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

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
Nurses warn of pay and burnout crisis as new report exposes pressures in Wales
A NEW national report has laid bare the growing pressures facing nurses and midwives in Wales, with concerns over pay, burnout and lack of professional development threatening the long-term future of the workforce.
The findings, published by the Nursing and Midwifery Council in its Spotlight on Nursing and Midwifery 2025 report, show that while many nurses remain deeply committed to their roles, large numbers feel undervalued, overstretched and reluctant to recommend the profession to others.
Responding to the report, Royal College of Nursing Wales said the data should act as a wake-up call for government and health boards.
Professor Sandy Harding, Associate Director of Nursing, Policy and Professional Development at RCN Wales, said:
“We welcome the determination and commitment shown by our existing nurses in Wales, with more than half surveyed saying they are satisfied with their day-to-day work and motivated by making a difference to people’s lives. However, the findings also present a stark reflection of the poor health of nursing in Wales.
“Too many nurses are not recommending the profession to others, are struggling and are facing abuse and discrimination in the workplace.”
Pay falling behind responsibility
One of the most pressing concerns raised in the report is pay.
Nursing leaders say salaries have failed to keep pace with the growing complexity of the job, heavier caseloads and the rising cost of living, leaving many staff feeling undervalued and financially squeezed.
For some, the pressure is forcing difficult decisions about staying in the profession or reducing hours.
RCN Wales argues that without meaningful improvements to pay, recruitment and retention will continue to suffer, placing further strain on already stretched hospital wards, community services and care settings.
Training and career progression gaps
The report also highlights inconsistent access to continuing professional development, with many nurses struggling to secure protected time or funding for further training.
According to the union, this not only limits career progression but risks undermining patient care in the long term.
Harding said: “Access to protected time and funding for continuing professional development remains inconsistent, undermining both career progression and the sustainability of the workforce.
“RCN Wales believes this is unacceptable and we will continue to support nurses and fight for fair pay, meaningful investment in professional development and better working conditions across Wales.”
Commitment remains strong
Despite the challenges, the report does note strong dedication among nursing staff.
More than half of those surveyed said they were satisfied with their day-to-day work and remained motivated by the difference they make to patients’ lives.
Health leaders say that commitment is a strength the NHS in Wales cannot afford to lose.
With around 35,000 members in Wales, the Royal College of Nursing says it will continue pressing ministers to address what it describes as a “workforce crisis” before it deepens further.
The union is calling for fairer pay settlements, safer staffing levels and guaranteed investment in training to ensure nursing remains an attractive and sustainable career.
Health
Doctor struck off after sexual misconduct findings at Withybush Hospital
Tribunal history reveals medic was removed in 2012 for dishonesty before being allowed back to practise
A DOCTOR accused of sexually harassing junior colleagues while working at Withybush Hospital had previously been struck off the medical register for lying about his qualifications, the Herald can reveal.
Dr Velmurugan Kuppuswamy is currently at the centre of fitness-to-practise proceedings after allegations he made sexually inappropriate comments and subjected two female doctors to unwanted physical contact during his time as a locum consultant in Haverfordwest.
But records show this is not the first time his conduct has come before regulators.
In 2012, an independent tribunal found he had been dishonest during an application and interview for a postgraduate cardiology training post at an NHS deanery in England.
The panel heard he falsely claimed to have submitted a Doctor of Medicine thesis, said he was a member of the Royal College of Physicians and stated he had passed a practical clinical skills assessment.
He initially admitted misleading information before later retracting parts of his account. The tribunal concluded he had “maintained his dishonest accounts” and had wrongly accused a witness of giving misleading evidence.
He was erased from the register and returned to India, where he later worked in a cardiac hospital.
In 2020, he applied to be restored to the UK medical register.
The General Medical Council investigated and opposed the application, arguing his expressions of remorse had come years late and raising concerns about a lack of independent evidence regarding his work overseas, as well as the absence of relevant ethics training.
However, an independent Medical Practitioners Tribunal at the Medical Practitioners Tribunal Service accepted his assurances that he had changed. His evidence was described as “compelling, heartfelt and genuine”, and the panel decided a well-informed member of the public would not be concerned about his return to practise.
His name was restored to the register.
Shortly afterwards, he began working shifts as a locum consultant at Withybush Hospital, which is run by Hywel Dda University Health Board.
Within months, fresh allegations emerged.
A tribunal has heard claims that between August and September 2021 he hugged junior colleagues without consent, touched their backs and waists, squeezed their wrists and arms and made sexually suggestive remarks at a staff social event.
On two occasions, he is alleged to have gripped one doctor so tightly it caused pain and ignored her requests to stop. He is also accused of staring at female colleagues, following groups of women around the venue, making comments about their bodies and placing a hand high on one doctor’s thigh.
Further allegations relate to behaviour at work, including sitting extremely close to a colleague, draping an arm behind her on a sofa and grabbing her arm while whispering comments.
According to the charges, his conduct created “an intimidating, hostile, degrading, humiliating or offensive environment” and amounted to a sexually motivated abuse of his senior position.
Dr Kuppuswamy denies wrongdoing.
Following the investigation, the case was referred to a tribunal by the General Medical Council. The decision on his fitness to practise was made independently by a Medical Practitioners Tribunal at the Medical Practitioners Tribunal Service.
The tribunal determined his behaviour amounted to serious professional misconduct and ordered that he be erased from the medical register.
Asked whether the doctor remains employed, the health board said it does not comment on individual staffing matters.
Medical director Mark Henwood said: “We have robust policies and procedures in place to ensure the safety of both staff and patients in our care and we take seriously our responsibility for their wellbeing. We are committed to providing a safe, supportive environment where patients and staff can be confident that best practice is being followed at all times.”
Health
‘Parking fine or miss my appointment’ say patients pressure mounts at hospitals
From sleeping on chairs to parking fines, patients say everyday barriers are pushing the NHS to breaking point
PATIENTS across West Wales are describing a health service under such strain that some say they now expect to be penalised simply for trying to access care.
At Glangwili Hospital, stories of patients sleeping on chairs for days due to a lack of beds have been accompanied by growing frustration over issues that begin long before anyone reaches a ward — including parking, access, and the sheer difficulty of getting through the hospital doors.
One disabled patient said they had resigned themselves to receiving a £25 parking fine in order to attend hospital appointments.
“I now accept I will be fined,” they said. “Parking is impossible, but it’s that or miss my appointment. I am too disabled to park miles away and the disabled spaces are always full.”
Others have described spending days in A&E or side rooms, unable to lie down, while waiting for a bed to become available. One patient admitted on New Year’s Day with pneumonia said they slept in a chair for four nights without a pillow or blanket before being moved, only to later discover they also had flu and should have been isolated sooner.
Across social media and in correspondence with the Herald, patients and families repeatedly stress that frontline NHS staff are not to blame — instead pointing to a system that they say is buckling under years of structural strain.
Glangwili, the largest hospital managed by Hywel Dda University Health Board, serves Carmarthenshire and is home to the county’s only accident and emergency department following the closure of A&E at Prince Philip Hospital. That closure, along with reductions in services elsewhere, is frequently cited by patients as a turning point.
Several people said the loss of local A&E and cottage hospitals has forced more patients into already stretched units, increasing ambulance reliance and long-distance travel — particularly difficult in a largely rural region.
Further west, uncertainty over services at Withybush Hospital continues to fuel anxiety, especially given the scale of reinforced autoclaved aerated concrete (RAAC) identified across the site.
Hywel Dda has acknowledged that almost 90% of Withybush is affected by RAAC, while Glangwili itself is the oldest acute hospital in Wales. The health board says more than £50 million has been spent on the two hospitals in recent years, largely to address critical safety and infrastructure risks rather than expand capacity.
Patients, however, question where that money is felt on the ground.
Some have criticised NHS procurement and management structures, while others point to social care as the missing piece. Repeated comments highlight the lack of care packages and closed care homes, which many believe are leaving medically fit patients unable to be discharged — effectively blocking beds and creating bottlenecks throughout the system.
“There’s nowhere for people to go,” one reader said. “Until social care is sorted, nothing will change.”
Concerns have also been raised about staff morale, with some alleging bullying cultures and burnout contributing to recruitment and retention problems. Again, blame is consistently directed upward rather than at nurses, doctors or porters.
Behind it all looms the long-promised new ‘super hospital’ for Carmarthenshire — first discussed in 2006 and formally launched in 2018. Eight years on, construction has yet to begin, and public confidence in the project is fading.
While Hywel Dda and the Welsh Government insist improvements are under way — including additional funding to expand capacity at Glangwili and improvements to patient experience — many patients say their reality feels far removed from official assurances.
For those attending appointments, sleeping in chairs, or weighing up a parking fine against missing care, the crisis is no longer abstract.
“It’s not politics,” one patient said. “It’s whether you get treated — and how.”
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