Monkeypox?

[MonkeypoxThread]

Apologies if there is already a thread about this - the search function is useless atm! I will get this deleted if it's a duplication.

Just interested to read MNers views on this as I don't know what to make of the news reports, and I know there are very knowledgable MNers. I think it's hard for people with no knowledge of things like this, to gauge the "significance" of these cases from the news.

On a scale of 1-10, with 1 being "meh, whatever, fuck it" and 10 being "PANIC MODE ENABLED" I'm normally about a 3. Is that about right?

Death rate figures for monkeypox are between 1% and 11%. This seems to be one of the more mild strains, so probably more like 1% - but that is still a significant number if it takes off. It also is worse for children, and causes congenital abnormalities if pregnant women catch it. That would be a rate of about 1 child dying in your average primary school, or around 10 in an average 11-18 secondary.
Covid is much less, more like 0.1% or even less with vaccines and disproportionately affecting the elderly. Obviously both are very dangerous for the immunocompromised.
If monkeypox is spreading more easily now between humans and isn't contained it would be a far worse pandemic than covid. It should be containable though with good isolation of contacts, but public health and individuals who might be in contact do need to act now rather than being complacent.
We have enough vaccines for close contacts, but nowhere near enough to consider a mass vaccination programme.

Interestingly, for the poster comparing to measles above, the death rate from the mildest strain of monkeypox is similar to death rate from measles in West Africa.
It's hard to compare in Europe as this is the first monkeypox outbreak - healthcare, but also no population immunity to monkeypox.
The more dangerous strains of monkeypox are ten times more deadly than measles.

I started out as a 1 last week and I am now hovering on a steady 5/6. The child ending up in ICU was pause for thought, followed by learning that pregnant women, children under 12 and those with compromised immune systems are most at risk.
Recognising the cases are now spreading in the community and with MP being spread via respiratory droplets, contaminated items, touch and face to face contact - limited but most definitely happening, I am now not feeling so confident at all.
Vaccines and treatments are available is the good news, the not so good news is that it will take a long time to roll out and what is going to happen in the meantime....

It is giving me vibes of something that is not going away anytime soon, and I wouldn't be surprised if does become a serious health issue.

The most worrying thing for me was the incubation period.
It is 21 days, that means infected people may continue their lives without a rash or symptoms and still be spreading MP without knowing it.

It is also now the length of time you need to isolate for: 21 days!
All contacts in the household also 21 days
All sexual contacts 21 days

What is this starting to feel like? <said with an extremely heavy heart, as there is no way I am doing another lockdown>

Are we ready for Chris Whitty again and his graphs folks?

Are we ready to become scruffbags again while celebs get their hair and make up done?

There will be no more disruptions, country can't afford more

I think this is the crux of it. Where will the money come from? People will not isolate if they don't get paid, simple.

I was never personally scared of catching covid. Couldn't have cared less really. I would be petrified of catching monkey pox though

The most worrying thing for me was the incubation period.
It is 21 days, that means infected people may continue their lives without a rash or symptoms and still be spreading MP without knowing it.

Monkeypox isn't contagious during the incubation period. It can however be contagious during the early onset of symptoms (fatigue etc. - 1-2 days before the rash develops) which can begin at any time during the incubation period.

But people are not going to be walking around infectious for 21 days.

www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html#:~:text=Infection%20with%20monkeypox%20virus%20begins,symptoms%20and%20may%20feel%20fine.

The most worrying thing for me was the incubation period.
It is 21 days, that means infected people may continue their lives without a rash or symptoms and still be spreading MP without knowing it.

There is no evidence that people are infectious before they get symptoms. In fact WHO are not currently recommending that contacts isolate unless they develop symptoms. They say:

Asymptomatic contacts can continue routine daily activities such as going to work and attending school (i.e., no quarantine is necessary), but should remain close to home for the duration of surveillance. It may, however, be prudent to exclude pre-school children from day care, nursery or other group settings.

And -

Health workers who have unprotected exposures (i.e., not wearing appropriate PPE) to patients with monkeypox or possibly contaminated materials do not need to be excluded from work duty if asymptomatic, but should undergo active surveillance for symptoms, which includes measurement of temperature at least twice daily for 21 days following the exposure. Prior to reporting for work each day, the health worker should be interviewed regarding evidence of any relevant signs/symptoms as above.

www.who.int/publications/i/item/WHO-MPX-surveillance-2022.1

No idea why UK is going down the quarantine route (although I note it is only for the highest risk contacts) - I think it may backfire.

I'm still at level 3 despite the number of new cases reported today. We were told cases would likely go up significantly over the next week or two. They're encouraging people to come forward if they have symptoms and they'll have been intensively contact tracing since the earliest cases.

If cases are still rising at this rate after a couple of weeks I will be more concerned.

While it's a much milder illness, this has far more in common with smallpox than it does with covid. We have contained and eradicated a few smallpox outbreaks in the UK within living memory. We know how to do this. There was no national vaccine programme and there were no lockdowns. They used contact tracing, effective isolation of patients, occasional closure of specific venues and ring vaccination - just vaccinating those closest to the outbreak.

While it's a much milder illness, this has far more in common with smallpox than it does with covid. We have contained and eradicated a few smallpox outbreaks in the UK within living memory. We know how to do this. There was no national vaccine programme and there were no lockdowns. They used contact tracing, effective isolation of patients, occasional closure of specific venues and ring vaccination - just vaccinating those closest to the outbreak.

While that is true the way of life now is very different from what it was then and the way we live now is much more conductive to a wider spread.

I'm not sure this is particularly true for this disease because it does need prolonged close contact to spread and as far as we know people are not infectious until they become symptomatic. We may travel more now, but in the 1960's smallpox outbreaks it was normal for everyone to pile into the cinema several times a week because they didn't have a telly. Swings and roundabouts.

Life may have changed but nevertheless, it's much easier to control and contain this virus than something like covid, flu or the common cold.

Yes, but we travel a lot more for fun. We go to clubs in foreign places and have sex with people from all over. We are a lot more mobile.

You have your cinema, I give you the Piccadilly Line in the rush hour.

i haven’t rtft but I’m on a scale of 7. Despite people suggesting it’s “just like chickenpox” my son ended up in hospital with chickenpox and it almost killed him as it lead to a secondary bacterial infection and it was touch and go for a while. There’s no way I can go through that again so I’m super super concerned :-(

A major MP outbreak would wreak havoc in industry and services, with 21 day isolation periods for whole households, no asymptomatic excuses, none of that ‘it’s the flu’. This is nothing like Covid.

I’m not advocating for lockdowns because it’s nowhere near that at the moment but we need to be open minded to the potential for this to be a big deal and it could bring inevitable disruption regardless of if the country can afford it or not.

I don't think it would come to that. Because the death rate (in an unvaccinated community) is about the same as covid is now (mild strain in vaccinated population) and no-one is calling for return of restrictions for covid at current level of impact.

Doubly not likely as monkeypox's long term consequences (scarring) really doesn't present same burden to NHS as long covid.

Thank you, yes, i do have that big injection mark. Phew. 2 on the panickometre

My kids havent had it of course. 5 on the panickometre 😲 Omg it never ends!

It wasnt compulsory before it was stopped, in fact uptake had been low for years.
If you've only got one scar its possibly BCG, I have two scars, one BSG and one smallpox as I was born in the late seventies in a country that vaccinated against smallpox into the 1980s as part of the standard schedule.
DH, same age and grew up in the UK, just has the one scar.

For anyone who is interested, this isn't a bad introductory overview of death rates of various diseases.

https://en.wikipedia.org/wiki/List_of_human_disease_case_fatality_rates

We go to clubs in foreign places and have sex with people from all over.

Do we now? Most people don't do this.

Some people do though and I don't think it's an unreasonable ask for them to just knock it on the head for a bit.

Nobody died from a lack of casual sex.

Some people do though and I don't think it's an unreasonable ask for them to just knock it on the head for a bit
Nobody died from a lack of casual sex

It's about as reasonable as it is to ask that of people because of covid as it is right now (similar fatality rate, worse sequelae)

Single people were told they couldnt have their ONE non live in partner over when Covid cases were rising. It was made illegal

Just one kid in the U.K. in intensive care?

Unfortunate but not enough to cause concern. It's 0 for me