

And what about Australia?

Australia last night confirmed two cases, its first every monkeypox infections.

One is a man in his thirties who travelled from Britain to Melbourne with symptoms earlier this week.

The second case is a man in his forties who became mildly unwell days after returning to New South Wales from Europe. Both he and the person he lives with are isolating at home.

What do I do if I have symptoms? 

Anyone worried that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit. 

Health chiefs say their call or discussion will be treated sensitively and confidentially.

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2022-05-20 14:30:31Z
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