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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.

Health

Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’

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WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.

The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.

Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.

Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.

“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”

He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.

“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”

While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.

The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.

Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.

“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”

The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.

With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.

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Health

Government orders clinical review amid sharp rise in mental health diagnoses

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4.4 million working-age people now claiming sickness or incapacity benefit, up by 1.2 million since 2019, many because of a mental health condition

A CLINICAL review into how mental health conditions are diagnosed across the UK is expected to begin this week, following concerns within government over rapidly rising sickness-benefit claims linked to conditions such as autism, ADHD and anxiety.

Health Secretary Wes Streeting has commissioned leading clinical experts to examine whether ordinary emotional distress is being “over-pathologised” and to assess why the number of people receiving sickness and incapacity benefits has grown to 4.4 million – an increase of 1.2 million since 2019.

According to reports in The Times, ministers are particularly alarmed by the surge in the number of 16- to 34-year-olds now out of work because of long-term mental health conditions.

Streeting said he recognised “from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” but added that he had also heard from clinicians who say diagnoses are “sharply rising”.

“We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services,” he told the newspaper. “That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”

The review is expected to be chaired by Prof Peter Fonagy, a clinical psychologist at University College London specialising in child mental health, with Sir Simon Wessely, former president of the Royal College of Psychiatrists, acting as vice-chair.

Prof Fonagy said the panel would “examine the evidence with care – from research, from people with lived experience and from clinicians working at the frontline of mental health, autism and ADHD services – to understand, in a grounded way, what is driving rising demand.”

The move comes as the UK Government faces mounting pressure over the rising welfare bill. Ministers earlier this year pulled back from proposed changes to disability benefits, including those affecting people with mental health conditions, after opposition from Labour backbenchers.

Speaking on Monday, the Prime Minister said a fresh round of welfare reform was needed.

Keir Starmer said: “We’ve got to transform it; we also have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work.”

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Health

NHS Trust CEO ‘forced out’ after raising concerns — Welsh Govt denies wrongdoing

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A CONSERVATIVE MS has pressed the Welsh Government for answers after the sudden departure of the Velindre University NHS Trust’s chief executive, amid media reports that he raised concerns about alleged governance failures within NHS Wales Shared Services.

During Health Questions in the Senedd today, James Evans MS asked Health Secretary Jeremy Miles to explain why former CEO David Donegan left his post after just a year. Reports circulating in recent weeks suggest Mr Donegan had raised issues relating to governance, and in some accounts, possible criminality. These claims have not been substantiated publicly.

Velindre’s own 2024/25 annual report notes that the Trust “escalated concerns to Audit Wales and Welsh Government about the current governance of Shared Services, which hadn’t been reviewed since 2012.” No details of the concerns have been published.

Welsh Government response

Jeremy Miles MS confirmed in the chamber that correspondence relating to the issues does exist, but said it would not be appropriate to release sensitive material while internal processes are ongoing. He did not comment on the circumstances of Mr Donegan’s departure, citing employment confidentiality rules which are standard across the NHS and public sector.

A Welsh Government spokesperson has previously said that they expect all NHS bodies to follow “proper governance and HR procedures,” and that they “do not comment on individual employment matters.”

Velindre NHS Trust position

Velindre has not publicly stated that Mr Donegan was removed because of whistleblowing activity. The Trust has described his departure simply as a “change in leadership” and says it continues to engage with Audit Wales and the Welsh Government on governance matters.

Opposition criticism

After the exchange, James Evans MS — the Welsh Conservative Shadow Cabinet Secretary for Health — criticised the Health Secretary’s “lack of transparency”.

He said:

“I am extremely disappointed with the Health Secretary’s refusal to provide clarity on the circumstances surrounding Mr Donegan’s departure, or to release the correspondence relating to governance concerns within Shared Services. The public must be able to trust that millions of pounds of NHS funds are being managed properly.”

Mr Evans said he will write to the First Minister and Cabinet Secretary formally requesting the publication of correspondence “in the interests of full accountability.”

Context: What is NHS Shared Services?

The NHS Wales Shared Services Partnership (NWSSP) manages national procurement, payroll, recruitment, estates services and other core functions for health boards and trusts. It sits within Velindre University NHS Trust but operates independently of its operational healthcare work. Governance arrangements for NWSSP were originally set a decade ago and are subject to periodic review by Audit Wales.

There is no evidence at present of wrongdoing by the Welsh Government or NWSSP, beyond the concerns referenced in Velindre’s annual report.

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