What is monkeypox?
Monkeypox, apkoppor in Swedish, is a zoonotic virus (a virus spread from animals to humans) which most often occurs in areas of tropical rainforest in Central and West Africa. It is occasionally found in other regions, and a recent outbreak is now affecting Europe, North America and Australia.
"We've known about this virus in apes since the 1950s," Fredrik Elgh, consultant and professor of virology at Umeå told TT newswire when the first monkeypox cases were reported in Sweden in May. "Every type of animal has its own type of pox, us humans had closely-related smallpox which was wiped out in the 1980s. Smallpox were an enormous issue throughout the history of humanity, we can see that on old mummies."
"In more recent times, like the 1700s, we know that in every family, multiple children died of smallpox."
There is no vaccine for monkeypox approved in Europe, but vaccines for smallpox are effective against the virus, as the two viruses are members of the same family.
"The vaccine used against smallpox also has an effect on monkeypox," Elgh told TT. "That means that those born in the mid-70s or earlier will have a degree of immunologic memory. Young people have no immunity. There's also a new, sophisticated vaccine which gives good coverage after two doses."
"What's good about poxes is that even if you take the vaccine after you've been infected, it has an effect on the progress of the illness. There are also antiviral medicines," Elgh explained to TT.
What causes it?
Monkeypox is spread via close contact with an animal or human with the monkeypox virus. It can be transmitted via bodily fluids, lesions, respiratory droplets or through contaminated materials, such as bedding.
Recent cases of the virus in Europe are thought to have been spread through sexual activity, Klara Sondén, infectious disease physician at the Public Health Agency told newspaper Aftonbladet.
"That's new, compared to how the disease has spread previously," Sondén told the newspaper.
"The classic symptoms are skin lesions which cover the body. In the European cases, the problem has been localised to the genitals. Many of those with suspected infections have also reported that they recently had sexual contact with a new partner," she explained to Aftonbladet.
What are the symptoms?
The symptoms of monkeypox include a fever, headache, muscle aches, swollen lymph nodes, chills and exhaustion. A rash, similar to chickenpox typically develops, often starting on the face and spreading to other parts of the body, including the genitals.
Monkeypox typically has an incubation period of six to 16 days, but it can be as long as 21 days. Once lesions have scabbed over and fallen off, the person with the virus is no longer infectious.
However, Sondén explained to Aftonbladet that the incubation period for this new sort of monkeypox could be different.
"We're unsure of the incubation period. Usually, the incubation period is one or two weeks, but now we don't know for sure how long it is."
Why is it in the news now?
Although monkeypox is considered endemic in certain areas of Central and West Africa, the virus is making headlines now as this is the first time an outbreak has been reported elsewhere. In addition to this, the first cases in Europe were identified in individuals with no recent history of travel to affected areas and no history of contact with previous imported cases.
So far, the most recent monkeypox outbreak has affected nearly 16,000 people in 72 countries, with five reported deaths. Most of the cases have occurred in larger cities.
Is it dangerous?
The type of monkeypox seen in affected areas of Central and West Africa can be serious and can be deadly for those with weak immune systems, children or pregnant people.
"In those countries where it is more prevalent, which is in Central and West Africa, a fatality rate between one and ten percent has been reported," Elgh told TT newswire. "But then, you have to remember that that's in an African context where people are not as well-nourished and there isn't the same access to healthcare, so it can't be directly translated."
During the current outbreak, in countries where monkeypox is not endemic, there have been no deaths as a result of the virus. The majority have had a mild illness where the main symptom has been painful lesions.
77 cases of the virus have been reported in Sweden so far, up until the 21st July, according to the Public Health Agency. According to the agency, the number of cases in Sweden is limited compared to other areas of Europe, with up to 40 percent of cases assessed as having caught the virus within the country.
"There's nothing you need to think about in your daily life or at work," Sondén told Aftonbladet in May. "We're announcing this because we want to raise awareness of the sexual aspect. If you, for example, start showing symptoms after you've recently had sex with a new partner."
According to the WHO, 98 percent of reported cases have been in men who have sex with men, although this doesn't mean that other groups cannot catch the virus.
A small amount of cases have also been reported where those in question have been infected without physical contact, for example via bedding or towels which someone with monkeypox has been in contact with.
Other potential causes of infection are not yet clear, but according to the Public Health Agency, the virus could also be airborne; spread through small respiratory droplets, or be spread via damaged skin or through mucus membranes.
Could this cause a new pandemic?
It's unlikely, Elgh believes. He told TT that "this is not a new pandemic".
"The general public do not need to be worried about monkeypox," he added. "But my belief and hope is that this will not be a pandemic like corona. The most likely scenario is that as long as we contact trace properly, it will ebb out," he told TT.
He explained that the two viruses are different types of viruses, meaning that monkeypox cannot adapt as easily as the Covid-19 virus.
"Monkeypox is a DNA virus, while coronavirus is a RNA virus," he explained to TT. "DNA viruses are much more stable, which means that you don't need to be worried that they will adapt as quickly. It would take a lot and a long time before they adapt to humans."
The European Centre for Disease Prevention and Control also deems the risk of the virus spreading in the general population to be low.
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