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Health

Monkeypox Q&A: how do you catch it and what are the risks? An expert explains

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THE LATEST outbreak of monkeypox has, at the time of writing, reached 17 countries with 110 confirmed cases and a further 205 suspected cases. It’s a fast-moving story, so if you need to catch up on the latest, here are answers to some of the most pressing questions.

How is monkeypox spreading?

The first patient in the current outbreak had returned to the UK from travels to Nigeria where monkeypox is endemic. However, cases are now spreading among people who have not travelled to west or central Africa, suggesting local transmission is occurring.

Monkeypox usually spreads by close contact and respiratory droplets. However, sexual transmission (via semen and/or vaginal fluid) has been posited as an additional possible route. The World Health Organization (WHO) says: “Studies are needed to better understand this risk.”

Most cases in the current outbreak have been in youngish men, but the virus can spread to anyone.

There are no confirmed cases in Pembrokeshire at the present time.

What are the symptoms?

Early symptoms are flu-like, such as a fever, headaches, aching muscles and swollen lymph nodes.

Once the fever breaks, a rash can develop, often beginning on the face and then spreading to other parts of the body – most commonly the palms of the hands and soles of the feet.

Monkeypox lesions.
Evolution of monkeypox lesions. UK government/Wikimedia

How deadly is monkeypox?

Monkeypox is mostly a mild, self-limiting disease lasting two-to-three weeks. However, in some cases, it can cause death. According to the WHO, the fatality rate “in recent times” has been around 3% to 6%. The west African monkeypox virus is considered to be milder than the central African one.

Monkeypox tends to cause more serious disease in people who are immunocompromised – such as those undergoing chemotherapy – and children. There have been no deaths from monkeypox in the current worldwide outbreak, but, according to the Daily Telegraph, one child in the UK is in intensive care with the disease.

Why is it called monkeypox?

Monkeypox was first identified in laboratory monkeys (macaques) in Denmark in 1958, hence the name. However, monkeys don’t seem to be the natural hosts of the virus. It is more commonly found in rats, mice and squirrels. The first case in humans was seen in the 1970s in the Democratic Republic of the Congo.

Is monkeypox related to smallpox and chickenpox?

Monkeypox is related to smallpox – they are both orthopoxviruses – but it is not related to chickenpox. Despite the name, chickenpox is a herpes virus, not a poxvirus. (How “chicken” got in the name is not entirely clear. In his dictionary of 1755, Samuel Johnson surmised that it is so named because it is “of no very great danger”.) Nevertheless, the vesicles (little pus-filled blisters) caused by monkeypox are similar in appearance to those of chickenpox.

Are cases likely to continue rising?

Cases are likely to continue to rise significantly over the next two-to-three weeks, but this is not another pandemic in the making. Monkeypox doesn’t spread anywhere near as easily as the airborne virus SARS-CoV-2 that causes COVID-19.

Has monkeypox evolved to be more virulent?

RNA viruses, such as SARS-CoV-2, don’t have the ability to check their genetic code for mistakes each time they replicate, so they tend to evolve faster. Monkeypox is a DNA virus, which does have the ability to check itself for genetic mistakes each time it replicates, so it tends to mutate a lot slower.

The first genome sequence of the current outbreak (from a patient in Portugal) suggests that the virus is very similar to the monkeypox strain that was circulating in 2018 and 2019 in the UK, Singapore and Israel. So it is unlikely that the current outbreak is the result of a mutated virus that is better at spreading.

How is monkeypox diagnosed?

In the UK, swab samples taken from the patient are sent to a specialist laboratory that handles rare pathogens, where a PCR test is run to confirm monkeypox. The UK Health Security Agency has only one rare and imported pathogens laboratory.

Is there a vaccine for it?

Vaccines for smallpox, which contain the lab-made vaccinia virus, can protect against monkeypox. However, the vaccine that was used to eradicate smallpox can have severe side-effects, killing around one in a million people vaccinated.

The only vaccine specifically approved for monkeypox, Imvanex, is made by a company called Bavarian Nordic. It uses a nonreplicating form of vaccinia, which causes fewer side-effects. It was approved by the US Food and Drug Administration and the European Medicines Agency in 2019 – but only for use in people 18 years of age or older.

UK health secretary Sajid Javid said that the UK government will be stocking up on vaccines that are effective against monkeypox. The UK currently has about 5,000 doses of smallpox vaccine, which has an efficacy of around 85% against monkeypox.

Are there drugs to treat it?

There are no specific drugs to treat monkeypox. However, antivirals such as cidofovir and brincidofovir have been proven to be effective against poxviruses in animals and may also be effective against monkeypox infections in humans.

By Ed Feil, Professor of Microbial Evolution at The Milner Centre for Evolution, University of Bath

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health

Phone calls to reduce GP visits for 42% of patients this winter

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NEW research from the Royal Voluntary Service has shown that a simple phone call could significantly impact well-being, reducing GP visits by 42% among patients who receive regular telephone support.

The charity urges those feeling isolated this winter, particularly the elderly, to use telephone support services as a way to improve health and free up GP appointments, potentially reducing waiting times. It is estimated that if people experiencing loneliness in later life reduced their GP visits by just one appointment a year, this could free up 588,000 appointments annually.

As winter approaches, the Royal Voluntary Service reports that isolation can sharply increase, especially for adults over 75, with nearly half (47%) of people in this age group feeling lonelier in the colder months. Among those who live alone, one in six say they feel forgotten during winter, and 20% report having no one to turn to for emotional support.

In addition to loneliness, older generations face several winter worries, including increased heating costs, cited by 55% of respondents, and reduced ability to go out, which 29% said they dreaded as winter sets in.

To address these challenges, Royal Voluntary Service has launched the Stay Safe, Warm and Well campaign in partnership with Yakult. The campaign provides a guide for practical and emotional winter preparation, encouraging sign-ups for telephone support services and offering access to the Virtual Village Hall online community for events and activities. Practical advice on money-saving and energy-saving tips is also available through the guide.

Royal Voluntary Service Ambassador Elaine Paige, who has herself made support calls for the charity, described the positive impact these calls can have. “A warm, friendly phone call can transform someone’s day. Some conversations leave you smiling long after the call ends—something we could all use, especially in winter. For those facing the season alone, there are amazing people ready to remind you that you’re not alone,” she said.

The charity’s support services match volunteers with individuals across the UK for friendly chats, reducing isolation and boosting mental health. Catherine Johnstone CBE, Chief Executive of Royal Voluntary Service, said: “The feedback that conversations with volunteers are helping people to visit their GP less is testament to the value of connection.”

Yakult Marketing Manager Reshma Patel added: “Our research with Royal Voluntary Service shows that one in four adults over 75 feel they’d benefit from practical and emotional support over winter. We are committed to helping people access the Stay Safe, Warm and Well guide to support their overall well-being.”

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Health

Over 1500 patients in Wales blocked from leaving hospital

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THE First Minister Eluned Morgan has been pressured on her government’s failure to clear hospital beds in Wales, leading to delays for people seeking urgent medical care.

According to a report from BBC Wales, there are currently 1,600 patients across Wales waiting to be discharged from hospital compared to England where there are currently 12,000.

However, when comparing population sizes, it’s revealed that Wales is performing worse than its closest neighbour, with 0.05% of the population of Wales stuck in hospital beds compared to 0.02% in England.

The Welsh Labour government have been criticised for their failure to clear out backlogs in the system,

The Liberal Democrats have now called on the Welsh Government to provide urgent social care funding to local authorities to help alleviate pressures on the NHS in Wales.

Speaking in the Siambr on Tuesday, The Leader of the Welsh Liberal Democrats Jane Dodds MS described how over twenty years of Welsh Labour government in Wales had let to a “desperate situation in our NHS, with services nearing breaking point.

Welsh Labours refusal to change their approach and fix a system clogged up by mismanagement is directly responsible for the current situation faced by thousands of patients.

Delays in discharging patients from hospitals are placing huge pressures on both staff and those awaiting care, but there is a way out of this mess and the answer lies in social care.

I have been told by numerous professionals working in healthcare that the first step towards fixing our NHS is made by providing local authorities with the funding to fix social care services within their respected areas.

By dedicating adequate investment into our social care services, we can make life easier for patients discharged from hospital while also lifting the strain on health services throughout Wales.”

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Education

Concern over ‘highest-ever’ school bullying rates

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RATES of bullying in Welsh schools have reached record levels, with more than one in three children and young people reporting being bullied, the Senedd heard.

Gareth Davies raised concerns about a 6% increase in bullying between 2021 and 2023, according to a survey of more than 130,000 pupils in 200 secondary schools.

The Conservatives’ shadow mental health minister told the Senedd: “These results are higher than ever previously reported in the survey, which is deeply troubling.”

He said the latest survey showed regression on “just about every metric of pupil wellbeing”, including growing social isolation and a rise in behavioural issues.

Mr Davies, who worked in the NHS in north Wales for more than a decade, pointed to a 2021 legal duty to have regard to the mental health of children and young people.

He said: “The mental health of pupils has declined and reports of bullying in schools have only increased, so the Welsh Government have failed in that duty, unfortunately.”

Plaid Cymru’s Cefin Campbell called for an update to 2019 anti-bullying guidance for school governing bodies following a commitment from the Welsh Government eight months ago.

The shadow education secretary focused on the impact of poverty, warning the high cost of school uniforms can cause stress and lead to bullying.

Mr Campbell, a former lecturer, expressed concerns about penalties, such as detention, for pupils over non-compliance with uniform policies.

Raising a report on “horrific” experiences of racism in Welsh schools, he said one pupil was told a classmate did not want to sit next to them due to the colour of their skin.

“That’s entirely unacceptable in our schools,” said Mr Campbell.

Labour’s Carolyn Thomas warned children’s mental health is at an all-time low, pointing to smartphones and social media as major contributing factors.

She said: “They can be used to bully, manipulate and control, sending young people into an isolated world of despair, not thinking they can get out of it or go to somebody for help.”

The North Wales politician highlighted a petition calling for a ban on phones in schools.

Rhys ab Owen, an independent who represents South Wales Central, stressed that bullying can impact people for decades to come after school.

“But it’s an issue that doesn’t affect learners equally,” he said. “In Cardiff, around a third of learners come from ethnically diverse backgrounds.

“And I was staggered to read a survey from 2020, which said that 61.5% of learners had expressed stereotypes over skin colour, religion and nationality.”

In a statement on November 12 to mark anti-bullying week, Lynne Neagle accepted that bullying continues to be an issue in Welsh schools.

Pledging to prioritise the problem, Wales’ education secretary said new statutory anti-bullying guidance will be published for consultation after Christmas.

Ms Neagle pointed to concerning trends, including 42% of girls scoring high or very high in a questionnaire on psychological problems compared with 27% of boys.

She told the Senedd: “I wouldn’t want to be a teenager growing up today.”

Ms Neagle stated the Welsh Government provided more than £800,000 this year for one of the biggest surveys of children and young people in the UK.

She said: “The link between bullying and mental health is well known. At its most extreme, young people have taken their own lives as a result of being bullied. This is a tragedy for the young life lost, for their family and friends and for whole communities.”

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