December 4, 2019

expert reaction to monkeypox case confirmed in England

There has been a confirmed case of the rare disease Monkey Pox in the UK, it was reportedly contracted in Nigeria.

Prof Geoffrey Smith FRS, Professor of Pathology, University of Cambridge, Wellcome Trust Principal Research Fellow, and Chairman of the WHO Advisory Committee for Variola Virus Research, said:

“Monkeypox is a disease caused by infection with monkeypox virus.  Monkeypox virus is a poxvirus and a member of the same genus of poxviruses as vaccinia virus (the vaccine used to eradicate smallpox), cowpox virus and variola virus (the cause of smallpox).

“Monkeypox virus infection is rare and cases in UK have originated from those who contracted the disease in Nigeria and travelled back to UK.  About a year ago there were 3 cases of monkeypox virus in UK: two cases where infection was acquired in Nigeria, and one case of a health care worker who was infected within UK from one of the imported cases.

“Monkeypox virus comes in two types that originate from either central Africa (Democratic Republic of Congo) or West Africa.  Monkeypox virus strains that originate from West Africa are less dangerous than those present in Central Africa and are usually not associated with fatalities.  Over the last two years there have been more than 300 cases of monkeypox in humans in Nigeria and these have all been of the West Africa type.

“The disease in humans can be serious and looks like smallpox, but unlike smallpox, does not transmit efficiently from human to human.  So usually there are isolated sporadic cases.

“The reservoir of monkeypox virus in West Africa is in rodents with transmission to man and other primates are relatively rare zoonoses.

“Monkeypox can be prevented by vaccination with the smallpox vaccine (vaccinia virus).  In July 2018, a drug called TPOXX or ST-246 was licensed by the US Federal Drug Administration against smallpox.  This drug was also shown to be effective against other orthopoxviruses, such as cowpox, vaccinia and monkeypox virus.  The target of this drug is a protein called F13 that is highly conserved in all these viruses.

“Now that this case has been diagnosed and the patient quarantined, the chance of transmission to others is extremely low.  The public should not be concerned by this imported case of monkeypox and should continue with life as normal.”

Prof Jimmy Whitworth, Professor of International Public Health, London School of Hygiene and Tropical Medicine, said:

“Monkeypox is a viral infection that causes flu-like symptoms and a blistering rash.  Most infections are mild and patients recover fully although severe infections and even deaths have been known.  I understand the patient had recently been in Nigeria where there has been a widespread outbreak of monkeypox in progress since 2017.  There were two cases in the UK last year also associated with travel to Nigeria.  The infection is not easily transmitted between people, although there was a health worker in close contact with one of the cases who became infected last year.  The key public health measures are to isolate the patient and to identify and follow up any close contacts.  These are being done by the NHS and Public Health England so the risk to the general public is extremely low.  It is possible that additional cases will be identified from amongst the contacts of this case, or in other travellers returning from countries in Africa where the infection occurs.”

https://www.gov.uk/government/news/monkeypox-case-confirmed-in-england

Declared interests

Prof Geoffrey Smith: “I have no conflicts of interest in making this statement.”

Prof Jimmy Whitworth: “No conflicts of interest.”