Health alert for Aussie travellers from monkeypox hot spots

The World Health Organisation has warned that hundreds of unusual monkeypox cases might just be the ‘beginning’, with Australian travellers on alert.

The World Health Organisation has cautioned that hundreds of monkeypox cases found in recent weeks outside of countries where the virus usually circulates could be just the beginning.

“We don’t know if we are just seeing the peak of the iceberg,” Sylvie Briand, WHO’s epidemic and pandemic preparedness and prevention chief, acknowledged in a briefing to countries on the “unusual” spread of the virus.

Since Britain first reported a confirmed monkeypox case on May 7, nearly 200 cases have been reported to the UN health agency in countries far from the states where the virus is endemic.

The European Centre for Disease Prevention and Control (ECDC) has put the number of such cases at 219.

Endemic in a number of west and central African nations, monkeypox cases have suddenly been detected in more than 20 other countries around the world, including the United States, Australia, the United Arab Emirates and nearly a dozen EU countries.

The Spanish health ministry said on Friday that 98 cases had been confirmed there so far, while Britain currently counts 90 verified infections.

A patient with lesions on the hands from monkeypox. Picture: AFP/Brian W.J. Mahy/Centers for Disease Control and Prevention

Portugal has meanwhile registered 74 confirmed cases, health authorities said Friday, adding that all the occurrences are in men, mainly aged below 40.

On Friday, Argentina confirmed its first case in a 40-year-old man who had returned from Spain.

Mexico confirmed its first case on Saturday in a 50-year-old resident being treated in Mexico City.

On Monday, Nigeria reported 21 cases of monkeypox since January.

“We are still at the very, very beginning of this event,” Briand told member state representatives attending the World Health Assembly in Geneva.

“We know that we will have more cases in the coming days,” she said, but stressed there was no need to “panic”.

“This is not a disease the general public should be worried about. It is not Covid or other diseases that spread fast.” Monkeypox is related to smallpox, which killed millions around the world every year before it was eradicated in 1980.

But monkeypox is much less severe, with a fatality ratio of three to six percent. Most people recover within three to four weeks.

The initial symptoms include a high fever, swollen lymph nodes and chickenpox-like rash.

While many of the cases have been linked to men having sex with men, experts stress there is no evidence it was a sexually transmitted disease. Rather, it seems to be transmitted by close contact with an infected person who has blisters on their skin.

IS THERE A VACCINE FOR MONKEYPOX?

There is not much in the way of treatment, but some antivirals developed against smallpox exist, including one that was recently approved by the European Medicines Agency against smallpox, Briand pointed out.

Vaccines developed for smallpox have also been found to be about 85 percent effective in preventing monkeypox.

However, since smallpox has not posed a threat in more than four decades, most people under the age of 45 have not received the vaccine, and the supplies of the jabs are today very limited.

Briand said experts were trying to determine what had spurred this “unusual situation”, saying preliminary investigations did not seem to indicate that the virus that causes monkeypox had changed or mutated.

She voiced hope that the spread could be halted.

“We have a good window of opportunity to stop the transmission now,” she said. “If we put in place the right measures now, we probably can contain this easily.”

Australian Government Deputy Chief Medical Officer, Professor Michael Kidd and Deputy Chief Medical Officer Dr. Sonya Bennett at Parliament House in Canberra. Picture: NCA NewsWire/Gary Ramage

ALERT FOR AUSSIE TRAVELLERS

Australian travellers returning from countries where monkeypox cases have been identified, as well as those planning trips to hot spots, have been warned to be alert for signs of infection and to seek medical assistance urgently if they occur.

And primary health care workers around the country have also been urged to be on the lookout for patients with symptoms of monkeypox in the wake of two confirmed cases in NSW and Victoria.

In a webinar for GPs, primary care nurses and other clinicians, the federal Department of Health has provided a briefing on what to look out for and what to do when faced with a potential case.

Deputy chief medical officer Professor Michael Kidd revealed the department’s National Incident Centre had been activated to support the national response to the monkeypox outbreak.

Both cases were in returned travellers, one from the UK and one from Europe.

“While there are currently no specific treatments available for monkeypox infection, outbreaks can be controlled,” Professor Kidd said.

“As monkeypox is similar to smallpox, smallpox vaccine may be used to protect some people from getting monkeypox. It’s also thought that some antiviral treatments for smallpox may also be effective in treating monkeypox.

“The department is co-ordinating the necessary approaches for both potential vaccination and for potential treatments for high risk people in collaboration with states and territories.”

Professor Kidd said monkeypox was a rare zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions of the world.

“Australian travellers who are returning from or going to countries where cases have been identified are encouraged to be aware of the signs of infection and to seek medical help promptly if they think they may be at risk,” he said.

The incubation period for monkeypox is generally six to 13 days but can range from five to 21 days, said Professor Kidd.

Monkeypox lesions are often found on the hands: Picture CDC/Getty Images

SYMPTOMS

“The distinctive rash usually begins between one to three days after the appearance of fever and can be concentrated on the face, arms or legs rather than the trunk, however some people may develop the rash without developing fever first,” he said.

“And the number of lesions can vary from a small number to several thousand. People who’ve recently returned from overseas or who’ve been in contact with someone who is a case in Australia and who develop any of these symptoms should seek medical advice immediately.

“Monkeypox is usually a self-limiting disease with symptoms lasting from two to four weeks however severe cases can occur and death has occurred in rare instances.”

In addition to fever and rash, patients can also experience swelling of the lymph nodes. In most cases the rash appears on the face, palms of the hands and soles of the feet but in about 30 per cent of cases can affect genitalia, and in about 20 per cent of cases, eyes.

It is confirmed through a combination of laboratory testing and clinical assessment.

HOW IS IT TRANSMITTED?

Associate Professor John Blakey, a consultant in respiratory medicine at Sir Charles Gairdner Hospital and Curtin University, said respiratory problems were rare with monkeypox.

“If you’ve heard that monkeypox is often spread by breathing in infected droplets, like influenza or Covid-19, this seems like another bad news story for people with existing lung diseases like asthma and COPD,” he said.

“However, it appears less easily transmitted than those viruses, and the simple measures you are familiar with like hand washing, mask wearing, and self-isolating if exposed are all protective.

Human-to-human transmission can occur through close contact with lesions on the skin, body fluids, including respiratory droplets, and contaminated materials such as bedding.

PREVENTIVE MEASURES

“Respiratory problems are also very uncommon with Monkeypox, and tend to be due to infections with other organisms taking advantage of someone’s weakened immune system. With that in mind, ensure you and your lungs are in the best possible shape by avoiding cigarette smoke, taking regular preventer therapy, ensuring you exercise and eat healthily: that way you are likely to be one of the many people for whom viral infections are an inconvenience, not a serious illness”, said Prof. Blakey.