What is monkeypox and how is it transmitted?

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) that causes small lesions on the skin, headaches and fever. It’s similar to chickenpox or smallpox, though the illness tends to be less severe than smallpox.

The symptoms of the disease caused by the virus are generally mild and clear up in 2-4 weeks without treatment, but can occasionally result in more serious illness if the patient has a weaker immune system.

The disease is called monkeypox because it was first discovered in macaques – a type of monkey – in a Denmark laboratory in 1958. Around 12 years later, the first human cases were discovered in the Democratic Republic of Congo in West Africa.

Scientists believe that, rather than monkeys, the disease could have been transmitted to humans through close contact with rats or other rodents in sub-Saharan Africa. 

Since then, the disease has spread to other countries but has generally been contained within the West African region. In the past few weeks, however, cases have emerged in Europe and North America.  

Why are people concerned about it in Germany?

After the first case was discovered in the UK at the beginning of May, experts assumed that the virus was likely to be present in other European countries.

This prognosis turned out to be accurate, and Germany reported its first case of the virus on May 20th. Since then, six cases in total have been discovered in the Bundesrepublik, including one in Munich and three in Berlin. A further patient with the virus is currently being treated in isolation at Freiburg University Hospital, while authorities have reported evidence of infections in Saxony-Anhalt as well. 

The Health Ministry and Robert Koch Institute (RKI) have said they expect more cases to emerge as time goes on.

“We are in the early stages of this outbreak,” Lothar Wieler, the head of the RKI, said on Tuesday. 

Much is still unknown, he said, but the situation is being closely monitored. Samples from many more people are being analysed, and authorities are also looking for contacts of people with a proven infection. 

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Is this another Covid pandemic? 

Thankfully, no. So far, around 250 cases of the virus have been reported to the World Health Organisation (WHO) in 16 countries worldwide. Though this figure is worrying, the WHO has said that the risk to the general public is still very low.

Speaking to journalists on the sidelines of German Doctors’ Day in Bremen, Health Minister Karl Lauterbach (SPD) emphasised that the developments should be taken seriously. But, he said, the difference between Covid-19 and monkeypox are vast.

“What we are currently experiencing with monkeypox is not the beginning of a new pandemic,” he told DPA. Since the pathogen is well known to health experts, countries are well-equipped to bring the situation under control with good contact tracing and caution, he added.

One major difference between Covid-19 and monkeypox is the way it is transmitted.

According to experts, monkeypox is much harder to transmit to another person than the coronavirus. While Covid-19 can be passed on through airborne droplets and particles, monkeypox infections generally occur after sustained and close physical contact with an infected person or animal.

Of the recent cases that have become known to the RKI, most had been infected at large events “that were connected with sexual activities”, Wieler explained.

What should people do if they suspect they have monkeypox?

On Tuesday, the RKI issued recommendations that anyone who suspects they have monkeypox should self-isolate for 21 days.

If people notice small, red lesions appearing on their skin, they should contact their doctor or local health authority, who may require tests to be carried out and will likely ask for information about contacts. 

The contacts of infected people should also isolate for 21 days, the RKI said.

Generally, monkeypox is most identifiable through changes to the skin. The illness starts with red lesions, which pass through different stages and eventually crust over after the incubation phase of the virus is complete. 

Other symptoms of the disease include headaches, fever, chills, muscular aches and exhaustion. 

Experts also say that prevention is better than cure. Richard Pebody, head of the pathogens team at WHO Europe, recommends regular hand-washing, good hygiene and safe sex as practices to prevent the spread of the illness. 

What is the Health Ministry doing to contain the virus? 

Germany wants to control the spread of monkeypox by tracing contacts and quickly isolating infected people. 

Speaking in Bremen on Tuesday, Lauterbach said that the situation required a “tough response” and that the spread of disease could be contained if outbreaks were caught early. 

Now that the RKI has formulated isolation guidelines for both contacts and infected people, these will are set to be passed onto the 16 German states in the form of a recommendation.

The states will then be responsible for implementing and enforcing the rules.

In addition, health experts are currently investigating whether existing vaccines should be rolled out to certain segments of the population.

This is a view supported by Klaus Rheinhardt, the head of the German Medical Association. Rheinhardt said on Tuesday that he thought vulnerable groups should be inoculated with the smallpox vaccine, which is believed to be highly effective against monkeypox.

This could include people with illnesses that weaken their immune system. Experts believe that the majority of people who died after a monkeypox infection in West Africa were HIV patients. 

Germany currently has around 100 million doses of smallpox vaccines in storage. Smallpox vaccination was compulsory in West Germany until 1975 and in East Germany until 1982, but the vaccination campaigns were phased out shortly before the eradication of the virus. 

READ ALSO: Monkeypox: German health expert calls for isolation measures