There have been 34 laboratory-confirmed cases of monkeypox reported in Scotland since 23 May 2022. This includes an additional two cases since our last report on 28 June 2022. (PHS 1st July 2023).
Close contacts of the cases are being identified and provided with health information, advice and, where appropriate, vaccination.
Plans for a wider pre-exposure vaccination programme are in development for some healthcare workers who work in high-risk settings and some gay and bisexual men at higher risk of exposure. Full details on how eligible people can get vaccinated will be set out by Scottish Government in due course.
As of Thursday 30 June, there are 1,235 confirmed cases in the UK.
Wendi Shepherd, monkeypox incident director at UKHSA, said:
“The monkeypox outbreak continues to grow. Our investigations and information from confirmed cases continue to show that the overwhelming majority of cases are in gay, bisexual or other men who have sex with men.”
Anyone can get monkeypox and it can spread from person to person through:
- touching clothing, bedding or towels used by someone with the monkeypox rash
- touching monkeypox skin blisters or scabs (including during sex)
- the coughs or sneezes of a person with the monkeypox rash
|UK nation||Confirmed cases||Change since last report (26 June 2022)|
A high proportion of England cases were known to be London residents (77%, 692 of 898 with reported home address)
Information on the symptoms of and treatment for monkeypox are available on NHS inform.
I know that many will just shrug their shoulders when I am spreading doom as usual. Yes, we have been lucky so far that the virus strain is the milder version and – at least in Europe – there have not yet been any deaths. Still, as always, the more a virus spreads, the better it is being provided with opportunities to evolve. We should have learned by now that trusting that a specific type of virus rarely mutates or usually only does this rather slowly, is not necessarily always true. Surprises are actually possible, as we found out the hard way. And the higher the burden of infections, the bigger the problem becomes if the trust in the absence or speed of mutations may have been misguided.
We have seen this with Covid.
Do we want to repeat the same mistakes with monkeypox (and other viruses)?
In both cases we have been told initially that the risk for the general public was estimated to be extremely low. Well,….. not so sure whether this wording would still be fully appropriate.
Containment was unachievable… apparently in both cases.
Transmission mechanisms are obviously – at least in part – different.
Still, we are dealing with a respiratory virus (Covid) on one hand and haven’t learned to follow simple precautionary measures properly to reduce the burden of infections.
Then we are dealing with a virus which can apparently quite easily be spread not only via direct contact but also via environmental contamination (Monkeypox).
How can we expect an exhausted health service to deal with all this? And at the same time catch up with long waiting lists, repair broken bones after car accidents and so forth?
Are we expecting them to work as underpaid cleaners in hazmat suits only because we are not willing to adhere to some basic hygiene rules and precautions?
Also, currently we appear to marginalise… because the majority of monkeypox cases were (so far) in the MSM community. Back in the 80s we made the same mistake in relation to the HIV virus. But it became a threat to everybody… suddenly everybody started to carry some condoms around in their handbag for what we called “safer sex” at the time (yep, to a certain extent this dampened the spirits a bit). I am not even mentioning the further contaminated blood scandals which aggravated the issue. HIV may have lost some of the horrors of the past because there are now quite effective treatments but we should remember that it took years until those became widely available.
Virologists will shudder…when I compare very different viruses in a rather simplified way… apples and pears… but I think we could have learned lessons from one virus for better dealing with another.
Back to monkeypox: After reading the underneath linked article about environmental contamination and astonishing survival skills of this virus in the environment, I don’t think that we should underestimate its potential. This is where I am beginning to shudder (not a virologist) and keep my fingers crossed that linen, towels etc. (for example in hotels and B & B) are being washed above 60 degrees (as per WHO guidance https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1):
‘Materials from infected patients (e.g. dermal crusts) or fomites (e.g. bed linen) may remain infectious for months to years.’ (https://www.ecdc.europa.eu/en/all-topics-z/monkeypox/factsheet-health-professionals).
And to be honest: even if mild, who would want to suffer blisters and lesions in delicate areas like the two poor patients described in the study?
One would not necessarily get them there… could be anywhere else… but surely, it won’t be pleasant in any case.
And a last word about vaccination: Again, we trust that we can outcompete other nations in the run for the (in this case scarce) vaccines. What – if any – moral justification do we have for this, considering that some regions in Africa have been plagued with this virus (including the strain with an over 10% mortality rate) over many years? Will they – again – get leftover vaccine doses shortly before their expiry date?