Ireland on alert for monkeypox as virus spreads across Europe

WHO meets to assess outbreak as UK records 20 cases, with virus spreading in community

The health service is bracing itself for the arrival of the monkeypox virus, which is spreading in a number of European countries.

A committee of the World Health Organisation was due to hold an emergency meeting on Friday to discuss the situation.

The HSE has set up a multidisciplinary incident management team to prepare for the possible arrival of monkeypox, and infectious diseases experts are on alert for patients with symptoms of the virus.

While no cases have as yet been identified in Ireland, 11 new cases of monkeypox have been confirmed in the UK, bringing the total number of cases recorded there to 20.

Germany, Italy and Belgium all reported their first cases of the virus in recent days. Spain said it has identified 30 cases, mainly in the Madrid region where the regional government closed a sauna linked to the majority of infections.

For the first time, the virus seems to be spreading in the community. Previous cases in the UK were linked back to travel from high-prevalence areas such as west Africa.

Most of the UK cases so far are in gay, bisexual and men who have sex with men. The HSE is advising members of these communities to be alert to any unusual rashes or vesicular lesions on any part of their body.

According to the Health Protection Surveillance Centre, monkeypox is a rare disease. It occurs primarily in remote parts of central and west Africa. There are two types of monkeypox: West African monkeypox and Congo Basin monkeypox. The Congo Basin type is more severe, but only the milder, west African type has been spread to countries outside Africa.

Not very infectious

Infection can be spread from person to person through contact with bodily fluids and skin lesions of a monkeypox case.

Monkeypox is not very infectious, the HPSC says, as it takes close physical contact to spread between people.

“Contact with close family members or sexual contact poses the biggest risks of person-to-person spread. The risk of spread within the community, in general, is very low,” it advises.

Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. The virus causes a rash that starts out on the face before spread on the body. Raised red spots quickly develop into little blisters, typically within one to three days of fever onset.

Sam McConkey, associate professor at the Royal College of Surgeons in Ireland, said the strain of monkeypox spreading in recent weeks was “less transmissible and less likely to cause death than the east African one” but 1-3 per cent of people who get the virus “can die from this”.

He added: “It can potentially cause lung disease - again a bit like chicken pox in adults - it can lead to lung problems and needing oxygen and intensive care.”

Speaking on RTÉ Radio One , he said there was no reason to panic but preparations were required. “It clearly behoves GPs and hospitals to be ready for it. You have to wear all the goggles and masks and blue PPE covering every bit of your skin [in medical settings] just like Covid again, and dispose of that carefully”.

The HPSC says monkeypox infection is usually a self-limiting illness and most people recover within weeks, although severe illness can occur in people with very weak immune systems, and in very small babies.

There is no medical cure and treatment consists of relieving symptoms.

UK health secretary Sajid Javid said the UK government had some stocks of the smallpox vaccine, which could be effective against monkeypox as the viruses are quite similar. This is being offered in the UK to very close contacts of those who have been affected.

“Most cases are mild, and I can confirm we have procured further doses of vaccines that are effective against monkeypox,” Mr Javid said.

Mild symptoms

Spain is assessing different therapeutic options, such as antivirals and vaccines, but so far all cases have mild symptoms and therefore no specific treatment has been necessary, Spanish health minister Carolina Darias told reporters on Friday.

Additional cases of monkeypox are likely to be detected in the United States but the risk to the general public is low at this time, a senior US administration official said on Friday. The first case of monkeypox this year in the US was confirmed on Wednesday by the Massachusetts Department of Public Health. The infected man had recently traveled to Canada.