What is monkeypox?

Monkeypox is a disease caused by the monkeypox virus, which belongs to the orthopoxvirus genus. Other orthopoxviruses are the variola virus (which causes smallpox), the vaccinia virus and the cowpox virus.

Is it a new disease?

No. It was initially discovered in monkeys in 1958 but the first known human case of monkeypox was discovered in 1970 in Congo. The disease later spread to several African countries.

While there have been isolated reports of the disease occurring outside Africa in the past, this is the first time transmission is being reported without any known epidemiological links to West or Central Africa.

Have we ever had monkeypox in Malta in the past?

The first case was only recorded last week.

How is it transmitted?

There are different ways. It could be through contact with a skin rash, sores or body fluids of an infected person, through respiratory droplets in prolonged face-to-face contact, through close household contacts or through intimate contact during kissing, cuddling and sexual activity.

Another mode of transmission is via ‘fomites’, materials or objects contaminated with the virus, such as an infected person’s clothing or bedding.

It can also be transmitted through the placenta from mother to foetus or through a bite or scratch of an infected animal.

What symptoms should I look out for?

Fever, chills, headache, back pain, muscle aches, swelling of the lymph nodes (in the neck, armpit or/and groin) and exhaustion are all symptoms of the virus.

Symptoms typically occur within six to 13 days of being infected but the incubation period may last up to 21 days.

Within one to three days of the onset of fever, the person may also develop a rash. The rash develops slowly and may be very itchy, potentially leading to secondary bacterial infections.

Most of the cases in this outbreak have presented with a rash localised to the genital region  but the rash may also involve the face, palms and soles, the eyes and the mouth.

How long does it last?

The illness typically lasts two to four weeks. Once all the scabs of the rash have fallen off, the person is no longer infectious.

Is monkeypox dangerous? And who is most at risk?

Monkeypox is usually a self-limiting disease with mild to moderate symptoms but it may cause severe illness in immunosuppressed people, young children and pregnant women.

Complications are rare but may include secondary bacterial infections, pneumonia, sepsis, encephalitis and corneal infections. 

I have had contact with an infected person. What do I do?

Inform your doctor and monitor your symptoms or a new rash for 21 days from  last contact. Make sure you keep your hands clean.

If you develop symptoms, you’d need to self-isolate, avoid contact with pets and abstain from sexual activity until monkeypox is excluded.

Also, the  person should not donate blood for at least three weeks from last contact.

What do I do if I get monkeypox?

If you develop symptoms, you should inform your doctor immediately. It is advisable to call your doctor before turning up at the clinic, firstly to avoid the risk of spread and also because the physician would need to wear the appropriate personal protective equipment.

Most cases of monkeypox do not require hospitalisation.

What about my pets? 

If infected with monkeypox, avoid coming into contact with pets. There is a potential risk of human-to-animal transmission, which could result in animals then transmitting it back to humans, creating a loop of infection. However, to date,  there are no reports of infections occurring in animals or pets in the EU.

What is the treatment?

In most cases, there is no specific treatment.

An antiviral called Tecovirimat was licensed for treatment of monkeypox in adults and in children weighing at least 13kg by the European Medicines Agency earlier this year.

However, the drug is not yet widely available.

Is there a vaccine for it?

There is no vaccine licensed in Europe specifically to prevent monkeypox.

The smallpox vaccine is known to prevent monkeypox but this is no longer routinely administered due to smallpox having been eradicated.

Early post-exposure vaccination (within four days of contact with a monkeypox case) with a third generation smallpox vaccine may prevent the disease or decrease its severity.

Can the virus mutate?

All viruses can mutate but,  overall, the monkeypox virus is associated with a relatively low mutation rate. So far, there is no evidence the virus has mutated.