Health

Public health officials confirm second case of Monkeypox identified in Wales

Published

3 years ago

June 4, 2022

A SECOND monkeypox case has been identified in Wales, public health officials have said today.

Yesterday the UK Health Security Agency (UKHSA) said 18 new cases have been identified in the UK, bringing the total to 225 cases in the UK as of 2 June.

Monkeypox – which is usually found in west and central Africa – has been on the increase during the past month with more than 200 confirmed cases recorded in Britain, Portugal, Spain and the United States.

Anyone can get monkeypox. Currently most cases have been in men who are gay, bisexual or have sex with men, so it’s particularly important to be aware of the symptoms if you’re in these groups

Dr Graham Brown, Consultant in Communicable Disease Control for Public Health Wales, said: “Public Health Wales is today (3 June) confirming that an additional case of monkeypox has been identified in Wales. This brings the total in Wales to two.”

“We are working with the UK Health Security Agency (UKHSA), Public Health Scotland, and Public Health Agency Northern Ireland, and we are ready to respond to cases of monkeypox in Wales.

“The case is being managed appropriately. To protect patient confidentiality, no further details relating to the patient will be disclosed.

“We are reassuring people that monkeypox does not usually spread easily between people, and the overall risk to the general public is low. It is usually a mild self-limiting illness, and most people recover within a few weeks. However, severe illness can occur in some individuals.

“Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.”

“A rash can develop, often beginning on the face, then spreading to other parts of the body, particularly the hands and feet.”

“The rash changes and goes through different stages before finally forming a scab, which later falls off.”

“Everyone is being asked to be aware of the monkeypox symptoms, but it is important that gay and bisexual men are alert as it’s believed to be spreading in sexual networks.”

“Anyone with unusual rashes or lesions on any part of their body should contact NHS 111 or call a sexual health service if they have concerns.”

Cases of monkeypox in the UK, including in Wales, are reported on the UKHSA website.

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.

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.

[Image and Q&A republished from The Conversation under a Creative Commons license. Read the original article.]

Health

More than 400,000 visit pharmacies for common health issues

Published

2 days ago

January 21, 2025

Tom Sinclair

THE WELSH public is being encouraged to visit local pharmacies for free advice and treatment for a wide range of illnesses. New figures reveal that over 400,000 people used the Common Ailments Service in the past year alone.

Pharmacies offer convenient access to healthcare professionals, often without the need for an appointment, freeing up GP slots for those with more complex or urgent medical needs.

Common ailments service

Available in 99% of pharmacies across Wales, the service provides free, confidential advice and treatments for 28 common illnesses, such as sore throats and urinary tract infections. Since its launch in 2013, it has supported nearly 1.25 million people.

Around 220 pharmacies now offer the Pharmacist Independent Prescribing Service, allowing pharmacists to treat conditions such as ear, skin, and respiratory infections, sinusitis, and migraines.

A survey found that 95% of patients who used the service would have otherwise sought help from a GP or other healthcare provider.

Prescribing services expanding

Each year, up to 100 community pharmacists in Wales undertake prescribing training. From 2026, all newly qualified pharmacists will be registered prescribers, enhancing the range of services available at local pharmacies.

Primary care reforms

The Cabinet Secretary for Health and Social Care, Jeremy Miles, highlighted ongoing reforms to deliver more care closer to home during a statement to the Senedd.

Key statistics include:

GPs handle around 100,000 calls and 68,000 appointments daily.
Optometrists conduct over 2,000 consultations each month.
More than 420,000 new dental patients have been treated since April 2022.
District nurses see approximately 31,000 patients each month, equating to 1% of Wales’ population.

Comments from key figures

Health Secretary Jeremy Miles said:
“We know there is very high demand for GP services in Wales, with around 1.6 million people contacting their practice each month.

“For most common health concerns, your local pharmacy is the best option, providing free and easy access to treatment.

“We are working with the NHS to provide more care in the community, closer to people’s homes, and to make it easier for people to choose the right service for their health needs.”

Gwawr Davies-Jones, a pharmacist at High Street Pharmacy in Barry, added:
“Since the new pharmacy contract was implemented in 2022, our role has changed considerably. Instead of being in the dispensary, we are now in the consultation room for most of the day, offering clinical services.

“On average, we carry out more than 20 consultations daily, from providing contraception to emergency medicine supplies.

“The demand for advice on common conditions is great, giving pharmacists an opportunity to share advice and treatment, including prescribing antibiotics and other prescription-only medicines without the need to see a GP. This helps free up much-needed appointments for more complex conditions.

“We feel we offer an invaluable service to our community. The services we provide alleviate pressures on the NHS, giving pharmacists great satisfaction knowing they are making a difference.”

Supporting NHS pressures

Pharmacies in Wales offer treatment for 28 common illnesses under the Common Ailments Service. Many also provide emergency contraception, annual flu vaccinations, and regular contraception services.

The Welsh Government has significantly supported this service expansion, increasing its investment by 24% since 2016-17, with an additional £9.9 million allocated this year.

***Cabinet Secretary Jeremy Miles visited High Street Pharmacy in Barry today to meet pharmacist Gwawr Davies-Jones.***

Health

Lymphoedema patients to benefit from online mental health support

Published

2 days ago

January 21, 2025

Tom Sinclair

NHS Wales’ digital wellbeing service has teamed up with a pioneering clinic to help patients manage the mental health impacts of Lymphoedema and Lipalgia Syndrome.

The Lymphoedema Wales Clinical Network (LWCN) established a psychological support service – the only one of its kind in the UK – after patients spoke of the emotional challenges of living with these conditions.

Patients revealed how their physical symptoms were often accompanied by depression, anxiety and worries about appearance.

Support offered by the service’s two psychologists is now being complemented by direct referrals to SilverCloud® Wales, a suite of online, self-help courses based on Cognitive Behavioural Therapy (CBT).

Dr Jayne Williams, National Lymphoedema Consultant Psychologist for LWCN said: “This is an exciting time for us.

“We’re looking at different ways for people to access psychological therapies – SilverCloud being one of them. The aim is to provide timely, preventative support before people get to crisis point.

“As SilverCloud is online, it has the capacity to reach many more people than we could see face-to-face, and its flexibility means that it fits around busy work and family lives.

“Being able to offer something that patients can do in their own way, at their own pace is brilliant.”

NHS Wales online CBT project manager Fionnuala Clayton said the new referral pathway was inspired in part by feedback from a ‘Living Well with Lymphoedema’ event hosted by LWCN, where patients were asked what they would like from its emerging psychology service.

“Patients wanted to feel as though they were not alone and that they still had a healthy and happy life despite their condition,” said Fionnuala. “They wanted easy access to support for building resilience alongside help to help themselves.

“Coming away from the event, we knew a referral pathway would support many patients across Wales.”

Lipalgia Syndrome – also known as Lipoedema – is an abnormal build-up of adipose fatty tissue, usually in the lower half of the body, which more commonly affects women.

Lymphoedema is another incurable, long-term condition which develops due to a damaged or poorly-functioning lymphatic system. Damage can occur as a result of many factors including obesity, surgery, cancer treatment, infection or injury.

People who are sedentary are particularly vulnerable as the lymphatic system relies on movement to remain healthy and move the lymph fluid around the body. Symptoms include swollen and painful heavy limbs and a higher risk of skin infections and wounds.

Said Dr Williams: “These are conditions that people have to learn to live alongside forever, which can be incredibly difficult.

“They have to cope with swelling and pain, they may have to wear compression bandages or garments, carry out daily skin care routines and do lots of movement.

“We see lots of people with very low mood. There’s also a lot of anxiety around body image and intimacy.

“Feeling people are judging you, and perhaps not being able to find clothes or shoes that fit you, means your whole identity and your social confidence can be affected. You can feel more isolated and withdrawn.”

Around 25,000 people across Wales use LWCN services.

Local health board lymphoedema services can refer people to the psychology service within the National Lymphoedema Team, which is hosted by Swansea Bay University Health Board.

Dr Williams said several patients had been referred to SilverCloud’s Space for Positive Body Image programme after attending a body image workshop.

Other courses on offer include support for anxiety, depression and stress.

Anyone in Wales aged 16 or over can self-refer to SilverCloud, without seeing a GP and from the comfort of their own home.

Fionnuala Clayton added: “We’re delighted to onboard the Lymphoedema Wales Clinical Network. This has been a collaborative effort between services, working together to identify how best support patients living with Lipalgia Syndrome and Lymphoedema.”

For further information and support on Lymphoedema and Lipalgia Syndrome, visit https://lwcn.nhs.wales/

To self-refer to SilverCloud Wales, visit https://nhswales.silvercloudhealth.com/signup/

Health

Tufnell talks tough on health care following ‘in-depth survey’

Published

3 days ago

January 20, 2025

Sarah Jane Absalom

TOP Hywel Dda health board officials are turning a blind eye to its escalating health care failings despite pocketing six-figure salaries.

So says Mid and South Pembrokeshire MP Henry Tufnell who is calling for an urgent meeting with Hywel Dda’s chief executive, Phil Kloer.

“The Hywel Dda Health Board needs to recognise that there’s a problem with health care outcomes and care delivery, but what is it going to take for them to recognise that?” Henry Tufnell commented this week.

His comments followed an in-depth survey of 1,000 people living in Pembrokeshire which confirmed that a staggering 62% have to wait more than a week for a GP appointment. 43% have cited a lack of available appointments as their biggest challenge, while no fewer than 87% claim healthcare services have worsened in recent years.

“But it’s the real stories that show the scale of the crisis,” continued Henry Tufnell.

“I know of a cancer diagnosis that has been delayed by over a year, while ambulance waiting times can be more than 13 hours, even for urgent cases. Critical care needs are going unmet and this is forcing patients to seek private treatment.”

Tufnell has now submitted a Freedom of Information (FOI) request to Hywel Dda University Health Board demanding greater transparency on waiting times, service provision and a plan strategy to fix the crisis.

“Despite all the latest evidence, in addition to everything we gathered during the election campaign, there’s still no acceptance by the Board that there’s a problem,” he said.

“But it’s their responsibility to deliver health care within this county, and they’re failing. The management is failing us here in Pembrokeshire and there’s a complete lack of transparency and accountability. All these people sitting in management roles are being paid huge amounts of money, some bringing in six figure salaries. But they’re failing.”

Mr Tufnell has now requested an urgent meeting with Hywel Dda chief executive Phil Kloer which is expected to take place on February 14.