THE UNITED ARAB Emirates became the first Gulf country to announce a case of monkeypox today, insisting it was “fully prepared” to handle any outbreak.

The UAE is believed to be just the second Middle Eastern country after Israel to detect monkeypox, whose appearance in a number of countries has caused alarm after the coronavirus pandemic.

The case was found in a 29-year-old woman arriving from West Africa, who is receiving medical treatment, the Ministry of Health and Prevention said.

“We have put in place precise mechanisms for diagnosing suspected patients,” a ministry statement said.

“The technical advisory team for pandemic control has also prepared a comprehensive guide for surveillance, early detection of the disease, management of clinically infected patients and precautionary measures.”

Monkeypox, which is not usually fatal, can cause a fever, muscle aches, swollen lymph nodes, chills, exhaustion and a chickenpox-like rash on the hands and face.

The virus can be transmitted through contact with skin lesions or droplets of bodily fluid from an infected person.

After outbreaks in Europe and North America, the World Health Organization yesterday said the risk of the disease spreading widely among the general population is very low.

Transmission can be stopped outside endemic countries in Central and West Africa, the WHO said, adding that fewer than 200 confirmed and suspected cases had been recorded since early May in Australia, Europe and North America.

News UK cases

A total of 37 more cases of monkeypox have been detected in England and Scotland, public health officials said yesterday, taking the total to 57.

Thirty-six confirmed cases were found in England, and one north of the border, the UK Health Security Agency and Public Health Scotland said.

The UKHSA said it was now advising high-risk contact cases of confirmed cases who have not tested positive or developed symptoms to isolate for up to 21 days.

It has also bought supplies of smallpox vaccine, which is being offered to close contacts to reduce the risk of symptomatic infection and severe illness.

Chief medical adviser Susan Hopkins said contact tracing was helping to limit the close-contact spread of the virus, which causes a chickenpox-like rash.

“Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact a sexual health service if they have any symptoms,” she added in a statement.

“A notable proportion of recent cases in the UK and Europe have been found in gay and bisexual men so we are particularly encouraging these men to be alert to the symptoms.”

The first case of monkeypox in the UK was announced on May 7 in a patient who had recently returned from Nigeria, where the disease is endemic.

Health officials said last week that further cases were not connected to travel and there appeared to be community transmission.

The risk to the general population, however, remained extremely low, they added.

European countries

The Czech Republic, Austria and Slovenia have also registered their first cases of monkeypox, health authorities said today.

In the Czech Republic, the disease was detected in a man at Prague’s Military University Hospital, according to Pavel Dlouhy, head of the Czech Society for Infectious Diseases.

“It was only a question of time, we have been expecting this for days,” Dlouhy told AFP.

The Czech National Institute of Public Health said in a statement today that the sick Czech had shown symptoms of the disease after returning from a music festival in Antwerp, Belgium in early May.

In Austria, a man, who was hospitalised in Vienna on Sunday with symptoms of monkeypox, including fever, has been confirmed to have contracted the disease, the capital’s health authorities said.

In Slovenia, a man, who developed symptoms after returning from the Canary Islands, has also been confirmed to have monkeypox, according to health authorities.

Over the past few days, several European and North American countries including Britain, France and the United States have reported cases of the rare virus, which is endemic in parts of Africa.

Medical authorities have said, however, that the risk that the disease will spread widely is low.

US response

The United States is preparing to give monkeypox vaccines to close contacts of people infected and to deploy treatments, with five cases now either confirmed or probable and the number likely to rise, officials said yesterday.

There is one confirmed US infection so far, in Massachusetts, and four other cases of people with orthopoxviruses — the family that monkeypox belongs to, senior officials with the Centers for Disease Control and Prevention said at a press briefing.

All the suspected cases are presumed to be monkeypox, pending confirmation by testing at CDC headquarters, said Jennifer McQuiston, deputy director of the division of high consequence pathogens and pathology.

One orthopoxvirus case is in New York, one in Florida and two in Utah. All those infected so far in the United States have been men who had a relevant travel history.

Genetic sequencing of the Massachusetts case matched that of a patient in Portugal and belonged to the West African strain, the milder of the two monkeypox strains.

Monkeypox has symptoms similar to smallpox but is far less severe, with most people recovering within weeks.

“Right now we are hoping to maximize vaccine distribution to those that we know would benefit from it,” said McQuiston.

“Those are people who’ve had contacts with a known monkeypox patient, health care workers, very close personal contacts, and those in particular who might be at high risk for severe disease.”

Greater risk to immunocompromised 

In terms of supply, the United States has around one thousand doses of JYNNEOS, a Food and Drug Administration (FDA) approved vaccine for smallpox and monkeypox “and you can expect that level to ramp up very quickly in the coming weeks as the company provides more doses to us,” said McQuiston.

It also has around 100 million doses of an older generation vaccine, ACAM2000.

Both use live viruses but only JYNNEOS is non-replicating, making it the safer option, said McQuiston.

People who are immunocompromised or have particular skin conditions, including eczema, are at greater risk, added John Brooks, a medical epidemiologist.

Transmission of monkeypox occurs through close, sustained skin-to-skin contact with someone who has an active rash, or through respiratory droplets in someone who has lesions in their mouth and is around another person for an extended period of time.

The virus causes a rash, with skin lesions focused on certain areas of the body, or spread more widely. In some cases, during early stages, a rash can start on the genital or perianal areas.

While scientists are concerned that the growing number of cases worldwide may potentially indicate a new type of transmission, so far there is no hard evidence to back that theory, said McQuiston.

Instead, the uptick in cases might be linked to specific spreader events, such as recent raves in Europe that might explain the higher prevalence among gay and bisexual men.

But, warned Brooks, “by no means is the current risk of exposure to monkeypox exclusive to the gay and bisexual community.”

The CDC is also developing treatment guidance to allow the deployment of antivirals tecovirimat and brincidofovir, both of which are licensed for smallpox.

The monkeypox outbreaks in non-endemic countries can be contained and human-to-human transmission of the virus stopped, the World Health Organization said yesterday.

Fewer than 200 confirmed and suspected cases had been recorded so far, the WHO’s emerging disease lead Maria Van Kerkhove said.

“This is a containable situation, particularly in the countries where we are seeing these outbreaks that are happening across Europe, in North America as well,” Van Kerkhove told a live interaction on the UN health agency’s social media channels.

- © AFP 2022