MonkeyPox in UK

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kerrya1
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MonkeyPox in UK

Post by kerrya1 » Tue May 17, 2022 12:51 pm

There now seem to be 7 confirmed cases of Monekypox in England, but only one of the cases is confirmed to have visited a part of Africa where is is endemic. The other six cases don't appear to have visited a high risk region or to have had contact with the case that did.

How possibly is it that there is an asymptomatic carrier of monkeypox who would't have come to the attention of contact tracers?

One of my collagues at work was slightly freaking out about it today, but nothing I've read about it from reputable sources suggests that it is likely to be the "next pandamic" or that it is particularly dangerous to those who do catch it. I told them not to worry and that there is already a vaccine so if there was an outbreak that could be used.

https://www.gov.uk/government/news/monk ... st-updates

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Re: MonkeyPox in UK

Post by jdc » Tue May 17, 2022 1:22 pm

kerrya1 wrote:
Tue May 17, 2022 12:51 pm

How possibly is it that there is an asymptomatic carrier of monkeypox who would't have come to the attention of contact tracers?
Found this, which doesn't necessarily rule out asymptomatic infection but does say we haven't seen it yet:

"Monkeypox is not considered contagious during its incubation period and asymptomatic monkeypox infection has not been documented. Transmission occurs through fluids secretion, mainly from the respiratory tract or skin lesions. The distinctive symptoms of human monkeypox greatly aid in its early detection and containment. Nevertheless, secondary transmission from imported cases is possible..."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463189/

It also talks about sporadic monkeypox introductions into human populations and says "monkeypox outbreaks were self-limiting, with human transmission chains ending without establishing epidemics" which is is at least slightly reassuring. Also gives a figure of 85% efficacy for the vaccine you mentioned and they "calculated R0 for monkeypox to be 2.13 (uncertainty bounds 1.46–2.67)"

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Re: MonkeyPox in UK

Post by Stephanie » Tue May 17, 2022 1:51 pm

mikeh has said on his Facebook:
It's very interesting from an infectious disease epidemiology point of view, but of little immediate relevance to most. Here's a thread of some key points
- typically very limited human-to-human transmission, needs very close contact to transmission to occur (for example, skin to skin contact).
- therefore, transmission is nothing like COVID19
- and so to add to other public health voices, very very low risks to wider general public
- if thought to be a close contact, then public health teams will follow up
- In itself, monkeypox can be very nasty (case fatality rates upwards of 1%, albeit most outbreaks in areas where healthcare is v limited)
- UK has several specialist facilities for handling unusual tropical medicine cases. NHS is very good at this. And we have had monkeypox here in the UK before.
- Name is a bit misleading. First identified in monkeys, but small animals like rats/other rodents a more common host
- interesting hypotheses that less smallpox vaccination means lower population immunity against the related-but-different monkeypox virus, and thus outbreaks may become more common.
- that's very much tbc, but is plausible and interesting
- these imported cases do indicate a wider burden of disease elsewhere in the world (typically in parts of West/Central Africa)
- we should be giving more consideration to understanding local and global implications of Lassa Fever, #monkeypoxvirus, Ebola and other rare but serious pathogens.
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Re: MonkeyPox in UK

Post by dyqik » Thu May 19, 2022 11:05 pm

It's made it to Massachusetts now. Apparently arriving from Canada.

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Re: MonkeyPox in UK

Post by bob sterman » Fri May 20, 2022 5:58 am

WHO update...

https://www.who.int/emergencies/disease ... 022-DON383

"transmitted by droplet exposure via exhaled large droplets"

Now if only we knew of a simple non-pharmaceutical intervention we could ask people to adopt to reduce the risk of transmission???

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Re: MonkeyPox in UK

Post by kerrya1 » Fri May 20, 2022 5:59 am

News this morning seems to suggest cases in a few mainland Europe countries, and Australia too, with some of them ordering smallpox vaccine "just in case".

BBC News - Monkeypox cases investigated in Europe, US, Canada and Australia
https://www.bbc.co.uk/news/health-61506562

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Re: MonkeyPox in UK

Post by Bird on a Fire » Fri May 20, 2022 10:52 am

It's quite worrying that it seems to be all over the place already, without clear connections between cases and the region of endemicity. Sightly... familiar.
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Re: MonkeyPox in UK

Post by Bird on a Fire » Fri May 20, 2022 11:07 am

Nine more cases of infection with the Monkeypox virus have been confirmed in Portugal, totalling 14, according to the Directorate-General for Health.

he DGS added, in a statement, that the identified cases remain under clinical follow-up, and are stable.

The new cases were confirmed by the National Institute of Health Doctor Ricardo Jorge (INSA) late yesterday afternoon, with two samples still being analysed.

Regarding the remaining suspected cases, the DGS says that the samples will still be sent for analysis by INSA.

At the moment, the statement said, “epidemiological surveys are still ongoing, with the aim of identifying transmission chains and potential new cases and their respective contacts”.

The health authority appeals to people who have ulcerative lesions, skin rash, palpable lymph nodes, possibly accompanied by fever, chills, headache, muscle pain and tiredness, to seek clinical advice.

The director of the National Program for Sexually Transmitted Infections and HIV confirmed that the first five confirmed cases were detected at a clinic linked to sexually transmitted diseases in young men aged between 20 and 50 years old.

“They were identified in the context of care at a sexually transmitted disease clinic because they had genital lesions. The route of sexual transmission is not classically described [as likely to cause this infection], but there is transmission through close, intimate and prolonged contact”, said Margarida Tavares.

All cases, she stressed, are located in the region of Lisbon and Vale do Tejo.

“But for now we don't know if there is a relationship. And yes, there can be dispersion across the country,” she added.

The Monkeypox virus is of the Orthopoxvirus genus (smallpox is the best known of this genus) and the disease is transmitted through contact with animals, or close contact with infected people or contaminated materials.

The disease is rare and usually does not spread easily among humans.

This is the first time that Monkeypox virus infection has been detected in Portugal.

In 2003, a few dozen cases were reported in the United States of America.

The United Kingdom also recently reported similar cases of ulcerative lesions, with confirmation of Monkeypox virus infection.
https://www.theportugalnews.com/news/20 ... 20/05/2022
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Re: MonkeyPox in UK

Post by Chris Preston » Fri May 20, 2022 11:22 am

The two cases in Australia are travellers who have recently returned from the UK and (unspecified) Europe.

It strikes me that this version might be more transmissible than is traditionally associated with monkeypox.
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Re: MonkeyPox in UK

Post by Bird on a Fire » Fri May 20, 2022 11:30 am

Chris Preston wrote:
Fri May 20, 2022 11:22 am
The two cases in Australia are travellers who have recently returned from the UK and (unspecified) Europe.

It strikes me that this version might be more transmissible than is traditionally associated with monkeypox.
Indeed. Early reports seem suggestive of (mostly?) sexual transmission.
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Re: MonkeyPox in UK

Post by shpalman » Fri May 20, 2022 11:36 am

bob sterman wrote:
Fri May 20, 2022 5:58 am
WHO update...

https://www.who.int/emergencies/disease ... 022-DON383

"transmitted by droplet exposure via exhaled large droplets"

Now if only we knew of a simple non-pharmaceutical intervention we could ask people to adopt to reduce the risk of transmission???
Washing your hands?

Are these large droplets the size of small boulders droplets? I'm sure they just fall down and don't hang about in the air, the WHO wouldn't consistently get that wrong.

Anyway there's a case in Italy in someone recently returned from the Canary Islands. Well, I'm sure there are others, but this is one they know about.
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Re: MonkeyPox in UK

Post by shpalman » Fri May 20, 2022 6:16 pm

Actually three cases in Italy, one of which is someone recently returned from Austria.
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Re: MonkeyPox in UK

Post by Gfamily » Fri May 20, 2022 10:26 pm

Oh my, the humanity
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Spandex might help.

ETA Ooops, sorry - forgot humour may be deprecated in weighty matters
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Re: MonkeyPox in UK

Post by bjn » Fri May 20, 2022 10:40 pm

Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

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Re: MonkeyPox in UK

Post by Gfamily » Fri May 20, 2022 11:10 pm

bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.
Not sure.
I was 3 in the last UK 'wild' outbreak, but lived at the epicentre of it, so I expect I had the jab.
Not least because the borough's Medical Officer of Health was our next door neighbour.

A blog about the outbreak
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Re: MonkeyPox in UK

Post by Bird on a Fire » Fri May 20, 2022 11:10 pm

I prefer the natural immunity I got from fondling cows' udders.
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Re: MonkeyPox in UK

Post by Gfamily » Fri May 20, 2022 11:16 pm

Bird on a Fire wrote:
Fri May 20, 2022 11:10 pm
I prefer the natural immunity I got from fondling cows' udders.
genetic vari(ol)ation is cool
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Re: MonkeyPox in UK

Post by kerrya1 » Sat May 21, 2022 6:13 am

This whole situation is getting very "interesting" and I imagine the epidemiologists and contact tracers are working overtime trying to work out how this outbreak began and how it can be stopped.

Given the fact that most cases currently identified are gay, bisexuality, or MSM I can imagine that potentially exposed people may not always be keen to come forward which will make contact tracing harder.

Articles like this may not help much https://www.telegraph.co.uk/news/2022/0 ... nounce-11/

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Re: MonkeyPox in UK

Post by bagpuss » Sat May 21, 2022 10:44 am

bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

I have a very clear and distinct scar on my left upper arm from mine (born 1970). Small, slightly puckered/bumpy area a few mm across. I think this is pretty standard - certainly I have seen many such in people of my age and older. So if you have such a scar, you've almost certainly had one. If not, you may well not have, although I don't know how common it is not to have one.. Google images has many examples.

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Re: MonkeyPox in UK

Post by bjn » Sat May 21, 2022 7:20 pm

bagpuss wrote:
Sat May 21, 2022 10:44 am
bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

I have a very clear and distinct scar on my left upper arm from mine (born 1970). Small, slightly puckered/bumpy area a few mm across. I think this is pretty standard - certainly I have seen many such in people of my age and older. So if you have such a scar, you've almost certainly had one. If not, you may well not have, although I don't know how common it is not to have one.. Google images has many examples.
I don't have any such scar. Looks like I'm not then.

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Re: MonkeyPox in UK

Post by KAJ » Sat May 21, 2022 7:36 pm

bjn wrote:
Sat May 21, 2022 7:20 pm
bagpuss wrote:
Sat May 21, 2022 10:44 am
bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

I have a very clear and distinct scar on my left upper arm from mine (born 1970). Small, slightly puckered/bumpy area a few mm across. I think this is pretty standard - certainly I have seen many such in people of my age and older. So if you have such a scar, you've almost certainly had one. If not, you may well not have, although I don't know how common it is not to have one.. Google images has many examples.
I don't have any such scar. Looks like I'm not then.
I have such a scar. I've always thought it was from tuberculosis (BCG) vaccination, not smallpox. A quick Google suggests the scars are similar.

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Re: MonkeyPox in UK

Post by basementer » Sat May 21, 2022 7:37 pm

bagpuss wrote:
Sat May 21, 2022 10:44 am
bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

I have a very clear and distinct scar on my left upper arm from mine (born 1970). Small, slightly puckered/bumpy area a few mm across. I think this is pretty standard - certainly I have seen many such in people of my age and older. So if you have such a scar, you've almost certainly had one. If not, you may well not have, although I don't know how common it is not to have one.. Google images has many examples.
Caution: though I did have a smallpox jab, my visible vaccination scar is not from that, it's from BCG (tuberculosis.) That was the only vaccination I remember that scabbed and scarred. So it might be unwise to infer from a scar exactly what the vaccination was for.
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Re: MonkeyPox in UK

Post by bagpuss » Sat May 21, 2022 9:39 pm

basementer wrote:
Sat May 21, 2022 7:37 pm
bagpuss wrote:
Sat May 21, 2022 10:44 am
bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.

I have a very clear and distinct scar on my left upper arm from mine (born 1970). Small, slightly puckered/bumpy area a few mm across. I think this is pretty standard - certainly I have seen many such in people of my age and older. So if you have such a scar, you've almost certainly had one. If not, you may well not have, although I don't know how common it is not to have one.. Google images has many examples.
Caution: though I did have a smallpox jab, my visible vaccination scar is not from that, it's from BCG (tuberculosis.) That was the only vaccination I remember that scabbed and scarred. So it might be unwise to infer from a scar exactly what the vaccination was for.
Yes, it's not the most reliable method, but in the absence of any kind of reliable records, it is at least some indication.

I have a BCG scar too. That is more of a smooth pale bump with slight puckering around it, while the smallpox one is slightly indented and just puckering, no bump. It seems this is fairly typical but I would not want to imply that it's a perfect test.

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Re: MonkeyPox in UK

Post by jimbob » Sat May 21, 2022 9:50 pm

bjn wrote:
Fri May 20, 2022 10:40 pm
Side thought, how do you know if you’ve been vaccinated against small pox? I was born in the UK before 1971, but it doesn’t seem to have been compulsory. I have no records from that far back.
I remember getting the vaccination in the mid 1970s before going to New Zealand for my fifth birthday.

I do remember it being little prickles rather than the jab of tetanus.

I did find my vaccination certificate for it a couple of years ago
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Re: MonkeyPox in UK

Post by Tessa K » Sun May 22, 2022 2:52 pm

I have no idea if I was vaccinated. I can't tell from the scar because I did so much growing my scar is a thin line about 4cm long.

I can't help singing monkey pox in the uk to the tune of Anarchy in the UK.

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