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Originally Posted On: https://sloanestreetsurgery.co.uk/articles/mpox-what-you-need-to-know-about-the-virus-and-its-spread/

Can you tell me more about the Mpox virus that has been in the news lately?

The World Health Organisation recently declared Mpox a global health emergency in response to the growing number of cases of Mpox both in Africa and other continents.

Mpox belongs to the same family of viruses as smallpox but causes milder symptoms like fever, chills and body aches. People with more serious cases can develop characteristic lesions on the face, hands, chest, and genitals. Most people recover but some become very sick.

Formerly known as monkeypox, the virus that was first identified by scientists in 1958 when there were outbreaks of a “pox-like” disease in monkeys.  The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC), and since then the infection has been reported in several African countries.

In 2022 cases spread globally and were reported in multiple countries including the UK. The WHO declared this outbreak an emergency. In the UK the disease was largely sexually transmitted and predominantly affected men who have sex with men. It was caused by the Clade II lineage and was brought under control by vaccines.

The Democratic Republic of Congo has been experiencing a tragic outbreak of Mpox over the last months and with 27,000 people being infected and over 1100 deaths. This was initially caused by clade 2 lineage Mpox but latterly a new strain of concern (Clade 1) has been identified and was seen to spread to neighbouring African countries.

The clade 1 lineage virus had not previously been seen outside of Central Africa but was recently identified in Sweden and Pakistan prompting concern and hitting the headlines this week. No cases of clade 1 Mpox have been identified in the UK at the time of writing.

How is Mpox transmitted?

Mpox does not spread easily between people unless there is very close contact. This close contact can include;

• direct contact with skin lesions or scabs (including during sexual contact, kissing, cuddling or other skin-to-skin contact)
• coughing or sneezing of someone who has mpox when they are close to you
• contact with clothing or linens (such as bedding or towels) used by someone with mpox.

What are the features of Mpox?

It takes 5-21 days to become unwell after being infected.

Most illness is self-limiting, that’s to say most people recover fully within several weeks with no treatment.

The illness begins with fever, headache, muscle aches, backache, swollen lymph nodes, chills exhaustion and joint pain. Within one to five days of the fever arriving a rash develops often beginning on the face and spreading to other parts of the body including the soles of the feet and palms of the hands. Lesions can also affect the mouth, genitals and anus.  The rash changes and goes through different stages before finally forming scabs which eventually fall off.

How is Mpox diagnosed?

Identifying Mpox can be difficult as other infections and conditions can look similar. It is important to distinguish Mpox from chickenpox, measles, bacterial skin infections, scabies, herpes, syphilis, other sexually transmissible infections, and medication-associated allergies.

Detection of the virus is by PCR swab.

What is the treatment?

Treatment is supportive – most Mpox is mild, and people affected by it recover naturally with the support of painkillers and reassurance.  Antiviral drugs targeted against Mpox do exist and tend to be reserved for people who are at the highest risk of severe disease. People who have been vaccinated against smallpox will have a milder disease

Can I be vaccinated?

Vaccines are used to protect high risk individuals and are only available through the NHS.

The Mpox vaccine is currently offered to:

• gay, bisexual and other men who have sex with men (GBMSM) at highest risk of exposure. Your doctor or nurse will advise vaccination for you if they consider you are at high risk – for example if you have multiple partners, participate in group sex or attend ‘sex on premises’ venues. Staff who work in such premises may also be eligible
• healthcare workers who are caring for and who are due to start caring for a patient with confirmed Mpox
• people who have already had close contact with a patient with confirmed Mpox. Vaccination with a single dose of vaccine should be offered as soon as possible (ideally within 4 days of contact but sometimes maybe given up to 14 days).

Because of the limited supply, only one dose of vaccine may be offered now.

Should we be worried?

There are no cases of the new lineage of Mpox in the UK, and it is a virus which does not transmit easily between people which is good news. There are treatments and vaccinations for Mpox that already exist. Furthermore, the tragic Mpox outbreak seen in the DRC thrives due to poor living conditions and diminished healthcare systems which are not comparable to the UK. We should not be worried at this stage but should be vigilant as we await more information.

What should I do if I have concerns?

Please phone our team and book a telephone appointment with one of our doctors. Please do not attend the surgery if you think you may be infected.

To book an appointment online click here or call us on 0207 245 3999.

Article produced by Sloane Street Surgery, a private GP practice in London that provides world-class private healthcare for patients in Chelsea, Knightsbridge, Belgravia, West London, Hampshire, and beyond.