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Monkeypox – what Kiwi experts say you need to know

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What you need to know about the virus that causes monkeypox.
Video / AP / Getty

The Ministry of Health and infectious disease experts have reassured the public that monkeypox is a safely manageable disease, after the first case was detected in New Zealand tonight.

The infected person is in their 30s, and in isolation at their Auckland home after recently returning from overseas travel in a country with reported cases of monkeypox, the ministry said in a statement just after 7pm.

Infectious disease expert, Professor Michael Baker, told the Herald tonight there was no need for the public to panic about the emergence of the disease that has been detected in 50 countries.

“It’s a very manageable infectious disease, nothing like Covid-19,” the University of Otago epidemiologist said.

“It generally has a very good outcome particularly in adults in high income countries like New Zealand. It’s a case of recognising and managing cases effectively. They’ve had multiple cases in Australia, it was just a matter of time before we got cases here.”

University of Otago infectious disease expert, Professor Michael Baker, says there is no need for the public to panic about the emergence of the disease in NZ that has been detected in 50 countries.
University of Otago infectious disease expert, Professor Michael Baker, says there is no need for the public to panic about the emergence of the disease in NZ that has been detected in 50 countries.

In their statement tonight, the ministry also assured that most people with monkeypox can be safely managed at home and there have been very few deaths from monkeypox globally.

In late May, Associate Minister of Health Dr Ayesha Verrall said the disease is unlikely to spawn a major local epidemic and many infected people get better without treatment.

But what should the Kiwi public know about the global ​​outbreak of a disease that rarely appears outside Africa?

WHAT IS MONKEYPOX?

Monkeypox is a virus that originates in wild animals like rodents and primates and sometimes jumps to people – mostly in central and west Africa, where the disease is endemic.

Scientists first identified the disease in 1958 after two outbreaks of a “pox-like” disease in research monkeys. The first known human infection was in 1970, in a 9-year-old boy in Congo.

WHAT ARE THE SYMPTOMS AND HOW IS IT TREATED?

Monkeypox belongs to the same virus family as smallpox but it has milder symptoms.

In their statement tonight, the ministry said some smallpox vaccines can provide protection against the virus.

The ministry is currently working with Pharmac to explore options for access to smallpox vaccines that can be used as part of the targeted prevention of spread of monkeypox in certain situations. Anti-viral drugs are also being developed.

Health officers use thermal head checks to detect monkeypox on arriving passengers at Soekarno-Hatta International Airport in Tangerang near Jakarta, Indonesia. Photo / Getty Images
Health officers use thermal head checks to detect monkeypox on arriving passengers at Soekarno-Hatta International Airport in Tangerang near Jakarta, Indonesia. Photo / Getty Images

The first symptoms of monkeypox include one or more of the following: headache, acute onset of fever (>38.0C), chills, swollen lymph nodes, muscle and body aches, backache and tiredness. The characteristic rash, which typically looks similar to chickenpox, appears after a few days.

“Anyone with lesions that look like chickenpox who have been in contact with a case or have been to Africa should be wary,” Baker said.

Monkeypox can be fatal for up to one in 10 people and is thought to be more severe in children.

The US Centres for Disease Control and Prevention said incubation – from infection to symptoms – usually lasted one week to a fortnight but could be as short as five days and as long as three weeks.

But most people recover within about two to four weeks without being hospitalised.

Belgium has introduced a compulsory three-week quarantine for anyone infected with monkeypox.

Associate Health Minister Dr Ayesha Verrall says local health officials have been in touch with peers overseas about monkeypox. Photo / Mark Mitchell
Associate Health Minister Dr Ayesha Verrall says local health officials have been in touch with peers overseas about monkeypox. Photo / Mark Mitchell

“We certainly have to be prepared for the scenario because it has been in other Western countries,” Verrall said of New Zealand’s own response.

University of Canterbury Associate Professor of Epidemiology Arindam Basu believed protection measures will be necessary in New Zealand, as over the next few weeks more Monkeypox cases will likely emerge.

“Monkeypox and Covid-19 are different diseases and spread through somewhat different pathways, but at a personal level, personal hygiene measures and protection with masks are super important for both diseases, especially as Covid-19 cases will continue to rise,” Basu said.

“Being watchful about contacts, keeping a diary, and getting the tests at the first instances of common cold-like symptoms may be helpful.”

Since reports of monkeypox emerged internationally, the ministry has provided information about the virus on its website.

The ministry has also provided advice to public health units, primary health organisations and sexual health clinics to assist with identifying potential cases.

HOW MANY MONKEYPOX CASES HAVE THERE BEEN IN THE PAST?

The World Health Organisation estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6000 cases annually, and Nigeria, with about 3000 cases a year.

However, many infected people are likely missed due to poor health monitoring systems in various countries.

Isolated cases of monkeypox are spotted outside Africa, including in the US and Britain, but the cases have typically been associated with travel to Africa or contact with animals from areas where the disease is more common.

The Associated Press reported that in 2003, 47 people in six US states had confirmed or probable cases. They caught the virus from pet prairie dogs housed near imported small mammals from Ghana.

WHAT IS DIFFERENT ABOUT THIS OUTBREAK?

It’s the first time monkeypox appears to be spreading among people who didn’t travel to Africa. Most of the cases involve men who have had sex with men.

In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden.

Britain’s Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening. The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.

IS MONKEYPOX SPREAD THROUGH SEX?

The ministry said in a statement cases of monkeypox outside of endemic countries have primarily been identified among gay and bisexual men and men who have sex with men, and international cases have been clustered around events where this occurs.

Monkeypox had not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people’s body fluids and clothing.

Dorsal surfaces of the hands of a monkeypox patient, showing a rash during the recuperative stage. Photo / CDC via AP
Dorsal surfaces of the hands of a monkeypox patient, showing a rash during the recuperative stage. Photo / CDC via AP

Verrall said monkeypox lesions were distinctive but the disease could incubate undetected at first.

“It can be transmitted by close physical contact or by droplets … But the suspicion is that the cluster that’s emerging in Europe has been spread by sexual contact,” she said.

Michael Skinner, a virologist at Imperial College London, told the Associated Press in May it’s still too early to determine how the men in the UK were infected.

“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person’s sexual orientation and irrespective of the mode of transmission.”



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