First monkeypox case in Scotland detected

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First monkeypox case in Scotland detected
Monkeypox virus particle, TEM: Monkeypox virus particle, coloured transmission electron micrograph (TEM)Image source, Science Photo Library
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Symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion

The first case of monkeypox in a person in Scotland has been confirmed.

There have so far been 20 confirmed cases of the viral infection in the UK.

Public Health Scotland said the affected individual "is being managed and treated in line with nationally agreed protocols and guidance".

Details of the Scottish case were released as new guidance from the UK Health Security Agency urged anyone at the highest risk of having caught monkeypox to isolate for 21 days.

The advice applies to anyone who has had direct or household contact with a confirmed case.

Contacts are advised to provide their details for contact tracing, forgo travel, and avoid contact with immunosuppressed people, pregnant women, and children under 12.

Monkeypox is most common in remote parts of Central and West Africa.

in Spain, Portugal, Germany, Belgium, France, the Netherlands, Italy and Sweden, as well as the UK - where the first European case was reported on 7 May.

Cases have also been detected in Australia, the US and Canada.

The WHO, which described the recent outbreaks as "atypical, as they are occurring in non-endemic countries", says another 50 suspected cases are being investigated.

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What are the symptoms?

Monkeypox rashImage source, UKHSA
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The rash changes and goes through different stages, and can look like chickenpox or syphilis, before finally forming a scab, which later falls off

Initial symptoms include fever, headaches, swellings, back pain and aching muscles.

Once the fever breaks a rash can develop, often beginning on the face, then spreading to other parts of the body, most commonly the palms of the hands and soles of the feet.

The rash, which can be extremely itchy or painful, changes and goes through different stages before finally forming a scab, which later falls off. The lesions can cause scarring.

The infection usually clears up on its own and lasts between 14 and 21 days.

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Smallpox vaccine available

Dr Nick Phin, director of Public Health Science and medical director at Public Health Scotland, said the "overall risk to the general public is low".

"We have well established and robust infection control procedures for dealing with such cases of infectious disease and these will be strictly followed," he said.

"We are working with NHS boards and wider partners in Scotland and the UK to investigate the source of this infection.

"Close contacts of the case are being identified and provided with health information and advice. This may include the offer of vaccination."

There is no specific vaccine for monkeypox, but a smallpox jab offers 85% protection as the two viruses are quite similar.

Dr Phin added: "Anyone with an unusual blister-like rash or small number of blister-like sores on any part of their body, including their genital area, should avoid close contact with others and seek medical advice if they have any concerns."

Close physical contact

Monkeypox is a rare viral infection most common in remote parts of Central and West Africa.

The disease, first found in monkeys, does not tend to spread easily between people but can be transmitted through close physical contact.

A person is considered at high risk of having caught the infection if they have had household or sexual contact with, or have changed the bedding of an infected person without wearing personal protective equipment (PPE).

Other people who may have come into contact with a case do not need to stay at home and isolate, but should watch out for symptoms such as fever and a rash.

A large proportion of the UK cases have been identified in gay and bisexual men, and men who have sex with other men.

A monkeypox lesion taken in 2003Image source,

An expert in infectious diseases said superspreader events were likely to be behind the recent rise in global cases.

Sir Jeremy Farrar, director of charitable health foundation Wellcome Trust, told programme the trust had "never seen anything like this before, with such a number of cases" in so many countries.

He said: "The virus may have changed, but I think that's unlikely.

"More likely is, I think, that the niche that this virus now finds itself in has allowed for some superspreader events and those individuals involved in that have then travelled to other parts of the world and taken the infection with them."

He said the UKHSA "deserves great credit" for its "textbook example" response to the outbreak.

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