Health authorities are investigating a recent outbreak of monkeypox cases that have been reported in countries outside of Central and West Africa where the rare disease is endemic.
As of May 21, the World Health Organization (WHO) reported 92 confirmed cases of monkeypox and 28 suspected cases from 12 non-endemic countries, including several European nations, the United States, Canada and Australia.
Two cases have been identified in Australia: the first is a 30-year-old man in Victoria, announced by the state health department on May 19.
A second case, a man in his forties, was confirmed in NSW the next day. Both had recently traveled to Europe and are now isolating themselves.
Officials are investigating the likely source of this outbreak as reported cases so far have not established travel links to Central and West Africa, where the virus is endemic. WHO predicts there will be more cases in the coming weeks as surveillance expands to non-endemic countries.
Experts say that monkeypox is usually a mild viral infection that spreads through close contact.
Although the risk to the general population is low and the outbreak “contained”, they say awareness is important as investigations continue.
Here’s what you need to know.
What is monkeypox?
Monkeypox is a viral zoonosis, which means it is a virus transmitted to humans from animals, including a number of rodents and non-human primates.
According to Professor Raina MacIntyre, an epidemiologist at the University of NSW, it is closely related to the virus that causes smallpox but is clinically less severe.
‘It is usually found in animals, including monkeys, but also in other animals, and can occasionally spread from animals to humans and very occasionally from human to human,’ Professor MacIntyre told SBS News.
With the eradication of smallpox in the 1980s and the consequent end of smallpox vaccination, the WHO says that monkeypox has emerged as “the most important orthopoxvirus for public health.”
The first case of monkeypox in humans was identified in 1970 in the Democratic Republic of the Congo in a nine-year-old boy, according to the WHO. Smallpox had been eliminated in the region two years earlier.
There are two main strains of the monkeypox virus in Central and West Africa.
“One [strain] has about a one percent death rate, which is similar to COVID-19. And the other has a death rate of around 10%, which is similar to the first SARS, ”said Professor MacIntyre.
The current outbreak in non-endemic countries appears to be the least severe strain.
How does it spread and what are the symptoms?
Monkeypox can spread to humans through close contact with an infected person or animal, the WHO says. It is transmitted from one person to another by close contact with injuries, body fluids or material contaminated by the virus.
Australian Medical Association (AMA) Vice President Dr Chris Moy said that, unlike viruses like COVID-19, it requires “fair contact, so it’s not something that will spread like wildfire.”
“It’s actually quite difficult to catch. Typically, it requires very close physical contact with someone else who has been infected with it and goes through skin, broken skin or through the eyes or nose, ”he told SBS News.
Dr Moy said most cases are mild and include symptoms of a high fever, headache, swollen lymph nodes, muscle and muscle aches, and a blistering smallpox-like rash on the body.
People with monkeypox are usually infectious for up to 21 days, until the lesions have healed and the symptoms no longer persist.
Who is at risk?
People at risk are those who have had close physical contact with someone infected while they are symptomatic.
Associate Professor John Blakey, a respiratory physician at Sir Charles Gairdner Hospital, told SBS News that “we are all at risk of contracting a virus to which we do not have that kind of natural immunity.”
According to the WHO, many of the reported cases from non-endemic countries have been identified in men who have sex with men.
“The reason we are currently hearing more case reports of monkeypox in communities of men having sex with men may be due to positive health-seeking behavior in this demographic group,” he says.
Professor Blakey said this was likely due to the mode of transmission rather than this community more or less vulnerable to catching the virus.
“There seems to have been a large spread event … that’s why there seem to be a lot of reports of transmission among men having sex with men,” she said.
On Sunday the United Nations AIDS agency (UNAIDS). that some monkeypox reports have used language and imagery that “reinforce homophobic and racist stereotypes,” warning to exacerbate stigma and undermine the response to the growing epidemic.
“Stigma and guilt undermine confidence and the ability to respond effectively during outbreaks like this one,” said UNAIDS Deputy Executive Director Matthew Kavanagh.
Thorne Harbor Health is a community organization that supports LGBTIQ + communities in Victoria.
Its Director of Promotion Policy and Communications, Colin Batrouney, said these narratives were “married during the first decades of the HIV and AIDS epidemic with catastrophic effects for both gay men, their loved ones and the community. in general”.
“Hopefully we’re over now,” he said.
He said the impacts of language stigma are many.
“For some, it reinforces both internalized and external homophobia which can have devastating consequences for the mental health and well-being of gay men,” he said.
“In addition, it can lead to gay men not seeking diagnosis or treatment when they need it, leading to increased transmission and acquisition of infections.”
But WHO points out that the risk of monkeypox is not limited to sexually active people or men who have sex with men.
“Anyone who has close physical contact with someone who is contagious is at risk. Anyone with symptoms that could be monkeypox should seek immediate advice from a health care practitioner, “she says.
How worried should we be?
At this point, experts warn that the risk to the general population is low, but awareness is important in managing the outbreak.
Sylvie Briand, WHO director of preparedness for global infectious risks, said Tuesday that although the outbreak “was not normal”, it was “containable”.
“We don’t make a mountain out of a pile of moles,” he said speaking at the World Health Assembly in Geneva.
In Australia, Dr Moy said there is currently no need for the general public to panic.
“It’s really more of a medical issue that we need to pay attention to and hopefully when we have more information, we will have a better idea of what we need to do,” he said.
“We’ve all been shocked after COVID-19, but I don’t think we’ll be talking about anything like that in regards to monkeypox.”
Professor Blakey said people should take simple steps that have already become common practice due to the COVID-19 pandemic, including keeping physical distance, being careful with coughing and sneezing, wearing masks in crowded public places, and disinfect your hands.
He said people should also be aware that the virus can also spread by handling infected clothing and underwear.
Is it a vaccine?
According to the WHO, vaccines used during the smallpox eradication program also provide protection against monkeypox, while newer vaccines have also been developed and approved for use against the virus.
WHO is working on new guidelines for countries on vaccination strategies and is calling further meetings to support member states with further advice on how to address the situation.
Some countries are already taking precautionary measures to vaccinate people who may have been exposed to the virus.
France and Denmark have begun vaccinating close contacts for the virus, while Germany has ordered 40,000 doses to be ready to implement a similar strategy if an outbreak in the country becomes more severe.
Dr Moy said there is currently no vaccination strategy for monkeypox in Australia, but if needed in the future, it would primarily focus on close contacts.
On Saturday, Victoria’s Chief Health Officer Brett Sutton said conversations were ongoing with the Commonwealth about national medical supplies and the use of the smallpox vaccine for those who may have been exposed, along with the potential need for a small fraction of the frontline health workers are vaccinated.
He said someone’s close contacts with the virus will likely be asked to quarantine. Who is considered close contact and a time frame for isolation would be determined, she said.
The state health department asks anyone who develops symptoms, particularly if they have recently traveled abroad or had contact with a case, to seek medical assistance.