LAST UPDATE | 31 May 2022

PEOPLE SHOULD NOT be panicked or overly concerned over monkeypox but it is still important to look out for symptoms, a virologist has said. 

The second case of monkeypox in this country was confirmed by the HSE last night, after the first was identified over the weekend. A case had last week been identified in Northern Ireland. 

The HSE said last night that it was “not unexpected” that a second case would be identified and that anyone who had close contact with the individual while they were infectious would be contacted. 

Dr Kim Roberts, virology lecturer at Trinity College Dublin, said people should be mindful of the symptoms of monkeypox – a virus that has transmitted to humans from animals. 

These symptoms include fever, muscle aches, swollen lymph nodes, chills, exhaustion and a rash with blisters on the hands, face, feet, eyes, mouth and/or genital areas. 

“I think being aware is helpful, but we certainly don’t need to be panicking,” Dr Roberts told The Journal. 

“This shouldn’t be a virus that affects lots of people. We should be able to get it under control relatively easily.”

Dr Roberts has researched both respiratory viruses like coronaviruses and poxviruses like monkeypox.  

She said the risk should be minimal for the general population at the moment unless they have been advised by a public health official that they have been exposed to the virus. 

“If you are told that you have been exposed to the virus, you’ll then be given information by the public health teams that are contacting you as to how to look after yourself, how to see whether or not you’ve got any symptoms and how to prevent transmission to other people.”

The viral disease is usually confined to Central and Western Africa, but its emergence in countries that rarely experience outbreaks has raised concerns about how it is spreading.

The virus is only fatal in a small number of cases, but it can cause uncomfortable symptoms for weeks.

“For the vast majority of people, because this is a virus that isn’t adapted to humans, most infections are self limiting, they don’t need medical treatment,” Dr Roberts said. 

The virus can be passed on through close person-to-person contact, or contact with items used by a person who has monkeypox, such as clothes, bedding or utensils.

So it does not have the same airborne transmission risks as Covid-19. 

“There’s more likely to be transmission within a household. It’s highly unlikely to have transmission in a supermarket, for example,” Dr Roberts said. 

We’re not worrying in the same way [as with Covid-19] about transport on the bus. We’re not worrying in the same way about supermarkets because if you have that rash on you, you’re going to know and hopefully seek medical care and look after yourself.

The virologist said people don’t need to be “panicking”, partially because poxviruses like monkeypox have a longer incubation time than other viruses like the coronavirus. 

It takes 6-13 days on average between a person being exposed to monkeypox and developing symptoms/spreading it to other people. 

This compares to around two to five days on average for Covid-19.  

“Because it’s longer in comparison to SARS-coronavirus-2 [Covid-19], it’s much easier in many ways for the public health teams to identify people who have been exposed and break those chains of transmission,” Dr Roberts said. 

But some reasons for concern 

“For me, what’s different about this outbreak is just the number of countries it spread to and therefore the responsibility on each of those countries to contain those different outbreaks,” the TCD virologist said.  

Poxviruses are a “completely different” type of virus to the coronavirus. 

She said humans are “not a natural host” for monkeypox so it isn’t “well adapted to people”. 

“So transmission of this virus is harder” as a result, Dr Roberts explained. 

“That usually means skin-to-skin contact with the sores from the rash in order for transmission to really occur.

“So the transmission risks are very different,” she said. “You can get transmission within a hospital setting, but good use of barrier nursing and personal protective equipment reduces that risk.”

The smallpox vaccine can be used against monkeypox as it’s caused by a virus in the same family as smallpox. 

Smallpox was declared eradicated by the World Health Organization in 1980. Vaccinations against the disease concluded in 1972 in Ireland.

HSE CEO Paul Reid  said smallpox vaccines have been ordered to Ireland and the health service may decide to do a monkeypox vaccination campaign for healthcare workers. 

The HSE said that if the smallpox vaccine is given to someone within four days of being infected, it can have an impact on the illness. It still has an impact between four and 14 days of infection, but to a lesser degree, 

“There is a lot of cross reactivity between antibodies raised against smallpox or raised against the vaccine virus that protects you against smallpox and will also protect against monkeypox,” Dr Roberts said. 

She said people who haven’t been vaccinated against smallpox at any stage of their lives, so most people under the age of 50, “won’t have any immunity” to either smallpox or monkeypox. 

“It will be interesting to see about the older population because one of the questions is that if they’ve been vaccinated 50 plus years ago, the body will remember but they won’t have been boosted by natural circulating virus because the virus was declared eradicated in 1980. So your body hasn’t been silently seeing the virus, thereby boosting it,” the virologist said. 

“So it’ll be interesting to see. And I expect that there will be a range of responses. But I don’t think we’re going to get enough cases to be able to really answer that question.”

Note: This article was originally published yesterday before the second case was confirmed, it has been updated and republished to reflect the confirmation of the second case.