Monkeypox is a DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family.
Monkeypox was first discovered in monkeys, hence the name.. Later investigation found that rodents were the main carrier.
So it should really be called Ratpox which sounds equally unappealing!
Smallpox and Cowpox are also within the Poxviridae family. And handily enough, scientists believe that people who received the Smallpox vaccine may have a good lifelong production of antibodies that may provide protection – about 85% protection according to the CDC (The Centers for Disease Control and Prevention which is the national public health agency of the United States).
So those over 50 in the UK could have enough antibodies already!
Also, it means that there are vaccines readily available.
The early vaccine for Smallpox was a live virus, called Vaccinia.
It’s a similar virus to Smallpox (Variola) but less harmful.
Other vaccines included Variola Minor, a weaker strain of Smallpox.
These vaccines are similar to Varicella which is a mild virus that is given to stimulate protection against Chickenpox (Herpes Varicella).
There are some drawbacks to these old vaccines. They can’t be controlled very easily and can potentially cause harm to the recipient.
Luckily, there are more modern, attenuated vaccines that are not live and are less likely to cause a severe reaction.
So far, good news!
Even better news is that it is a DNA virus and not an RNA virus.
RNA viruses make a lot of mistakes as they replicate and therefore we get lots of mutations. Coronavirus is an RNA virus. And therefore mutates readily.
DNA viruses have an auto-correction capability that prevents mistakes from being made during replication and therefore it doesn’t mutate much. Although it can evolve.
What about transmission?
Monkeypox is much harder to transmit than Coronavirus, for example.
Firstly, there isn’t usually asymptomatic transmission, unlike Coronavirus which as we all now know can be passed by people without symptoms.
Secondly, transmission is most common with actual bodily contact rather than aerosols in the air.
This means you are likely to inadvertently contract the virus through fomites (the virus being left on surfaces to be picked up later), like clothing, bedding, etc. As well as direct or close contact with the person.
How do I know if I’ve got Monkeypox?
The virus usually starts with cold/flu-like symptoms. Later a rash develops, usually on the hands, feet and genitals but can appear anywhere.
The rash then turns into blisters, very similar to Chickenpox. But swollen glands (lymph nodes) in the groin and neck differ from that of usual Chickenpox symptoms.
These lesions swell with puss, they then scab over and fall off over time, but can leave some scarring.
As with almost all infections, it’s usually accompanied by a high temperature.
The virus is usually self-limiting and can last between 2 to 4 weeks.
The Case Fatality Rate is reasonably low (between 1-10%) but due to the virus being mostly found in developing nations, (predominately Central and West Africa) we don’t have enough data to know how well we would fare with Western medical facilities and medication.
Is this the first outbreak of Monkeypox in the West?
There was an outbreak of Monkeypox in the USA in 2003.
The virus was brought into the country by imported rodents from Ghana. The rodents then infected the Prairie Dog population which in turn infected humans.
Of around 70 cases, there were no fatalities.
So why all the media fuss?
Well, even though it’s harder to transmit, education is the best way to retard a potential endemic.
There have been fatalities. So again, good education will help spot the disease early. As with most diseases, the earlier you catch them, the better the prognosis.
If it’s so similar to Smallpox, then surely we can eradicate it?
Err, no! Unfortunately not. Smallpox was only found in humans. So all we needed to do was vaccinate enough people to achieve herd immunity and then the virus couldn’t find enough hosts to continue.
Monkeypox is zoonotic. It’s found in many different species of animals. And we can’t vaccinate all the creatures which act as a reservoir for this particular virus.
Keep calm, no need to panic
So Monkeypox is not going to go away. But we know what it is, we know how to treat it, and once vaccinated or cured, you should never have to worry about it again!
About the author: Mark Waterfield is our lead Infection Control instructor. He is also a qualified paramedic with a keen interest in Emergency Care and general health.