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Rare Cases of Monkeypox Diagnosed in Britain
None of the individuals had traveled to the African countries where the virus is endemic
TUESDAY, May 17, 2022 (HealthDay News) -- Four men in England have been infected with a "rare and unusual" monkeypox virus.
Investigators from the U.K. Health Security Agency are investigating the cases and whether there is any connection between the men, according to the Associated Press. None of the individuals had traveled to the African countries where the virus is endemic. Three of the men are in London, and one is in Northeast England.
Three earlier cases were announced last week. In those cases, two of the patients lived in the same household. The third person had previously traveled to Nigeria, one of the countries where the virus is endemic in animals. Most people who get monkeypox recover quickly, within several weeks. The virus has symptoms that include fever, muscle ache, chills, and fatigue. A rash similar to that found in chickenpox and smallpox can form on the face and genitals in more severe cases.
The latest four cases all happen to be in men who identify as gay, bisexual, or men who have sex with men. However, monkeypox does not easily spread between people, and it is not known to be transmitted sexually. In Western and Central Africa, the virus is typically spread by touching or being bitten by an infected wild animal. However, it could be spread among people with extremely close contact, the British health officials said.
"The evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact," said Susan Hopkins, M.D., chief medical advisor for the U.K. Health Security Agency, the AP reported. "We are particularly urging men who are gay or bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay."
Public health officials consider the risk to the general population to be low. They are working with hospitals and international partners to determine if there is a similar rise in cases in other places. This includes tracing people who had contacts with the monkeypox cases, including airline passengers, the AP said. Doctors who see patients with unexplained rashes should seek advice from a specialist, public health officials said.
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Primary Care
Monkeypox is not COVID
The last time monkeypox was on my radar was in 2003, with almost half of the 35 confirmed cases surfacing in my home state of Wisconsin.1 The world had just emerged from the SARS-CoV-1 scare with its 8000 illnesses and 700 deaths; after spreading to 29 countries, it simply disappeared. The majority of the patients with monkeypox reported exposure to prairie dogs (which were likely infected at a pet distribution center in Texas involved with the importation of African rodents) and about 26% of the patients were hospitalized—some as a precaution only—and 2 of the patients presented with serious clinical illness.
Today, monkeypox has returned to the headlines (which often fail to note that there has been a persistent outbreak in Nigeria since 2017… apparently, it takes emergence in European nations, Australia, and North America to garner attention). As of May 25, 219 cases had been recorded in nations where monkeypox is not considered endemic, including 5 cases in the United States.
Monkeypox is related to smallpox and causes a self-limited disease lasting from 2 to 4 weeks.2 Transmission usually occurs through close contact (via lesions, bodily fluids, large respiratory droplets, and contaminated material) with an infected person or animal. Incubation occurs over 6 to 13 days (range, 5—21 days) following infection. Initial symptoms (lasting 0–5 days) include fever, headache, lymphadenopathy, back pain, myalgia, and asthenia. The eruption of skin lesions occurs 1 to 3 days after the appearance of fever, primarily on the face (95% of cases), palms of the hands and soles of the feet (75%), oral mucosa (70%), genitalia (30%), and conjunctiva (20%). Lesions typically evolve from macules to papules, vesicles, pustules, and crusts. The case-fatality rate is 3% to 6%.
So, is this our next pandemic? I think not. We should be vigilant, but not overly worried. There are several features of monkeypox, which are favorable for public health intervention:
Keep your eyes open, keep informed, and report immediately any suspect cases to your local or state public health department.
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