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Monkeypox under the microscope (archive image)
Photo: Andrea Männel / dpa
After several cases of monkeypox in people in Great Britain, the Robert Koch Institute (RKI) in Germany is sensitizing doctors to the virus infection.
In an article published by the RKI it says: In view of the cases in the United Kingdom, monkeypox should be considered as a possible cause in the case of unclear smallpox-like skin lesions even if those affected have not traveled to certain areas.
In Great Britain, the number of recorded cases of the rare disease had increased to seven, the health authority UK Health Security Agency (UKHSA) announced on Monday.
Connections between those affected are only partially known.
Two cases occurred within one family.
For the other affected people, it is largely unclear where they got infected.
Four recently reported cases involve men who have had sexual contact with other men.
They are said to have been infected in London.
The first infection, which became known in Great Britain at the beginning of May, is said to be due to an infection in Nigeria.
In response, British experts emphasized that monkeypox is not easily transmitted from person to person and that the risk to the general population is very low.
The most recent cases now suggest that human-to-human transmission did occur.
The fact that the contact between the cases cannot be traced indicates that there are unknown chains of infection in the population.
Droplet transmission possible
According to the UKHSA, the viral disease usually causes only mild symptoms, but can also have severe courses.
According to the UKHSA, the first signs of illness include: fever, headache, muscle and back pain, swollen lymph nodes, chills and exhaustion.
An itchy, painful rash with blisters or pustules may develop and spread to other parts of the body, often starting on the face.
The rash looks different depending on the phase and can resemble chickenpox and syphilis.
Symptomatic patients are contagious through close contact until the smallpox has completely healed and the scabs have fallen off - usually after two to three weeks.
The viruses can be transmitted through contact with bodily fluids or crusts, and the sexual transmission of smallpox viruses is also possible, according to the RKI report.
According to the World Health Organization (WHO), monkeypox can also be transmitted through small droplets.
The incubation period is therefore usually between six and 13 days.
Experts suspect that the monkeypox pathogen circulates in rodents, and monkeys are considered false hosts.
"Infections can be transmitted through contact with the secretions of infected animals," says the RKI report.
Many are no longer vaccinated
Smallpox has been considered eradicated worldwide since 1980 after a major vaccination campaign.
As the RKI explains, large parts of the world's population no longer have vaccination protection.
Since 2017, an increasing number of human cases of monkeypox have been diagnosed in Nigeria - and cases linked to travel there, especially in the United Kingdom.
In a specialist article from 2019, three RKI employees stated: "Outside of Africa, monkeypox in humans has only been identified three times: in 2003 in the USA and in 2018 in the United Kingdom and Israel".
Most people – more than 30 cases were recorded – were therefore infected in several US states.
The virus was introduced to the USA with the transport of 800 small mammals from Ghana.
Those affected are said not to have been infected directly from these animals, but through contact with prairie dogs that had been kept close to the Ghanaian animals before they were sold on.
Science journalist and analyst Lars Fischer sees the number of cases in the UK and evidence of ongoing transmission between people outside of Africa as evidence the virus is changing behaviour.
In an article in the journal "Spektrum der Wissenschaft" he wrote that African experts in particular warned that monkeypox could develop from a regionally widespread zoonosis into a globally relevant infectious disease.
The virus may occupy the ecological and immunological niche that the smallpox virus once occupied, wrote a team led by Malachy Ifeanyi Okeke from the American University of Nigeria in a publication in 2020.
Fischer currently considers it unlikely that the outbreak in Great Britain will become an epidemic.
kry/dpa