‘We are not expecting thousands of cases’: disease expert plays down monkeypox fears
Monkeypox virus isn't expected to transmit as quickly and as widespread as Covid-19. Picture: Cynthia S. Goldsmith, Russell Regner/CDC via AP, File
Monkeypox is “more controllable” than Covid-19, infectious diseases expert Professor Sam McConkey has said.
He does not expect high transmission rates in Ireland despite growing concerns.
One case in the east of the country has been confirmed and a potential second one is under investigation. Hospital emergency departments have been alerted to the possibility of more cases arriving at their doors with contact training in place through the public health system.
“The monkeypox isn’t really the Covid-19 pandemic at all,” he said.
“It is much less infectious. You have to get up close and personal, skin-to-skin or very close to people to catch it. I think that is very reassuring.”
He said contact tracing which includes a three-week isolation period will prove critical in limiting further spread here.
“There probably will be some more imported cases from Europe or the UK,” he said.
“And it is possible to have some localised transmission in Ireland, so I wouldn’t be surprised if there are a few secondary cases but I don’t expect sustained secondary transmission.”
It is not likely to circulate “in an uncontrolled” manner, he estimated.
The National Virus Reference Laboratory in Dublin is the only laboratory processing monkeypox samples, he said.
“As far as I know, there isn’t any other laboratory in the Republic of Ireland, and maybe no need for that either,” he said. “We are not expecting thousands of cases.”
Although people are on high alert after the last two years, he said there are genetic differences between monkeypox and Covid-19.
“Monkeypox doesn’t mutate or probably won’t mutate as much as Covid-19,” he said. “Covid-19 kept changing."
Monkeypox is a DNA virus which mutates more slowly than RNA viruses, of which coronavirus is one.
“I don’t believe we will have multiple mutants of monkeypox in the way we have got used to with Covid-19,” he said.
Supplies of a smallpox vaccine which is also used against monkeypox have been secured by the HSE. This is expected to be used for cases, higher risk close contacts and healthcare workers treating monkeypox patients.
Prof McConkey said this can be given after exposure to the virus, saying: “It’s not exactly a therapy but it can prevent the disease and ameliorate it and make it milder.”
Symptoms include an itchy rash that can blister similar to chickenpox and it can be more serious for pregnant women, infants and immunocompromised people.
He has led clinical trials with this vaccine in a modified form in Ireland, the UK and Gambia. It is approved by the European Medicines Agency and is 85% effective against monkeypox.
It is “very reassuring” the HSE has access to this, he said. Cleaners should also be prioritised, he said, and laboratory staff.
“Everybody is looking for that right now, there is a run on that product,” he said.
Smallpox was eradicated by 1980 with vaccination programmes halted worldwide, this has been linked as one potential reason for monkeypox outbreaks.
“In the 1950s and 60s large numbers of the population in the world were inoculated against smallpox, other people had smallpox and they were protected by the infection,” he said.
“The waning immunity to smallpox is allowing a susceptible population to grow up and be susceptible to monkeypox and to get it, and for it to spread.”
