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?

You have to be in close contact with someone in order to catch it

That is not true alternative you can catch Monkeypox within 1metre of being close to them - it is possible to catch MP from a person you sit next to on a train, tube or plane. I think you probably need to update your research. Ditto lang

"Meanwhile, being seated directly next to a monkeypox case on a plane, sharing a car or taxi, or being within 1 meter of an infectious person without wearing appropriate PPE, were scenarios that would put an individual at "medium risk" of exposure to the virus, the UKHSA said"

Full PPE against monkeypox consists of an FFP3 mask, a long-sleeved gown, gloves and eye protection, according to the organization.

fortune.com/2022/05/23/can-you-catch-monkeypox-on-a-plane-how-health-officials-are-calculating-your-risk/

Our idea of 'close contact' seems to be very different.
Of course this needs to be on our radar, we don't know the true number of cases yet, and it spreading in the community and has been for weeks.

**and it has been spreading

Sorry, still not a concern.

"Monkeypox is caused by an orthopoxvirus, and creates a bubbly rash of lesions that can leave disfiguring scars."

I'd be concerned if I caught it!

From your own link:

David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, told Fortune on Monday that in most cases, monkeypox infections were caused by physical contact.

“That means if one person who is not infected touches a person’s lesion, or sore, who is infected, if that sore is open and weeping it can put virus on the skin that enters the other person’s body through a microscopic entry point,” he said in a phone call.

Heymann stressed that it would be very rare for surfaces in public spaces to become contaminated with the virus.

“It’s a disease that hasn’t been studied well, so we’re just beginning to understand it. But I think it would be wrong to say it’s everywhere, and it certainly isn’t transmitted by the respiratory means that COVID-19 is transmitted,” he explained.

There is a discrepancy between UKHSA advice and WHO advice. WHO are not even advising quarantine of what UKHSA calls 'high risk' contacts, just daily monitoring for symptoms. I think UKHSA is being over cautious and I worry that it will backfire. It's one thing (and sensible) to require people with active infection to isolate. It's quite another to expect contacts to quarantine for three weeks when there is no evidence that people are infectious before they develop symptoms.

I'm posting this again because it discusses many of these issues as well as the 'MSM' angle.

"it certainly isn’t transmitted by the respiratory means that COVID-19 is transmitted"

By that he means as aerosols that can stay suspended in air for some time/hours in an enclosed space... Which took many long enough to discover/believe to be true re Covid.

However Monkeypox can be transmitted by droplets, by coughing and sneezing.

Im not being goady Im simply demonstrating that there is still a lot of resentment around from the different rules for different folks twattery that has been used during Covid.

lang Your post has made no difference to my view, Heymann freely admits that he does not really know at this stage how infectious this strain is likely to be, and information is scarce. He also acknowledges that MP can be spread in other ways apart from physical contact. It has now been confirmed that contaminated items can cause spread, so just because ONE person happens to think it is rare others have now confirmed otherwise.

I have ZERO, in fact on a scale of 1-10 in confidence, I have around -30 for the WHO. Their handling of covid was entirely unacceptable, far too slow to acknowledge the danger and risks causing many more tens of thousands of deaths than there should have been through a total lack of action and direction. Even now, they have refused to demand access to the source of the pandemic and are backing China all the way. So please do not expect me to take my cues from WHO. I hope we withdraw the whole ghastly set up, and replace it with a global organisation that is fit for purpose.

I will take my lead from British scientists and UKHSA as they have already proven their ability and world class expertise to deal with industrial sized health problems for the last two years, and I have much more confidence in their observations - indeed in their decision to ask the infected to quarantine AND close contacts, given what is at stake.

I am not sure of your intentions to minimise and silence discussion, but it is not helpful. Many of us feel very reassured and indeed more informed sharing information and learning about the facts.

Well, I hope other people watch it.

@milkyaqua

It said' can' not will!

What?

However Monkeypox can be transmitted by droplets, by coughing and sneezing.

Great, so after two years of people thinking I've got Covid when I'm coughing all the time they'll now think I've got monkey pox instead!

I think the pus filled boils all over your face will be the more pressing issue out of the two for most people pinky should it happen to you.

I think this is a very useful article (just out today I believe) which describes recent cases in the U.K

I won’t make a judgment on whether this is “mild” or not but rather invite you to look at the descriptions of the symptoms and the inconvenience of the extended isolation.

www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00228-6/fulltext#.Yo4WdHs_Vph.twitter

I'm not sure what conclusions about severity can be reached from such a small study (total 7 cases over a three year period). The report even states "None of the patients in our series experienced any of the commonly recognised severe complications of monkeypox such as pneumonitis or superimposed bacterial sepsis."

The study interpretation is:

"Human monkeypox poses unique challenges, even to well resourced health-care systems with HCID networks. Prolonged upper respiratory tract viral DNA shedding after skin lesion resolution challenged current infection prevention and control guidance. There is an urgent need for prospective studies of antivirals for this disease."

Hmmm, not particularly reassuring at all.
The symptoms and complications described are not at all what you would expect to be classified as a mild illness.

I think in terms of outbreaks they refer to an illness as 'mild' to indicate it generally does not require hospitalisation.

You are entirely correct.

This has been said several times o this thread, and on many, many covid threads beforehand.

Mild means o hospital treatment required. It is not a synonym for trivial symptoms only. You can be very unwell indeed, and at home utterly floored and barely functioning for days/weeks and it still be mild (because you were at home, not in hospital)

As far as I can tell, and I’m very happy to be corrected if someone can find more information,

The study I posted (lancet article) isn’t a study of only the hospitalised cases.

it is all of the U.K. cases between 2018 and 2021.

that’s it. 7 cases. That’s everything we had in that period and that is what happened to them.

As a high consequence disease (which doesn’t mean severe but has potential to disrupt the population) patients are sent to these special centres. I don’t think all initially, but at some point??

I wonder if all the current cases have been sent to these centres too? Maybe different now because no longer as “rare”?

Yes the government are telling patients to isolate at home if they think they have monkeypox but after contact tracing are you moved to one of these centres?

I noted that the mother (final person to catch it in the family group) had to isolate for a total of 49 days because of the way it ran through the family, staying with her baby, then catching it herself.

I also noted they decided not to treat the youngest child with antivirals because none of the drugs have been trialled in under 12s.

It is small. I don’t know if there is any reason why the new cases should be different now, as they are all from the same clade in west Africa (I.e. not the more severe one).

I wonder if all the current cases have been sent to these centres too? Maybe different now because no longer as “rare”?

Yes the government are telling patients to isolate at home if they think they have monkeypox but after contact tracing are you moved to one of these centres?

I hope if people are moved to the centres someone has thought about who will care for children and pets.

In the case of the family all parents and children were moved to the specialist centre, presumably a mix of potentially at risk infection and no one else would be able to care for them at home.

As for pets, I believe there is to be updated guidance (today) to say that people who are diagnosed (possibly also exposed) must not stroke their pets as they are at risk of passion into them and the health authorities are concerned about creating a new animal reservoir which could ultimately lead to monkeypox becoming endemic in Europe.

Perhaps more reassuringly (??)

It has been around for a couple of years, undetected and spreading very slowly (I would expect covid restrictions helped) and is only now kicking off because of these particular superspreader events.

amp.theguardian.com/world/2022/may/25/monkeypox-may-have-been-circulating-in-uk-for-years-scientists-say

Sorry, I should say that it is a hypothesis that it might have been hanging around for a few years at low levels.

of course it is too early to say for sure.

Following up on my comment about whether people have to go to specialist hospitals…

the U.K. gov webpages list monkeypox as a High Consequence Infectious Disease (HCID) and their guidance says

”Once an HCID has been confirmed by appropriate laboratory testing, cases in England should be transferred rapidly to a designated HCID Treatment Centre. Occasionally, highly probable cases may be moved to an HCID Treatment Centre before laboratory results are available.”

www.gov.uk/guidance/high-consequence-infectious-diseases-hcid

However, on the government’s latest updated pages on Monkeypox, it says

”UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases and are advising those who have been risk assessed and remain well to isolate at home for up to 21 days.”

www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates

It doesn’t say what happens once you exhibit symptoms and are confirmed case.

As for pets, I believe there is to be updated guidance (today) to say that people who are diagnosed (possibly also exposed) must not stroke their pets as they are at risk of passion into them and the health authorities are concerned about creating a new animal reservoir which could ultimately lead to monkeypox becoming endemic in Europe.

Not easy! How am I supposed to stop the cat rubbing around my legs? If I'm exposed I won't be quarantining from DH at home either, we don't have the space. It'll be the same as Covid, we'll just have to get on with it.

BTW I'm talking about exposure, not actually having monkey pox! DH and the cat would probably banish me to the shed in that case!

Not easy! How am I supposed to stop the cat rubbing around my legs?
They recommend sending your pet to a friend, relative or care facility if you have monkey pox. Because if the pet becomes a reservoir for the virus it will have to be put down.