Do you catch monkeys?
Until this worldwide epidemic, the monkey was spread by infected rodents – including mice, rats and even squirrels – in West and Central Africa.
Humans can contract the disease – which comes from the same family as smallpox – if they are bitten by infected animals, come into contact with their blood, body fluids, or pus, or eat wild game or bushmeat.
Orthopoxvirus, which causes pox, can enter the body through broken skin – even if it is not visible, including the eyes, nose and mouth.
Despite being spread mostly by wild animals, it was known that the monkey can be transmitted between people. However, health chiefs insist it was rare until the current outbreak.
Human-to-human transmission can occur if a person touches clothing or bedding used by an infected person, or by direct contact with viral storyboards. The virus can also spread through coughing and sneezing.
In the ongoing increase in cases, experts think the virus passes from skin to skin during sex – although this mechanism has not been seen until now.
How deadly is it?
Acne is usually mild, with most patients recovering within a few weeks without treatment.
However, the disease kills up to 10 percent of cases. But this high rate is thought to be due to a historical lack of testing meaning that a tenth of known cases are deaths rather than a tenth of all infections.
However, with the mild form the death rate is around one in 100 – the same as when Covid first hit.
The West African version of the virus, which is mild compared to the Central African strain, is responsible for the current outbreak. No deaths have been reported as part of the ongoing outbreak.
How is it tested?
It can be difficult to identify shingles as it is often confused with other infections such as chicken pox.
The diagnosis is confirmed by a clinical assessment by a health professional and examination at a UK specialist laboratory – the UKHSA Virtuous and Ordered Cell Laboratory.
The test involves taking a sample from a skin lesion, such as a patch of rash, fluid from the lesion or pieces of dry crust.
What are the symptoms?
It can take up to three weeks for monkey-infected patients to develop any telltale symptoms.
Early symptoms of the virus include fever, headache, muscle aches, back pain, swollen lymph nodes, chills and fatigue – meaning it could, in theory, be mistaken for other common illnesses.
But its unusual feature is a rash that often starts on the face, then spreads to other parts of the body, usually the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which eventually falls off.
How long is a person contagious?
A person is contagious from the moment his rash appears until all the rashes fall off and there is skin underneath.
The rash may also contain an infectious virus.
The contagious period is thought to last for three weeks but can vary between individuals.
What should I do if I have symptoms?
NHS England is advising Britons to contact their sexual health clinic if they have a rash and blisters and have been in close contact with a suspected or confirmed case of rabies or have been to West or Central Africa in the past three weeks.
Britons are asked to contact the clinic before their visit and avoid contact with others until they have been seen by a doctor.
Gay men and bisexual people have been asked to be especially careful with these symptoms as most cases are diagnosed in men who have sex with men.
What is a monkey even?
The monkey was first discovered when an outbreak of a smallpox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of the Congo and infections have been reported in several countries in central and western Africa since then.
Only a few cases have been reported outside of Africa and they were restricted to people with travel links to the continent.
The UK, USA, Israel and Singapore are the only countries to have detected the virus before May 2022.
Mumps is a rare viral disease that kills up to one in ten of those infected but does not spread easily between people. This tropical disease is endemic in parts of Africa and is characterized by rare and unusual rashes, bumps and sores (file photo)
Nurses and doctors are advised to be ‘watchful’ for patients who have a new rash or rash lesions (as above)
Is it related to chicken pox?
Despite causing such a rash, chicken pox is not related to monkeys.
The infection, which usually affects children, is caused by the varicella-zoster virus.
In contrast, monkeypox – like smallpox – is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against mallypox.
Are young people more dangerous?
Britons under the age of 50 are most likely to be affected by mumps, according to the World Health Organisation.
This is because children in the UK were routinely given the smallpox jab, which protects against mumps, until 1971.
WHO also warns that the death rate has been high among young children.
Does it spread as easily as Covid?
Top experts insist we won’t see Covid-style infection rates in the monkey outbreak.
A World Health Organization report last year suggested the natural R 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 one-third the R level of the Indian ‘Delta’ strain.
But the actual rate may be lower because ‘distinctive symptoms are very helpful in its early detection and prevention,’ the team said, meaning it is easier to detect cases and isolate them.
Covid is spread mainly through droplets that an infected person emits whenever they breathe, talk, cough or sneeze.
How is the UK managing the outbreak?
MailOnline revealed monkey patients and their close contacts, including NHS staff, are being given the Imvanex smallpox vaccine.
The strategy, known as ring vaccination, involves shooting and monitoring anyone in close proximity to an infected person to create a herd of immunity to prevent the spread of the disease.
Additionally, people close to those with confirmed monkey infection are told to stay at home for 21 days and avoid contact with children under 12, immunocompromised people and pregnant women.
The government said unprotected direct contact or high-risk environmental exposure included living in the same house as a person with a monkey, having sex with them or even simply changing their bedding ‘without appropriate PPE’.
As with Covid, a person who has come within one meter of an infected person is classified as a monkey touch.
This low contact category, which also includes sitting next to a person with a monkey on a plane, means that the monitor will call them every day for three weeks and will be advised to stay out of work for 21 days if their work involves children or colleagues who are not immune.
Britain has stopped requiring people by law to quarantine themselves if they become infected with monkeys, but ministers are considering a public health campaign to alert gay and bisexual men, because of the number of cases in this group.
What if it continues to spread?
Experts told MailOnline they ‘could see a role’ in the introduction of the jab for gay men in the UK ‘if this is not dealt with quickly’.
People close to known cases in the UK are already being given the jab, which was originally designed for smallpox. The two viruses that cause scabies are very similar.
A health source told MailOnline ‘there will be a number of strategies we would look at’ if cases continue to rise.
Professor Kevin Fenton, London’s regional director of public health, said if outbreaks in the capital continue to grow then the distribution of vaccines and treatment could be extended to more groups.
He said there are ‘plans in place’ to have more antiviral drugs if the outbreak continues to grow.
What other countries have detected cases?
More than 40 countries – including America, Spain and Italy – have detected monkey cases.
Most cases have been detected in the UK, Spain, Portugal, Canada and Germany.
There are a few antiviral drugs and treatments for smallpox that seem to work against monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January.
Is there a vaccine for it?
The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against smallpox because the viruses that cause the diseases are closely related.
Figures show 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 a dose, contains a modified vaccine virus, which is similar to smallpox and monkeypox, but does not cause disease in people.
Because of its similarity to the pox virus, antibodies produced against this virus provide cross protection.
Are there drugs to treat it?
There are a few antiviral drugs and smallpox treatments that seem to work for monkeys.
This includes the drug tecovirimat, which was approved for monkeys in the EU in January.
Tecovirimat blocks the virus from the infected cell, preventing the spread of the virus in the body.
An antiviral drug used to treat AIDS called cidofovir can be used to control the infection, according to the US Centers for Disease Control and Prevention (CDC).
It also works by inhibiting the growth of viruses.