Monkeypox Ireland: First case confirmed as potential second under investigation

Monkeypox Ireland: First case confirmed as potential second under investigation

Around 200 cases of the viral infection have been reported across Europe. Picture: Cynthia S. Goldsmith, Russell Regner/CDC via AP, File

The first case of monkeypox has been identified in Ireland, the health minister has confirmed.

Stephen Donnelly says the disease was detected in the east of the country by the Health Protection Surveillance Centre on Friday. The infected person has not been hospitalised.

It said this case was not unexpected following the presence of monkeypox cases in the UK and many European countries.

A further suspected case is also being investigated by health officials.

The HPSC is following up with all people who had close contact with the person while they were infectious.

It comes after an initial case was detected in the North, while 16 more cases of the virus were identified in England on Friday, health officials said.

The UK Health Security Agency (UKHSA) said the new cases bring the England total since May 7 to 101, and the UK total to 106.

There have been three confirmed cases in Scotland and one in Wales.

Almost 200 cases have been reported in more than 20 countries not usually known to have outbreaks of the virus, according to the World Health Organisation.

Monkeypox cases are usually found in West Africa, and the virus does not often spread elsewhere.

Mr Donnelly says the HSE has procured a number of "third-generation smallpox vaccines" to help combat the virus.

The disease, which was first discovered in monkeys, is usually mild but can cause severe illness in some cases.

Speaking at the Irish Medical Organisation (IMO) annual general meeting (AGM) in Dublin today, Mr Donnelly said the public health system is working on tracing the small number of cases identified here.

“I think it is important to say that while it is quite a sobering name, monkeypox, the advice is that for the overwhelming majority of people, the symptoms are quite mild,” he said.

He confirmed the HSE will receive a delivery of the smallpox vaccine to treat these cases and he is not aware of any concerns about shortages of this vaccine for Ireland.

The World Health Organisation said last week the smallpox vaccine is 85% effective against monkey-pox.

In Ireland, NIAC has advised the vaccine will be given to healthcare workers caring for monkeypox cases, he said, as well as to the identified cases and to higher risk close contacts of those patients.

He advised anyone concerned about monkeypox to only check "authoritative sources" including the HSE website for information.

Testing

There is just one centre in Ireland able to test for monkeypox as it is not typically available in Irish laboratories, a Waterford-based emergency department consultant said.

Speaking to the Irish Examiner at the IMO AGM, Dr Mick Molloy, emergency department consultant at Waterford University Hospital said he expects to see “single figures” in terms of cases here, meaning less than 10.

So far the HSE has confirmed one case and said a suspected case is being investigated.

Mr Molloy, who stressed he is not a specialist in this virus, said he is aware of two people under investigation which he assumes is the same pair traced by the HSE, and he said they went to two different emergency departments.

“It is not a very common test, and I think that it is done in only one location,” he said.

“It is a little more challenging if you are in a more remote location, not in Dublin city because the testing is in Dublin city.” 

He said the virus is being contained in the UK and he expects the now-robust public health and contact tracing system in Ireland to do the same here.

Patients are advised to isolate, and he said this is “a self-limiting disease” and isolation would not need to be done in a hospital unless tourists test positive for this while here.

He expects the backwards-facing contact tracing, which is so developed now in the wake of the Covid-19 pandemic, to track down any potential close contacts here.

All emergency departments have been contacted he said and are working together to share information on any cases potentially linked to monkeypox.

Symptoms

There are two types of monkeypox: West African monkeypox and Congo Basin monkeypox. The current outbreak is the milder, West African, type.

Symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

A rash can develop, often beginning on the face, which then spreads to other parts of the body including the genitals.

The rash can look like chickenpox or syphilis, and scabs can form which then fall off.

The incubation period of monkeypox is usually from six to 13 days but can range from five to 21 days.

Spread

Monkeypox spreads through close contact including contact with the skin rash of someone with the disease.

People who closely interact with someone who is infectious have a greater risk of picking up the virus, including household members, sexual partners and healthcare workers.

The risk of community spread is very low.

In a statement, the HSE said that the vast majority of these cases do not have a travel link to a country where monkeypox is endemic and many of the cases were diagnosed in sexual health clinics and self-identify as gay, bisexual or other men who have sex with men (gbMSM).

The HSE said that an incident management team is actively monitoring this "evolving international situation".

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