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Monkeypox patients could pass on the disease for up to four weeks after symptoms appear, experts tell DailyMail.com as the virus spreads to eleven nations.
Dr Amesh Adalja, an emerging infectious diseases experts at John Hopkins University, made the warning in an interview today.
People who catch the virus initially suffer a fever before rashes and skin lesions appear on the face and body. The virus can then be passed on through touching the affected areas or via droplets expelled in coughs and sneezes.
Experts warn America will detect more cases of monkeypox in the coming days as health chiefs probe at least seven suspected infections, including in New York City.
One case has been confirmed in Massachusetts in a resident who had recently traveled from Canada by car, but experts warn more will crop up in other states.
Eleven countries have reported cases to date outside of west Africa — where the virus is endemic — with Canada yesterday saying it had spotted two infections.
The outbreak has stoked fears internationally over the outbreak with the World Health Organization today convening an emergency meeting on the outbreak.
Also Friday, the Food and Drug Administration approved a smallpox drug that is planned to be used to treat incoming monkeypox patients.
Eleven countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind. More cases are expected in the coming days
Eleven more Britons have been diagnosed with monkeypox and all but one of them appear to have contracted it in the UK. The original UK patient had brought the virus back from Nigeria, where the disease is widespread
Dr Amesh Adalja (pictured), an infectious disease expert at Johns Hopkins, warned that there will likely be more cases of the virus in the U.S., but it is too early to say if it will eclipse the record mark of 43 cases set in 2003
Adalja told DailyMail.com that monkeypox patients could be infectious for up to four weeks.
He added: ‘[This is because] it can take a few weeks for the skin lesions to disappear.
‘People are contagious until their active skin lesions have dissipated.’
Dr Michael Head, a global health expert at Southampton University in England, agreed saying: ‘Based on previous monkeypox outbreaks and guidance from the NHS and WHO, the infectious period (i.e. when the virus can be transmitted to another person) can be comparable to the time period where the rash and blisters are present. This may be for two weeks, and may be longer.
‘Specifically here in this outbreak, we’re learning more about the cases and their presentations, and so many basic questions about their epidemiology are still to be clarified.
‘However, if onward transmission can indeed take place over a longer period of time, early identification of any possible cases is going to be vital in efforts to break those chains of transmission and contain the outbreak.’
New York City health officials revealed yesterday they were probing a suspected case at Bellevue Hospital in lower-Manhattan.
The unnamed patient was isolated and preliminary tests are now being conducted to confirm the infection. It is not clear where they may have caught it.
At least six other patients are also being monitored for infection after sitting within three seats of a case on a flight from Nigeria to the UK on May 4. Experts say the chance they have caught the virus is ‘low’.
On Wednesday America confirmed its first case of the virus this year with an infection in an unnamed man in Massachusetts.
The individual has been hospitalized and is understood to be in ‘good condition’. Work has begun to trace their close contacts.
Experts warn it is likely the U.S. will detect many more cases in the coming days in other states, but that it was not yet clear whether this would reach the heights of the 2003 outbreak where 43 people caught the virus.
Cases have also been detected in Canada, Belgium, France, Portugal, Spain, Italy, Sweden, the UK and Australia.
Health chiefs have raised concerns as it is not clear what has sparked the outbreak.
Several clusters of cases have bene detected so far, with most not linked to travel to west Africa — where the virus is endemic.
A number have also been linked to gay and bisexual men.
But Adalja emphasized yesterday that the virus may not have been passed on through sexual transmission, rather many individuals of this orientation could have been at a social event where the virus passed on.
Health authorities in the UK confirmed another 11 monkeypox cases today, more than doubling their previous total of nine.
Most cases are ‘mild’, with the country having secured ‘further doses of vaccines that are effective against monkeypox’.
The country is currently probing gay bars for the virus, and has asked sexual health clinics to check anyone who comes in with a rash — normally associated with STIs — for the virus.
Monkeypox is normally spread through contact with wild animals in west Africa, typically squirrels.
But in humans it can also be passed on through physical contact or respiration.
Initial symptoms appear about five to 21 days after infection and include a fever, headache, muscle aches, backache, chills and exhaustion.
A rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals. It goes through several different stages — making it look like chickenpox or syphilis — before finally forming a scab and falling off.
About one in ten cases of the virus are fatal, according to estimates.
But scientists say the strain currently circulating is less deadly, with about one in 100 patients dying from the virus — similar to when Covid first took off.
There is no specific treatment for monkeypox, but today the FDA approved the smallpox drug TPOXX for patients with the virus.
It is typically kept in reserve for smallpox cases, but because of the similarity between the viruses can also be deployed against monkeypox.
Monkeypox is spread via physical touch, experts say, which would explain why it seems to have spread in the sexual network of gay and bisexual men in parts of Europe
People who are infected with monkeypox often suffer from severe rashes, skin lesions and flu like symptoms. The virus kills around one-in-ten people it infects, though there is belief that the current strain making its way around the world has a mortality rate of one percent
There is also a vaccine available, called Jynneos, for people to help protect them against the virus. Data shows the jab prevents around 85 percent of cases.
The vaccine contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people.
The U.S. is already stockpiling the jabs for future, ordering 13 million for a reported $299 million.
Smallpox has been eradicated worldwide through vaccination and British children have not routinely been offered the jab since 1971.
It comes as the WHO confirms it is meeting today to discuss the growing outbreak in western nations.
Dr Meaghan Kall said the meeting confirms the agency is ‘taking the situation seriously’.
Spain today reported another 14 cases, bringing the nation’s total to 21. And Belgium detected two cases, one in Antwerp and the other in Flemish Brabant.
Germany subsequently confirmed its first ever monkeypox case in a patient who had ‘characteristic skin lesions’ — a tell-tale sign of the illness.
Meanwhile, France last night confirmed a 29-year-old man in Paris had contracted the virus. He had not recently travelled, suggesting the virus is spreading in the community.
And Australia last night confirmed two cases, including one man in his thirties who had travelled from Britain to Melbourne with symptoms earlier this week.
Elsewhere, Portuguese researchers today published a draft genome sequence of the virus.
The data, obtained from a male patient whose infection was confirmed on May 4 after he spotted skin lesions, will help scientists determine the origin and international spread of the currently circulating virus.
EVERYTHING you need to know about monkeypox: Strain ‘transmits through sex’ and is about as deadly as the Wuhan Covid variant — but a vaccine does exist
Monkeypox appears to be spreading globally for the first time in an outbreak that has caught health officials off-guard.
The UK has recorded seven cases of the virus but the majority of them are not linked which suggests more are going undetected.
Spain and Portugal have also spotted the virus for the first time ever and the US is monitoring six people who were on a flight with a positive case.
The majority of patients in the UK are gay or bisexual men, as are the eight Spanish men suspected of having the disease.
Portuguese officials have confirmed five men tested positive and over a dozen more are thought to be infected.
Health chiefs in the UK say the pattern of transmission is ‘highly suggestive of spread in sexual networks’.
Until now monkeypox had only been detected in four countries outside of Africa — the UK, US, Israel and Singapore, all of whom had links to Nigeria and Ghana.
Infections are more common in central and western Africa, where they can result from direct contact with infected animals.
Monkeypox can kill up to one in 10 people it infects — but the strain spreading globally is milder and has a fatality rate of about one in 100.
That is roughly the same as the first strain of Covid that came out of Wuhan, however vaccines and natural immunity have since made the coronavirus much weaker.
Monkeypox’s similarity to smallpox means jabs and drugs against that virus are also effective.
Here is everything we know about the UK monkeypox outbreak so far:
Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)
What is monkeypox?
Monkeypox is a rare viral infection which people usually pick up in the tropical areas of west and central Africa.
It is usually spread through direct contact with animals such as squirrels, which are known to harbour the virus.
However, it can also be transmitted through very close contact with an infected person.
Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.
Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent.
How deadly is it?
Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. Yet, the disease can prove fatal.
Monkeypox kills up to 10 per cent of people it infects.
However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.
The UK cases all had the West African strain of the virus, which is mild compared to the Central African strain.
It is thought that cases in Portugal and Spain also have the milder version, though tests are underway.
Is there a cure?
Because monkeypox is closely related to the virus that causes smallpox, jabs for smallpox can also protect people from getting monkeypox.
One vaccine, Jynneos, also known as Imvamune or Imvanex, has been licensed in the U.S., but it’s not approved in the UK.
The vaccine was shown to be around 85 percent effective in preventing monkeypox infection.
Antivirals and pooled blood from individuals vaccinated against smallpox can be used to treat severe cases.
What is the situation with the current UK outbreak?
Seven cases of monkeypox have been confirmed in the UK between May 6 and 15.
Six of the infected Brits had not recently travelled abroad, suggesting there is transmission between people in the UK for the first time.
Some of the cases are believed to have caught the virus through sex — which health experts have described as ‘bizarre’.
Monkeypox was not thought to spread via sexual intercourse but through close contact with lesions or respiratory droplets. However, just because it can spread during sex does not mean it is the virus’ primary route of transmission, nor does it make it an STI.
British medical chiefs are tracking down contacts of those infected to identify additional cases, as it is not clear how all of the infected people caught Monkeypox.
Health leaders are also working with international agencies to determine if similar outbreaks are occurring elsewhere.
What do we know about the U.S. cases?
One case has been confirmed in the U.S. in a man who travelled from Canada to Massachusetts by car.
The individual — who has not been named — is now in hospital and said to be in a ‘good condition’.
Officials are probing a case in New York City to determine whether a man has the virus. Another six people who shared a flight with a British monkeypox case are also being monitored.
Dr Jennifer McQuiston, a senior CDC official, warned that Britain’s current spate of cases could be the tip of the iceberg.
The lack of travel links and connections between the UK cases suggest there are ‘unknown chains of transmission happening’, she said.
‘You have two clusters that have no link to travel or to other people who are known to be associated with a recognised outbreak.
‘It suggests that there are unknown chains of transmission happening. If there appears to be unknown chains of transmission, it just puts on alert to be thinking: “Could this be spreading outside the UK?”‘
How worrying is it?
Health chiefs say the risk of a major outbreak is low.
But they have urged gay, bisexual and other men who have sex with men to be extra vigilant because they appear to be at higher risk of catching it.
These groups have been urged to look out for any unusual rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service without delay if they have concerns.
Most scientists believe the outbreak will be small and transmission nothing like the levels seen with Covid.
This is because monkeypox is poor at spreading between humans and relies on very close and prolonged contact between people.
How does it spread?
Monkeypox is not a sexually transmitted infection by nature, though it can be passed on by direct contact during sex.
Contagious lesions, through which infections are most likely to be passed on, can appear on any part of the body.
The infection can also be passed on through contact with clothing or linens used by an infected person.
Until now, monkeypox had only ever been detected in four countries outside of Africa – the UK, U.S., Israel and Singapore.
And all of those cases had travel links to Nigeria and Ghana.
What are the symptoms?
Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.
But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
What do I do if I have symptoms?
Anyone worried that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit.
Health chiefs say their call or discussion will be treated sensitively and confidentially.
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