Episode #73 – Monkeypox

Vismita Gupta-Smith

We are talking about monkeypox today. Is this a new disease? What is the treatment? Does the vaccine work? Who is at risk and why is WHO concerned about it?

Hello and welcome to Science in 5.

I’m Vismita Gupta-Smith. Our expert today is Dr Rosamund Lewis. Welcome, Rosamund.

Let’s start with explain monkeypox to us. What are the symptoms? Is this a new disease?

Dr Rosamund Lewis

Monkeypox is not a new disease. It was first discovered in a monkey in 1958 and hence the name. However, the first infection in a human was discovered in 1970 in a small child in the Democratic Republic

of the Congo. Since that time, increasing numbers of cases have been recognized. And in particular, over the last 5 to 10 years. What’s different now is that we’re seeing cases in other countries that normally don’t have monkeypox. And this is very
unusual. We’ve had the occasional outbreak or a single case detected in a traveler from West Africa. But in fact, we’ve never seen an outbreak like this before.

The most important thing about monkeypox is that it does cause a rash which can be uncomfortable, it can be itchy, and it can be painful.

So the most important thing about caring for someone with this illness is basically taking care of the skin and taking care of any symptoms that someone might have, such as pain or itchiness. It’s important to know that research over many years has
also yielded some vaccines and treatments for monkeypox.

These are new products and not yet widely available. However, the vaccine is recommended for persons who have been in contact with someone who has monkeypox. When it comes to treatment, most people don’t need the new products. Most people don’t have
a severe case of monkeypox and can be managed conservatively with regular care where it’s necessary. It may be possible to access the new treatments for a very select few patients who may need them.

Vismita Gupta-Smith

Rosamund, explain to us how monkeypox spreads, who is at risk, and how can they protect themselves?

Dr Rosamund Lewis

Sure. So monkeypox spreads through close face to face, skin to skin, direct contact. This is how it’s always been described. There may be some new things happening in this outbreak now. We don’t know everything. There’s still a lot to learn.

So at the moment, the people who are most exposed appear to be men who have sex with men. So it’s really important that all of us together make sure that the messages reach the people who need to have them right now. That is people who may be at risk right now. And right now, those people are men who have sex with men or other ones who may be in contact with them, including family members.

So because this virus does spread through close contact and person to person contact, it does mean that in the health care setting, a health worker who doesn’t know what they’re dealing with and may not have the right personal protective equipment may inadvertently be exposed. So we also want to be sure that health workers have the message that if they’re seeing someone who may have a rash that is undiagnosed or has not previously been diagnosed, it’s critically important to be aware that this virus is now newly spreading in different population groups and to ensure that all the basic precautions are taken to protect yourself with personal protective equipment.

Likewise, if there’s someone who has monkeypox, lives in a family setting may also want to take care that other members of the family are not immediately at risk. So while we’re talking about who is most at risk, of course it’s really important not
to generate stigma against population groups that are at risk. This includes men who have sex with men.

It can also include people who are traveling from different countries who may be carrying the virus without knowing it. It’s really critical that we avoid stigma.

The reason is that if people feel stigmatized, they will not feel comfortable coming forward for diagnosis and care. And we really do want to reach the people who may be at risk.

Vismita Gupta-Smith

Rosamund, WHO has described the risk as moderate. Explain to us why WHO is concerned about this outbreak?

Dr Rosamund Lewis

Most people who have monkeypox do not become very ill. However, WHO has described the risk as moderate because monkeypox is spreading in locations where it has never been reported before. So this new pattern of transmission is concerning and it’s
moving quite quickly.

So it’s really important for WHO and all countries and all parties and all stakeholders at the community level to understand where the risk may be, who may be at risk so that people can protect themselves. This is the message that we would like to
share is that people can protect themselves.

If you know your own risk, you can lower your own risk.

Vismita Gupta-Smith

Thank you, Rosamund. That was science in 5, until next time then, stay safe, stay healthy and stick with science.

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