Eleven countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind
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Monkeypox is spreading globally for the first time, in an outbreak that has caught health officials off-guard.

Eleven countries including Australia have now detected the tropical virus, which is usually only spotted within Africa.

Two men from Sydney and Melbourne have both returned from Europe infected with the rare tropical disease.

The Victorian case is known to have been in the UK where there are currently 20 cases, which are all among men from the gay and bisexual community.

Germany and Belgium today became the latest nations to declare monkeypox cases, while France and Australia announced patients had tested positive overnight.

Eleven countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind

Eleven countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind

A disproportionate number of cases are in gay and bisexual men, authorities have said. Health chiefs say the pattern of transmission is ‘highly suggestive of spread in sexual networks’.

NSW chief health officer Dr Kerry Chant said: ‘It is important to be particularly vigilant if you returned from overseas from large parties or sex on premises venues overseas.

‘You can imagine that some settings, such as sex on premises venues or other events and gatherings may lead to sort of what we’ve seen as super spreading events.

‘It is important that people who have recently returned from Europe who attended such parties be particularly alert given the worldwide case reports today.’

Here is everything we know about the monkeypox outbreak so far: 

Monkeypox is a rare viral infection which causes unusual rashes or lesions (shown in a handout provided by the Centers for Disease Control and Prevention (CDC) in the US

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)

How do you catch monkeypox?

Until this worldwide outbreak, monkeypox was usually caught from infected animals in west and central Africa.

The tropical virus is thought to be spread by rodents, including rats, mice and even squirrels. 

Humans can catch the illness — which comes from the same family as smallpox — if they’re bitten by infected animals, or touch their blood, bodily fluids, or scabs. 

Consuming contaminated wild game or bush meat can also spread the virus.

The orthopoxvirus can enter the body through broken skin — even if it’s not visible, as well as the eyes, nose and mouth.

Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people.

However, health chiefs insist it is very rare.

Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus’ tell-tale scabs. 

The virus can also spread through coughs and sneezes. 

In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.

How is it tested for? 

It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox. 

Monkeypox is confirmed by a clinical assessment by a health professional and a test in a specialist lab.

The test involves taking samples from skin lesions, such as part of the scab, fluid from the lesions or pieces of dry crusts. 

What are the symptoms?

It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.

Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.

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.

How long is someone contagious?

An individual is contagious from the point their rash appears until all the scabs have fallen off and there is intact skin underneath.

The scabs may also contain infectious virus material.

The infectious period is thought to last for three weeks but may vary between individuals.

What even is monkeypox?

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. 

The UK, US, Israel and Singapore are the only countries which had detected the virus before May 2022.

Nurses and doctors are being advised to stay 'alert' to patients who present with a new rash or scabby lesions (like above)

Nurses and doctors are being advised to stay ‘alert’ to patients who present with a new rash or scabby lesions (like above)

Is it related to chickenpox?

Despite causing a similar rash, chickenpox is not related to monkeypox.

The infection, which usually strikes children, is caused by the varicella-zoster virus. 

For comparison, monkeypox — like smallpox — is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.  

Are young people more vulnerable?

Britons aged under 50 may be more susceptible to monkeypox, according to the World Health Organization.

This is because children in the UK were routinely offered the smallpox jab, which protects against monkeypox, until 1971.

The WHO also warns that the fatality rate has been higher among young children. 

Does it spread as easily as Covid?

Leading experts insist we won’t be seeing Covid-style levels of transmission in the monkeypox outbreak.

A World Health Organization report last year suggested the natural R rate of the virus – the number of people each patient would infect if they lived normally while sick – is two. 

This is lower than the original Wuhan variant of Covid and about a third of the R rate of the Indian ‘Delta’ strain. 

But the real rate is likely much lower because ‘distinctive symptoms greatly aid in its early detection and containment,’ the team said, meaning it’s easy to spot cases and isolate them.

Covid is mainly spread through droplets an infected person releases whenever they breathe, speak, cough or sneeze. 

What do Australia health authorities say? 

On Friday, NSW chief health officer Dr Kerry Chant sent out an urgent warning for gay men in particular to watch out for symptoms – which include unusual rashes – and seek immediate help if worried.

‘We know it’s transmitted by that close skin to skin contact – you can be infectious and that close droplet contact in a very sort of close prolonged way,’ Dr Chant said.

‘We’re particularly urging men who are gay or bisexual, or men who have sex with men, to be aware of any unusual rashes or lesions and to contact by phone a sexual health clinic or GP without delay if they have any concerns.’

NSW health minister Brad Hazzard said the disease may currently be spreading like wildfire through Europe and the US as a result of the current warm weather party season.

‘In Europe and North America, they’ve come out of COVID and there’s a lot of partying going on.’ he said.

‘This virus is something which particular groups in the community are more likely to have and to convey as a result of the close associations that occur with people during this partying season in Europe.’

Dr Chant added: ‘It is important to be particularly vigilant if you returned from overseas from large parties or sex on premises venues overseas.

‘You can imagine that some settings, such as sex on premises venues or other events and gatherings may lead to sort of what we’ve seen as super spreading events.

‘It is important that people who have recently returned from Europe who attended such parties be particularly alert given the worldwide case reports today.’

Dr Chant said NSW Health has taken steps to ensure it identifies and reacts to any potential cases, including alerting sexual health clinics.

‘NSW Health has issued a clinician alert to GPs and hospitals across the state,’ she said, ‘We will be speaking with GPs about this issue again today.

‘Cases are occasionally reported in non endemic countries in returning travellers or their close contacts, or in owners of imported pets.

‘The infection is usually a mild illness and most people recover within a few weeks.’

 

What other countries have spotted cases?

Twelve countries — including the US, Spain and Italy — have now detected cases of monkeypox.

Spain this morning reported 14 new confirmed 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.

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. 

Meanwhile, Australia last night confirmed two cases, including one man in his thirties who had travelled from Britain to Melbourne with symptoms earlier this week. 

The Netherlands Portugal, Sweden and Canada have also detected cases.

How deadly is it?

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. 

Yet, the disease 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 version 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.

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related

Is there a vaccine for it? 

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related. 

 

Data shows it prevents around 85 per cent of cases, and has been used ‘off-label’ in the UK since 2018. 

The jab, thought to cost £20 per dose, contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people. 

Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.

Are there any drugs? 

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January

There are also a handful of antivirals and therapies for smallpox that appear to work on monkeypox.

This includes the drug tecovirimat, which was approved for monkeypox in the EU in January.

Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus within the body. 

An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).

It also works by stopping the growth of the virus.

What is the situation with the UK outbreak?

Twenty cases were confirmed in the UK between May 6 and 20.

No details about the eleven confirmed on May 20 have been released yet. 

But six of the previous nine confirmed cases were in men who have sex with men — which officials say is ‘highly suggestive of spread in sexual networks’.

How worrying is it?

UK health chiefs say the risk of a major outbreak is low.  

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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