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Monkeypox in Nigeria - Cases identified in the UK. (Update 1)

11 Sep 2018

Public Health England (PHE) have confirmed that a second individual has been diagnosed with monkeypox in England. 

This person had recently travelled to Nigeria where they are believed to have become infected. They were first admitted to Blackpool Victoria Hospital and following a positive test result were transferred to Royal Liverpool University Hospital.

This second case is not linked another patient who is currently being treated at the Royal Free Hospital in London.

Advice for travellers

Monkeypox is a rare viral infection found in central and west Africa. Monkeypox is similar to smallpox (eradicated globally in 1980) but is less severe. While the name implies monkeys are affected, rodents are likely to be a main source of infection.

Spread

People may become infected by:

  • Direct contact with the blood, body fluids or skin lesions of infected animals
  • Eating undercooked meat of infected animals
  • Direct droplet spread from close contact with infected respiratory secretions (e.g. through coughing), or skin lesions of infected people. Prolonged face to face contact is involved transmission.
  • Indirectly by contact with surfaces/materials contaminated by infected respiratory secretions or skin lesions

Occurrence

  • Monkeypox has been reported from 10 central or west African countries: Cameroon, Central African Republic, Democratic Republic of Congo, Gabon, Ivory Coast, Liberia, Nigeria, Republic of Congo, Sierra Leone and South Sudan

 The disease

  • Monkeypox is not usually fatal, though mortality rates of 1% – 10% have occurred in outbreaks. While severe infection is more common in children, some infected people are have no symptoms.
  • Monkeypox has an incubation period which can range from 5 – 21 days. Flu-like symptoms, swollen glands, fatigue and fever are typical of early infection. Skin eruption follows 1-3 days after fever and produces a rash on the face and body. This is similar to a chickenpox rash, although in monkeypox the skin lesions develop simultaneously, affecting the face and rest of the body. Scabs develop in about 10 days and patients are infectious until all the scabs have fallen fall off.

 Risk to Travellers

  • Travellers to central and west African countries reporting cases should be aware of the risk of infection. However, there are very few reports of visitors to Africa becoming ill with monkeypox and the risk to the vast majority of travellers is small.
  • The main risk is to long-term residents of affected areas.

Prevention

Travellers to central or west African countries are advised to:

  • Avoid contact with monkeys and rodents and avoid consuming undercooked meat from these or any other sources.
  • Wear protective clothing including gloves if involved in the slaughter of, or care of animals in affected countries.
  • Observe meticulous hand hygiene (including gloves) if visiting or caring for ill friends and relatives in affected countries.
  • Seek medical attention in the event of fever or rash during or return from travel to affected countries.