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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.

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Health

High pollen counts forecast for Wales this week

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CURRENT forecasts are for high pollen counts from today until Sunday across Wales, and airborne allergens expert has said. Max Wiseberg added: “This is not good news for hay fever sufferers across Wales. The main culprit is oak pollen which is now in peak season and there are some early grass pollens.”

Max continues, “However, better news is that, whilst there is no cure for hay fever, there are many measures and precautions you can take to help reduce the effects of the pollen. Although many hay fever sufferers find that nothing really works or that some remedies help, but nothing does the whole job, or what worked last year doesn’t work today, there is another way. A novel approach is to combine products for greater effect, and create your own ‘Hay Fever First Aid Kit’.”

“So if nothing works on its own, or your symptoms are particularly severe on a given day, create your own Hay Fever First Aid Kit, in other words use a combination of products, which can be complementary to one another. I suggest that your ideal Hay Fever First Aid Kit will consist of a prevention, such as HayMax organic drug-free allergen barrier balm, one (and only one) antihistamine, one (and only one) nasal spray, eye drops and one or more other natural products,”

Max goes on to explain how all the elements of a Hay Fever First Aid Kit work:

“The first thing is to avoid the pollen in the first place with an organic allergen barrier balm such as HayMax applied around the nostrils and bones of the eyes to help stop pollen getting in.”

“There are several forms of medication you can take that seek to reduce the effects of the pollen on the body.

  • Try an antihistamine, to counteract the effects of too many histamines, the body’s reaction to too much pollen; the most common are acrivastine, cetirizine, chlorphenamine, desloratadine, fexofenadine and loratadine.
  • Use a steroid nasal spray, which works by fighting inflammation and mucus production, helping clear nasal symptoms – itching, sneezing, watering and congestion.
  • Eye drops work in one of three ways; some stop the histamine release, some are anti-inflammatory and others block the inflammation caused by histamine.
  • There are several types of each, so if one doesn’t work particularly well or stops working, it’s worth trying another.”

“There are many other drug-free and natural products available for hay fever sufferers.

  • Quercetin is thought to limit the release of histamine; found naturally in many foods, it can also be taken in a capsule.
  • Butterbur is a herbal extract believed to have an antihistamine-like effect on hay fever symptoms and is available in capsules.
  • Immune boosting wellness formulae, such as Bee Prepared Daily Defence Immune Support which contains only all natural ingredients that help support the immune system, help the body fight the effects of the pollen.”
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Community

Fresh pleas to save much-needed Pembroke Dock day centre

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A PLEA to keep Pembroke Dock’s Anchorage Day Centre open is to be heard at a full meeting of Pembrokeshire County Council next week.

The Anchorage Day Care Centre in Pembroke Dock has been a “safe and happy place” for adults with learning difficulties and additional needs for decades.

In more recent years it has expanded to support elderly dementia sufferers.

But now the centre is expected to close, with services instead being offered elsewhere in the county, including Haverfordwest and Milford Haven.

A series of engagement events have taken place at The Anchorage recently, outlining the reasons and the options in continued service.

One parent, who wished to remain anonymous, said: “One young woman who attends ran out of the first meeting sobbing when she was told it was going to close. Another, at the second meeting, tried to address the meeting but was so choked up at the thought of not seeing her friends anymore she could hardly speak.”

In a submitted question to be heard at the May 9 meeting, member of the public Peter Welsh will ask: “Is the council aware of the huge impact the impending closure of the Anchorage Adult Day-care Centre in Pembroke Dock is already having to the health and mental wellbeing of my daughter and 20 other vulnerable adults with special needs and learning difficulties, who are unable to cope with changes to routine, or to process and understand what is happening to them?

“And would the council, therefore, please review its closure decision and retain the centre and the vital and invaluable service it provides not only to the individuals concerned but also to the parents?

“If not, what specific measures does the cabinet member have in place to support my daughter and these other individuals who need extra assistance to enable them to maintain their independence, value and allow their carers to have valuable respite from their caring responsibilities and what are the estimated costs for these substitute measures?”

A Pembrokeshire County Council spokesman has previously said: “Following the engagement sessions held with families and service users regarding the future of the centre on April 10 and 17 at the Anchorage, families said that they would like to maintain the Anchorage Day Centre and explained that they would write to the council in order to ask for the decision to be overturned.

“People who attend the service will be offered alternative care, all service users are currently having their individual care needs assessed by social work teams to fully understand which other services best meet those care needs.”

An online e-petition, on the council’s own website has been launched calling for it to stay open.

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Health

Chairman opens new NHS 111 Wales Service Centre in Haverfordwest

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IN a ceremonial occasion on Thursday (May 2), Thomas Baden Tudor, Chairman of Pembrokeshire County Council, inaugurated the new NHS 111 Wales service centre at Haverfordwest Ambulance Station. The event was marked by Mr. Tudor cutting the red ribbon, a task he was honoured to perform at the behest of Matthew Jones, Locality Manager of the Pembrokeshire Ambulance Service.

The NHS 111 service, which is accessible round the clock, offers urgent health advice and information about available services, including dental care and general medical guidance. This vital resource also provides support on managing illnesses and conditions and ensures continuity of care when GP offices are closed.

Speaking at the event, Mr. Tudor expressed his pride and privilege in participating in the launch, which underscores the community’s commitment to enhancing healthcare accessibility. The new service centre is expected to play a pivotal role in providing prompt medical advice and support to the residents of Pembrokeshire.

The service is free and can be reached by dialling 111 from any phone, ensuring essential healthcare advice is just a call away.

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