2022-06-09 10:07

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Monkeypox In The UK – Derek Maylor Reports

Derek Maylor, CWU Greater Mersey Amal Branch's H&S Coordinator and member of the North West BT Unions Health & Safety Co-ord, reports on the new virus that is raising some concerns across the country:

What is Monkeypox?

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in countries of central and west Africa. Monkeypox is a zoonosis: a disease that is transmitted from animals to humans. Human-to-human transmission is limited, but it can be transmitted through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets and contaminated objects. 

Background:

On 13 May the WHO was notified of two laboratory confirmed cases and one probable case of monkeypox, from the same household, in the UK. On 15 May, four additional laboratory confirmed cases have been reported amongst Sexual Health Services attendees presenting with a vesicular rash illness in men who have sex with men (MSM); based on currently available information, infection seems to have been locally acquired in the United Kingdom. The extent of local transmission is unclear at this stage and there is the possibility of identification of further cases. 

Monkeypox can be transmitted by droplet exposure via exhaled large droplets and by contact with infected skin lesions or contaminated materials. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.  The disease is often self-limiting with symptoms usually resolving spontaneously within 14 to 21 days.

Symptoms can be mild or severe, and lesions can be very itchy or painful. The animal reservoir remains unknown, although is likely to be among rodents. Contact with live and dead animals through hunting and consumption of wild game or bush meat are known risk factors.

Milder cases of monkeypox may go undetected and represent a risk of person-to-person transmission and there is likely to be little immunity to the infection in those travelling or otherwise exposed.

Current situation:

UK health authorities have established an incident management team to coordinate the extensive contact tracing which is currently underway in health care settings and the community for those who have had contact with the confirmed cases. Contacts are being assessed based on their level of exposure and followed up through active or passive surveillance for 21 days from the date of last exposure to a case. Vaccination is being offered to higher risk contacts.

A detailed backwards contact tracing investigation is also being carried out to determine the likely route of acquisition and establish whether there are any further chains of transmission within the United Kingdom for all cases. Sexual contacts and venues visited are actively being investigated for the four recent cases.

Risk Assessment approach for members:

Whilst monkeypox being acquired by droplet exposure that is rare and much more likelihood of getting the disease is by (very) close contact. The UK health bodies have reacted quickly promptly initiated appropriate public health measures in identifying, isolating cases and looking for the source of the disease which appears to have been locally acquired in the United Kingdom from a traveller to/from Africa.

The WHO have advised the UK to continue with intensive public health measures including local rash-illness surveillance in primary and secondary health care settings. The NHS are raising awareness among health care providers, including sexual health and dermatology clinic; health workers and other care givers caring for patients with suspected or confirmed monkeypox should implement standard, contact and droplet infection control precautions.

Should any member travel to Africa they will be advised to avoid contact with sick animals (dead or alive) that could harbour monkeypox virus (rodents, marsupials, primates) and should refrain from eating or handling wild game (bush meat). The importance of hand hygiene by using soap and water or alcohol-based sanitiser should be emphasised. There is no ban or any restriction for travel.

Conclusions:

  • The WHO state that human-to-human transmission can only result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects and that transmission via droplet respiratory particles requires prolonged face-to-face contact. Members are therefore currently not at any significant risk from contacting the virus at members premises, business or domestic, under normal working conditions.
  • Should any member get a dermatological complaint like a serious rash they should take medical advice, but that would be a normal course of action at any time.
  • The Branch [Greater Mersey Amal] will monitor the situation and readdress should advice from the WHO significantly change

Source: World Health Organization. (18 May 2022). Monkeypox. Available: https://www.who.int/news-room/fact-sheets/detail/monkeypox. Last accessed 1 June 2022


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