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Monkeypox: Six of your questions answered by an expert virologist

‘ANYONE can get it, it is just chance that it is spreading this way’

The Independent
Thursday 26 May 2022 18:09 BST
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Confirmed cases of monkeypox are rising int he UK with the latest number believed to be 81 as of Thursday.

Northern Ireland and Wales recorded their first cases earlier today. The UK Health Security Agency said the risk to the general population remains low despite the rising number of infections and added they have secured more than 20,000 Imavanex vaccines to treat monkeypox.

”There is still a lot about this outbreak that we do not yet know,” said Dr Sarah Pitt, lecturer at the University of Brighton and the Chief Virology Examiner for the Institute of Biomedical Science, who took part in an ‘Ask Me Anything’ for The Independent.

The virologist answered readers questions for an hour on Thursday afternoon. Here are six questions from readers and the answers from Dr Pitt.

What is the likelihood of asymptomatic transmission of this virus?

The World Health Organisation, which has been monitoring transmission in African countries where is it usually found says it is uncertain. However I think people will always get some symptoms even if it is only a few spots. Since many people recover without needing medical help, in countries where monkeypox is common, I suspect people do not always seek medical help, so the case is not officially recorded, but they could still pass it on. It is in the same virus family as smallpox and everyone who got that always showed symptoms.

Have these cases been ruled out as being shingles caused by antibody-dependent enhancement?

Yes. Samples from several of the patients have now been tested and the virus fully sequenced. They are all coming back as the same strain of monkeypox virus. Varicella-zoster virus which causes shingles is a Herpesvirus, so a completely unrelated virus.

What is the possibility of transmission to people like cashiers through touching contaminated articles?

It is a theoretical possibility, but people with the characteristic monkeypox rash should be self-isolating . So they should not be in a situation where they can contaminate material outside of their house. They will know that they have monkeypox.

Could monkeypox ever lead to death?

Yes, severe complications are known and some people do die from monkeypox, but it usually clears up on its own without any treatment. The groups most at risk of severe disease are the very young, the very old, immunocompromised and pregnant women. The strain of monkeypox which is causing the outbreak here in Europe carries a low risk of death if you are infected.

What would be in a monkeypox vaccine?

The vaccine which will be used is a new vaccine against smallpox, licensed for use in 2019. Smallpox and monkeypox viruses are very closely related and the vaccine is effective against both. Several countries across Europe have ordered batches of this vaccine already.

How come it is spreading so far and fast? And why amongst certain communities more?

We are not sure yet exactly why the virus is spreading so widely. My theory is that it most likely to be due to human behaviour. Quite a few viruses have changed their usual patterns of spread after the Covid-19 lockdowns. Also Spring of 2022 is really the first time international travel has been possible for large numbers of people. So we are all mixing and matching in ways that have not been possible for two years.

The reason it is spreading in particular groups is simply a quirk of fate. It requires very close contact to pass from person to person, so the pattern we are seeing is just a reflection of who has been in contact with someone with monkeypox. ANYONE can get it, it is just chance that it is spreading this way.

These questions and answers were part of an ‘Ask Me Anything’ hosted by Dr Sarah Pitt at 3pm on Thursday 26 May. Some of the questions and answers have been edited for this article. You can read the full discussion in the comments section of the original article.

Do you have any topics you’d like to see an expert host an ‘Ask Me Anything’ on? Let us know your suggestions in the comments below.

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