Dr Skye Scott
“This month we’ve witnessed the global Avian flu outbreak, chocolate Kinder eggs laced with salmonella, severe hepatitis of unknown cause among children across the world, an Ebola outbreak in West Africa, the first Polio case in Mozambique in 30 years, and… a global outbreak of monkeypox.”
How on earth do we respond to all this? The first unmeasured response is a combination of fear and disbelief. We invite you to think differently.
Take stock. How can you rebuild your own world to be safeguarded from these symptoms of global imbalance?
Be the LIGHT; because that is what you are.
What is Monkeypox?
Monkeypox is a viral illness, a cousin of smallpox. Smallpox was declared eradicated by the World Health Organisation in 1980. It is endemic in West and Central Africa and occurs commonly in the region. Occasionally, we find a case outside of this area. We expect this to happen more often because smallpox vaccines are no longer administered and the vaccines would have provided some cross-reactive immunity against monkeypox (85% prevention).
How does Monkeypox Spread?
Monkeypox originates from animal reservoirs that then jump to infect a person after they sustain a bite or scratch. Once a human is symptomatic, that human can infect other humans through close contact such as kissing, cuddling, or touching parts of the body with monkeypox lesions (wound) or contaminated items like linen/clothes. People who do not have monkeypox symptoms cannot spread the virus to others.
How Infectious is Monkeypox?
The current thinking is that you need to be symptomatic to spread monkeypox.This can happen through contact, body fluids or prolonged exposure with an infected carrier. With the information we have at hand (26 May 2022), the R(0) of this outbreak appears to be R ( 1.15 to 1.26.). This means for every infected person, another 1-2 people become infected. This is low and is comparable to other monkeypox outbreaks.
The R(0) of Covid-19 is 2-3. Common seasonal flu is R(1-2).\
How sick are people becoming in this current outbreak?
So far only 12% of people have been hospitalized and there have been one recorded death in 42 countries. Hospitalization is often for isolation and not for severity of disease..
What is the Incubation Period after Exposure?
Anything from 6 to 21 days. After you have been exposed to a symptomatic and infected individual, it can take up to 3 weeks for you to become symptomatic. You are NOT INFECTIOUS in that period of time. There is little evidence to support that we have asymptomatic spread.
What are the Symptoms of Monkeypox?
It starts with the invasion period which is characterised by body aches, swollen lymph nodes. It is followed by the rash which starts on days 1 – 3: rash starts on face and moves down the body. The rash has a distinctive evolution that takes about a month to complete its progression and scar. All lesions progress at the same rate. You are infectious until your rash resolves which can take up to 4 weeks.
What is the Difference Between the two ‘Clades’ of Monkeypox?
When talking about pox viruses, we talk about clades, in the same way we talk about variants of Covid-19. There are two predominant clades:
The Congo basin (~10% fatality rate)
The West African clade (~1% fatality rate)
It’s important to note that these areas have poor access to healthcare so that may contribute to infection and fatality rates. An American outbreak in 2003 resulted in 26% of those infected being hospitalised, 15% with severe disease but NO DEATHS.
How Easily does Monkeypox Spread?
Usually, not very easily – you need a very high viral load to infect another human paired with prolonged contact. We are unsure if the current outbreak is being driven by mutation and human behaviors (physical intimacy at large parties in Europe, see below). We learned from the 2003 USA outbreak that animal reservoirs outside of Africa can cause spread. In this instance, prairie dogs became infected after eating infected rodents. If monkeypox were to become established in a wildlife reservoir outside Africa, the public health setback would be difficult to reverse.
How Rapidly is the Current Outbreak Increasing?
As of 15 June 2022, WHO has reported a culminative 2103 confirmed cases in 42 countries. An unusual outbreak of monkeypox has been identified after suspected superspreading events in Antwerp, Belgium, Spain and the Canary islands. The strain detected after these events has a mild course of disease and is characterised by oral and genital ulcers. Monkeypox is NOT sexually transmitted infection but can spread during intimate physical contact between people. Anyone – regardless of gender identity or sexual orientation – can catch monkeypox if they have close contact with someone infected with the virus.
Is There a Vaccine against Monkeypox?
Yes, there are two vaccines for smallpox that are largely protective against monkeypox, about 85%. The one vaccine is a live vaccine and its use has been prohibited by the CDC due to a poor adverse effect profile. The other is available and recommended to prevent monkeypox before exposure. Post-exposure benefit has been shown in animal models only.
Are there monkeypox cases in South Africa?
The National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service, confirmed that a case of monkeypox has been identified through laboratory testing at the NICD on Wednesday, 22 June 2022. The case involves a 30-year-old male residing in the Gauteng province.
What to do if you think you have Monkeypox?
There is a broad differential for a blister-like rash, don’t panic. Book a virtual consultation with your family doctor and they will walk you through what to do next. Don’t forget to mention any travel you may have been on.
- Eat sustainably produced, whole foods rich in plants.
- Speak out against transport and trade of small and large captive animals.
- Avoid unnecessary antibiotics and animal food sources that have been fed
lots of antibiotics eg. Chicken, pork, beef. - Try to reduce your carbon footprint on the earth.
- Cultivate a diverse microbiome by spending time in nature, communing with other uplifting people and by eating a diet rich in fruit and vegetable produce.
- Prioritise washing your hands with soap and water rather than sanitisers or spraying down of household appliances. Sterile environments breed superbugs.
- Make sure you move everyday. Get your heart rate up and keep your body metabolically healthy.
- Get enough sleep so that you are calmer, kinder and more productive.
- Engage in activities and learning experiences that help to contribute to the restoration and replenishment of the fractured world.
Article courtesy of Health with Heart. Written by Dr Skye Scott and Melinda Whitfield.
Resources used to write this article include: WHO, the ECDC, Your friendly epidemiologist Katelyn Jetelina and the NICD.
