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Monkeypox: How it spreads, who’s at risk - here’s what you need to know
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GENEVA - Monkeypox is not a new disease, and in some African countries it is endemic. However, the international outbreak which began in May 2022, has prompted the World Health Organization (WHO) to declare a global health emergency. Here are some of the important things to know about monkeypox.
What is Monkeypox?
Monkeypox got its name in 1958, when it was detected in several laboratory apes. It is a zoonotic viral disease, which means it can be transmitted from animals to humans. It can also pass from human to human.
Human monkeypox was first identified in 1970 in the Democratic Republic of the Congo (DRC) in a 9-month-old boy, in a region where smallpox (a close relative) had been eliminated in 1968.
Symptoms are similar to those seen, in the past, in smallpox patients, but it is clinically less severe (smallpox was eradicated worldwide in 1980). In 2003, the first Monkeypox outbreak outside Africa was reported in the United States and was linked to contact with infected pet prairie dogs.
Despite the name, most of the animals susceptible to contracting the disease, and then infecting people, are rodents, such as Gambian giant rats, dormice, or tree squirrels.
Where is it typically found?
Monkeypox is most found in the rain forests of central and western Africa, where animals that can carry the virus are native, and the disease is endemic. In these countries, it is increasingly appearing in urban areas.
On occasion, it can also be found elsewhere, in people who could have been infected after visiting these countries.
What are the symptoms?
Symptoms usually include fever, severe headache, muscle aches, back pain, low energy, swollen lymph nodes, and skin rashes or lesions.
The rash usually begins on the first or third day of the onset of fever. The lesions may be flat or slightly raised, filled with clear or yellowish fluid, then crust over, dry up, and fall off.
The number of lesions varies, from a few to several thousand. The rash tends to appear on the face, the palms of the hands, and the soles of the feet. They can also be found in the mouth, genitals, and eyes.
Can people die from monkeypox?
In most cases, the symptoms of Monkeypox go away on their own within a few weeks but, in between three and six per cent of cases reported in countries where it is endemic, it can lead to medical complications and even death. New-born babies, children, and people with immune system deficiencies may be at risk of more severe symptoms and death from the disease.
In severe cases, symptoms include skin infections, pneumonia, confusion, and eye infections that can lead to vision loss.
Many of the fatal cases are children or people who may have other health conditions.
How is monkeypox transmitted from animals to humans?
The virus can be spread to people when they come into physical contact with infected animals, which include rodents and primates.
The risk of contracting it from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including contact with their flesh and blood).
It is crucial to stress that any food containing meat or animal parts should be cooked, especially in countries where Monkeypox is endemic.
How is it spread from person to person?
The virus is spread through physical contact with someone who has symptoms. Rashes, body fluids (such as fluids, pus, or blood from skin lesions), and scabs are particularly infectious.
Ulcers, lesions or sores can also be infectious since the virus can be spread through saliva. Contact with objects that have been in contact with the infected person - such as clothing, bedding, towels - or objects such as eating utensils can also represent a source of infection.
People who have the disease are contagious while they have symptoms (usually within the first two to four weeks). It is not clear whether or not people who are asymptomatic can transmit the disease.
Who is at risk of getting it?
Anyone who comes into physical contact with someone with symptoms or an infected animal, is at increased risk of infection.
Those who live with infected people have a high risk of infection. Health workers, by the very nature of their job, are at risk of exposure.
Children are often more likely to have severe symptoms than teens and adults.
The virus can also be transmitted from a pregnant woman to the foetus through the placenta, or through contact of an infected parent with the child, during or after delivery, through skin-to-skin contact.
How can I protect myself and others?
You can reduce the risk of contagion by limiting contact with people who suspect they have the disease, or are confirmed cases.
Those who live with infected people should encourage them to self-isolate and, if possible, cover any breaks in the skin (for example, by wearing clothing over the rash).
It is important to wear a face mask when in close proximity to the infected person, especially if they are coughing or have mouth sores, and when touching the clothing or bedding of an infected person. Avoid skin-to-skin contact by wearing disposable gloves.
Wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, especially after coming into contact with the infected person, with their clothing (including sheets and towels), or touching other items or surfaces (such as utensils or dishes) that may have come into contact with rashes or respiratory secretions.
Clean and disinfect any contaminated surfaces and dispose of contaminated waste (such as dressings) properly, and wash the infected person's clothing, towels, sheets, and eating utensils with warm water and detergent.
What should I do if I suspect that I have been infected?
If you think your symptoms might be related to Monkeypox, or if you have had close contact with someone who has these symptoms, or suspects that there is a possibility of being infected, notify your doctor immediately.
If possible, isolate yourself and avoid close contact with other people. Wash your hands frequently and follow the steps listed above to protect others from contagion. Your doctor, or other health professional, should take a sample for testing so you can get the right care.
Symptoms usually last two to four weeks and go away on their own without treatment.
Is there a vaccine?
There are several vaccines, developed for the prevention of smallpox that also provide some protection.
A smallpox vaccine (MVA-BN, also known as Imvamune, Imvanex, or Jynneos) was recently developed and approved in 2019 for use in preventing Monkeypox but it is not yet widely available.
The World Health Organization (WHO) is working with the manufacturer of the vaccine to improve access to it. People who have been vaccinated against smallpox in the past, will also have some protection.
Is there any treatment?
Symptoms often go away on their own without the need for treatment. It is important to care for the rash by letting it dry if possible or cover it with a moist bandage if necessary to protect the area.
Avoid touching any eye or mouth sores. Mouthwashes and eye drops can be used as long as products containing cortisone are avoided.
For severe cases, an antiviral agent known as tecovirimat, that was developed for smallpox, was licensed by the European Medicines Agency (EMA) for Monkeypox in 2022, based on data in animal and human studies. It is not yet widely available.
What do we know about the current outbreak?
In May 2022, cases were reported in more than 10 countries in non-endemic areas. Additional cases are being investigated. You can find the latest information on case numbers from the WHO here.
As of May 2022, there is no clear link between reported cases and travel from endemic countries, and no link to infected animals.
Studies are also underway in affected countries to determine the source of infection for each identified case and to provide medical care and limit further spread.
The WHO is working with all affected countries to improve surveillance and provide guidance on how to stop the spread and how to care for those who are infected.
Is there a risk that it will turn into a bigger outbreak?
Monkeypox is generally not considered highly contagious because it requires close physical contact with someone who is contagious (for example, skin-to-skin). The risk to the public is low.
However, the WHO is responding to this outbreak as a high priority to prevent further spread; for many years Monkeypox has been considered a priority pathogen. Identifying how the virus is spreading and protecting more people from becoming infected is a priority for the UN agency
Raising awareness of this new situation will help stop further transmission.
Is monkeypox a sexually transmitted infection?
The condition can be spread from one person to another through close physical contact, including sexual contact. However, it is currently unknown whether it can be spread through sexual transmission (for example, through semen or vaginal fluids). However, direct skin-to-skin contact with lesions during sexual activities can spread the virus.
Rashes can sometimes appear on the genitals and in the mouth, which probably contributes to transmission during sexual contact. Therefore, mouth-to-skin contact could cause transmission when there are lesions in one of these parts.
The rashes can also resemble some sexually transmitted diseases, such as herpes and syphilis. This may explain why several of the cases in the current outbreak have been identified among men seeking care at sexual health clinics.
The risk of becoming infected is not limited to sexually active people or men who have sex with men. Anyone who has close physical contact with someone who is contagious is at risk.
WHO response to stigmatizing messages circulating online?
Messages that stigmatize certain groups of people around this outbreak have been circulating: the WHO has made it clear that this is unacceptable.
Anyone who has close physical contact of any kind with someone with Monkeypox is at risk, regardless of who they are, what they do, who they choose to have sex with, or any other factor.
The WHO points out that it is inadmissible to stigmatize people because of a disease.
Anyone who has been infected, or who is helping care for people who are unwell, should be supported: stigma is likely to only make things worse and slow efforts to end the outbreak.
Loch Ness Monster is ‘plausible’ after fossil discovery in Morocco
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RABAT, MOROCCO - The Loch Ness Monster’s existence is “plausible” after fossils of plesiosaurs were found in a 100-million year old river system that is now Morocco’s Sahara Desert, researchers have said.
A new paper from the University of Bath suggests that plesiosaurs, once thought to be sea creatures, may have lived in freshwater - meaning the theory that the monster could have been a prehistoric reptile is likely.
“The ancient Moroccan river contained so many carnivores all living alongside each other. This was no place to go for a swim,” coauthor Dave Martill said.
Groups in Spain and Morocco push for border deaths inquiry
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By ASHIFA KASSAM and TARIK EL-BARAKAH
MADRID — Human rights organizations in Spain and Morocco have called on both countries to investigate the deaths of at least 18 Africans and injuries suffered by dozens more who attempted to scale the border fence that surrounds Melilla, a Spanish enclave in North Africa.
Moroccan authorities said the casualties occurred when a “stampede” of people tried to climb the iron fence that separates Melilla and Morocco. In a statement released Friday, Morocco’s Interior Ministry said 76 civilians were injured along with 140 Moroccan security officers.
Local authorities cited by Morocco’s official MAP news agency said the death toll increased to 18 after several migrants died in the hospital. The Moroccan Human Rights Association reported 27 dead, but the figure could not immediately be confirmed.
The association also shared videos on social media that appeared to show dozens of migrants lying on the ground, many of them motionless and a few bleeding, as Moroccan security forces stood over them.
“They were left there without help for hours, which increased the number of deaths,” the human rights group said on Twitter. It called for a “comprehensive” investigation.
In another of the association’s videos, a Moroccan security officer appeared to use a baton to strike a person lying on the ground.
In a statement released late Friday, Amnesty International expressed its “deep concern” over the events at the border.
“Although the migrants may have acted violently in their attempt to enter Melilla, when it comes to border control, not everything goes,” Esteban Beltrán, the director of Amnesty International Spain, said. “The human rights of migrants and refugees must be respected and situations like that seen cannot happen again.”
APDHA, a human rights group based in the southern Spanish region of Andalusia, and a joint statement released by five rights organizations in Morocco also called for inquiries.
A spokesperson for the Spanish government’s office in Melilla said that around 2,000 people had attempted to make it across the border fence but were stopped by Spanish Civil Guard Police and Moroccan forces on either side of the border fence. A total 133 migrants made it across the border.
Joint Communique by Ministers of the Global Coalition to Defeat ISIS
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MARRAKECH, MOROCCO - The following statement was released by the Foreign Ministers of the Global Coalition to Defeat Daesh/ISIS following today's meeting in Marrakesh, Morocco.
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The Ministers of the Global Coalition to Defeat Daesh/ISIS reconvened in Marrakesh, Morocco, today at the invitation of Moroccan Foreign Minister Nasser Bourita and U.S. Secretary of State Antony J. Blinken.
The Ministers welcomed the first Global Coalition to Defeat Daesh/ISIS meeting to be convened in Africa and reaffirmed their shared determination to continue the fight against Daesh/ISIS through both military and civilian-led efforts contributing to the enduring defeat of the terrorist group. Together the Ministers emphasized the protection of civilians as a priority and affirmed that international law, including international humanitarian law and international human rights law, as well as relevant UN Security Council resolutions, must be upheld under all circumstances.
The Ministers affirmed that ensuring the enduring defeat of Daesh/ISIS in Iraq and Syria remains the number one priority for the Defeat Daesh/ISIS Coalition. They stressed that despite significant setbacks suffered by Daesh/ISIS' leadership over the recent past, the terrorist group continues to conduct attacks in Iraq and Syria and represents an ongoing threat, as shown by the large-scale attack against the Al-Sinaa detention facility in northeast Syria in January 2022.
The Ministers reiterated the importance of allocating adequate resources to sustain Coalition and legitimate partner forces' efforts. Civilian-led efforts, including prevention, stabilization, countering terrorist financing, counter narratives and foreign terrorist fighter prosecution, rehabilitation and reintegration are increasingly necessary to achieve the lasting defeat of Daesh/ISIS. The Ministers emphasized the need to enhance civilian-led counterterrorism capabilities in Iraq. They also stressed the need to ensure sustainable long-term solutions for Daesh/ISIS fighters and family members in northeast Syria, including appropriate legal procedures to ensure those guilty of crimes are held accountable.
In Syria, the Coalition stands with the Syrian people in support of a lasting political settlement in line with UN Security Council Resolution 2254. The Coalition continues to support inclusive local recovery and stabilization in areas liberated from Daesh/ISIS and reconciliation and reintegration efforts to foster conditions conducive to a Syria-wide political resolution to the conflict under the parameters of UN Security Council Resolution 2254.
The Ministers also recognized the need to meet the evolving threat of Daesh/ISIS in Africa and welcomed the first three Africa Focus Group meetings, which took place in Brussels, Rome, and Marrakesh. Under the auspices of the Global Coalition to Defeat Daesh/ISIS, the Africa Focus Group will bolster the civilian-led counterterrorism capabilities of African members of the Defeat Daesh/ISIS Coalition by drawing upon the Coalition's experiences in Iraq and Syria, and leveraging lessons learned, as appropriate, from the Defeat Daesh/ISIS campaign there to the African continent. This effort includes sharing assessments on the threat of Daesh/ISIS and other terrorist organizations on the African continent and coordinating and collaborating on the most effective and efficient methods to address these issues, including through proactive information sharing and border management, as well as stabilization, prevention and deradicalization projects. The Ministers stressed the need for the Africa Focus Group to foster synergies with other existing international, sub-regional and regional counterterrorism efforts and initiatives on the African continent.
The Ministers stressed the importance of addressing underlying causes to insecurity in Africa, while reiterating that any lasting solution to halting the spread of Daesh/ISIS on the continent will rely primarily on national authorities, as well as sub-regional and regional efforts and initiatives that acknowledge and address the political and economic drivers of conflict. The Ministers noted with concern the proliferation of non-State actors, including separatist movements, and the deployment in Africa of private military companies that generate destabilization and further vulnerability of African states and that ultimately favors Daesh/ISIS and other terrorist and violent extremist organizations. The Ministers also recalled that the Defeat Daesh/ISIS Coalition will continue to be a civilian-driven effort by, with, and through our African members, in line with the principles of national ownership, and in accord with the specific needs of African member states. The Ministers saluted the entry of Benin into the Defeat Daesh/ISIS Coalition, bringing the total number of members up to eighty-five. The Coalition's efforts constitute an integral part of the global counterterrorism structure.
The Ministers confirmed the common view that ISIS-Khorasan is a growing threat to the South and Central Asian region. They strongly condemned the horrific ISIS-Khorasan attacks during Ramadan and the Eid holiday in Afghanistan aimed at civilians, especially minority groups. The Ministers are mindful of the need to remain resolute in countering the ISIS-Khorasan threat in Afghanistan, through Coalition working groups and individual member initiatives, in order to ensure the lasting defeat of Daesh/ISIS in South and Central Asia, and elsewhere in the globe.
The Ministers emphasized the need to address the global Daesh/ISIS threat through holistic and comprehensive coordination of efforts, which are a hallmark of the Defeat Daesh/ISIS Coalition. Such efforts include the initiatives forwarded by the Defeat Daesh/ISIS Coalition Working Groups, including Communications, Counter ISIS Finance, Foreign Terrorist Fighters, and Stabilization.
The Ministers also recognized the importance of finding sustainable solutions to the root causes of terrorism and violent extremism conducive to terrorism and underlined the importance of ensuring the meaningful inclusion and participation of women, youth and other marginalized populations in these efforts - noting the important role of civil society, including women's organizations and youth-led organizations in preventing and combating terrorism and violent extremism conducive to terrorism.
The Ministers also reiterated their global commitment to the survivors and families of victims of Daesh/ISIS crimes, including by holding the Daesh/ISIS leaders and perpetrators accountable. Recognizing that the atrocities carried out by Daesh/ISIS, including sexual and gender-based violence, constitute some of the most serious international crimes. The Ministers remain united in the determination to prevent future generations from enduring the suffering perpetrated by Daesh/ISIS. They therefore express their resolve to remain absolutely vigilant, in the framework of the Defeat Daesh/ISIS Coalition and beyond against the threat of terrorism, in all its forms and manifestations.
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