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Public health officials confirm second case of Monkeypox identified in Wales

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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.]

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Health

Hay fever warning – Tree pollen on the rise across Wales

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POLLEN experts are warning that the next few days could be significant for those who suffer from hay-fever.

“The first medium pollen counts of the season are forecast across Wales over the next 5 days,” says airborne allergens expert Max Wiseberg, “and many hay fever sufferers start to experience symptoms when the count reaches this level. The main culprit at this time is birch pollen, the pollen most tree pollen allergy sufferers are allergic to. So now is the time for hay fever sufferers to prepare for the season ahead.”

“Birch is arguably the most problematic tree of them all for hay fever sufferers,” continues Max. “In the same family as alder and hazel trees, the birch is the worst of the bunch for the 25% of UK hay fever sufferers who are allergic to tree pollen. The peak of the birch pollen season can run throughout April to mid May.”

“So now is the time to start preparing for the season ahead. If you are already starting to experience hay fever symptoms or want to avoid them being triggered, start to apply an allergen barrier balmsuch as HayMax, which works by trapping pollen before it enters the body and starts to work straight away. If you use antihistamines, many manufacturers recommend starting a month before your season starts, so if you haven’t started already, now is the time. And it’s the same with nasal sprays; they need several days to build up to their maximum protective effect and some makers advise starting using them one month before your hay fever season begins.”

“If your symptoms are particularly bad on a given day, or you find that nothing really works, or the remedy you use stops working, try combining products for a greater effect, in other words create your own ‘Hay Fever First Aid Kit’, a combination of products which can be complementary to one another. My recommendation would be an allergen barrier balm to trap the pollen, one (and only one) antihistamine to combat the overproduction of histamines, one (and only one) steroid nasal spray, as the nasal area is where the pollen enters and is most affected, plus one or more drug-free or natural products.”

“There are several practical things you can do to reduce the effects of pollen:

  • When you’re outdoors wear wraparound sunglasses to stop pollen getting in your eyes. Apply an allergen barrier balm to help prevent pollen getting up your nose. And wear a cap or other head cover and tie up long hair to stop pollen getting trapped in your hair,
  • When you return home, take off your shoes at the front or back door so you don’t bring pollen indoors with you, Washing your face, changing your clothes and having a shower will all help by removing pollen from your hair and body.
  • Keep pollen out of your home. Keep doors and windows closed. Dust and vacuum regularly, including fabrics and upholstery, to remove pollen. Damp dusting will help stop pollen being dispersed back into the air. If you have a pet, keep it well groomed and washed regularly, to remove pollen from its fur and keep it out of the room in which you sleep.”

“There is currently no cure for hay fever – they’ve been working on it for years – but until there is there are many products – both natural and conventional – and lifestyle changes you can try. Check out my website www. https://haymax.biz/hay-fever/ for more ideas. Good luck!”

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Health

RCN’s three urgent steps to rescue Welsh NHS sent to First Minister

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HELEN WHYLEY, Director of the Royal College of Nursing (RCN) Wales, has written to the First Minister calling for immediate action in three key areas to protect patients and secure the future of nursing in Wales.

The RCN first urges Vaughan Gething to deliver on promises in the Welsh government’s 2023/24 pay offer – prioritising patient safety by ensuring there are enough nursing staff to deliver safe and effective care. Second, the organisation warns him to responsibly introduce registered nursing associates to Wales. The letter ends by asking him to strategically invest in the education of nurses at all career stages, to meet future health care demands.

Promises in the 2023/24 pay offer included action on patients being cared for in inappropriate places (so-called “corridor care”), better access to flexible working, a 36-hour week, and more.

Helen Whyley said: “Now is the time for the First Minister to refresh his public commitment to safe and effective care. That would go a long way towards assuring nursing staff that his government will address the extreme pressures they are under.

“What’s critical is that the First Minister keeps nurses nursing in the NHS. That’s why he must make sure the Welsh government keeps every promise it made to our members last year to end industrial action. Those important promises could make a real difference to nurses and to their patients. That’s why our members accepted them in good faith – but half a year later, they have yet to feel a difference.

“New nursing roles are fantastic, but patients need to understand what that means for them – and, crucially, they need to be funded properly. Any risk to patient safety from registered nurses being inappropriately replaced is completely unacceptable. And this can’t become a distraction from getting the basics right, either. A national strategy for commissioning nursing education, all the way from student to advanced and consultant level, would be a fitting ambition for a new First Minister with a commitment to improving health.”

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Brain Injury Group Donates £3,000 to local services

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THE SOUTH WEST WALES BRAIN INJURY GROUP (SWWBIG) has announced donations to two local health boards, giving £1,000 each to Neath Port Talbot Neuro Rehabilitation Unit and the Community Brain Injury Services at Swansea Bay and Hywel Dda University Health Boards.

This funding boost for the health boards comes from the profits earned at the SWWBIG conferences in 2022 and 2023, which were organised and sponsored by JCP Solicitors and co-sponsored by Fieldbay (part of the ivolve Care & Support group).  

The conferences, which have taken place annually since 2011, provide an opportunity for individuals and families affected by brain injury, as well as healthcare professionals, charities, students and researchers across South West Wales to come together and explore the critical stages of survival and recovery. 

The 2022 and 2023 conferences each welcomed around 200 attendees and raised £3,000 in excess funds. The committee, made up of healthcare workers and practitioners in the field of brain injury, voted to donate to the brain injury services in their local health boards, ensuring that the funds can be used to assist the brain injury community in South West Wales in the best way possible. 

Suzanna Charles, Chair of SWWBIG said: “The South West Wales Brain Injury Conferences are always a huge success, as we are able to facilitate important conversations for professionals working in the field and offer support.

“What is more, the conferences raise vital funds which will go towards providing ongoing rehabilitation for those affected by brain injury. We are proud to provide this additional funding which will have a direct, positive impact on brain injury survivors in our local area. 

“The journey through rehabilitation is different for everyone, and it is so important to have a supportive network of healthcare professionals and experts to guide patients while listening to their individual needs.”

The main objective of the South West Wales Brain Injury Group is to provide a forum for individuals with an interest in acquired brain injury, to educate and encourage development and dissemination of good practice. For more information on SWWBIG or to register your interest to attend the conference in 2024, please visit www.swwbig.co.uk.   

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