Understanding the Monkeypox Outbreak

In a recent episode of the Pre-Hospital Care Podcast; Professor Kelechi Nnoaham joined Eoin Walker to examine the viral Monkeypox (MPV) outbreak that has been in the headlines this year in the UK.






While the Monkeypox virus was first isolated from laboratory monkeys in transit from Singapore to Denmark in 1958, the first human case was recorded in 1970 when the virus was isolated from a child in the Democratic Republic of the Congo (DRC). They initially suspected that the child had contracted smallpox, before isolating Monkeypox.


Carriers for Monkeypox are generally rodents such as mice, rats and squirrels.


Immunity to Monkeypox had previously been achieved through smallpox vaccinations, but in recent years – the lack of vaccination efforts have paved the way for Monkeypox to once again gain clinical relevance.


Scientists have for decades predicted that cases of Monkeypox would rise in frequency and volume, with the lack of smallpox vaccinations being a key factor in a lack of preparedness against the virus.


“The herd immunity that we enjoyed globally, from that vaccination, over time has suffered a degree of attrition, which is part of the reason we are here today,” Professor Nnoaham added.


He explained that there are two clades, or ancestries, of the Monkeypox virus. The Central African variant has been reported more frequently and has a higher case fatality rate of between 3 to 6 percent, while the West African clade that is much less frequently documented – and up until now had shown little to no degree of human to human transmission.


Interestingly, it is this West African variant which has a much lower fatality rate of about 0.6% and much milder symptoms that appears to be driving the outbreaks outside of Western and Central Africa right now.


Before the current international outbreak, there had been a number of isolated and sporadic cases. This time, however, is different. The number of reported cases and the frequency of positive tests for the virus are far greater than in previous outbreaks.


There were well over 700 positive cases reported by the beginning of June across about 30 countries internationally, while 302 of these cases were reported in the UK.


Under-reporting in rural Central and Western Africa indicates that these areas are hotspots for the spread of Monkeypox.


The ease of global travel and climate change both play a role in our susceptibility to viral outbreaks, and in the wake of COVID-19, the world is hyper-aware of viral threats. In the case of Monkeypox in particular, the trade of exotic pets and international travel are both key markers for the spread of the virus.


On the bright side, increased surveillance and controls in developed countries have helped to ensure that cases are identified more readily outside of Africa, so the spread can be limited and indicating that current numbers are representative of number of cases.


BHA Medical, a leading provider of innovative medical technology and solutions around the world, has introduced a Monkeypox Lateral Flow Antigen Rapid Test – able to quickly identify positive cases of the virus.


The product is a lateral flow detection of monkeypox virus antigen in human whole blood, serum, plasma, rash exudate, or nasal swab. The product uses a double antibody sandwich method. During the test, a specimen is dropped into the specimen hole, the specimen is superimposed under the capillary effect. If the specimen contains monkeypox virus, a colour band appears in the test area (T) indicating a positive result for monkeypox virus. If the specimen does not contain the corresponding substance, there will be no colour bands in the test area (T), and the result will be negative. The Performance Characteristics show that the positive and negative coincidence rates are 100%


To find out more about this product, click here.


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