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Q&A With Hull Virologist Dr Cheryl Walter on Monkeypox Virus

Dr Cheryl Walter is a University of Hull Virologist with more than 15 years of experience working on a variety of viruses and virus-host systems.

She graduated with a PhD in Microbiology from Rhodes University in South Africa in 2008, and continued her research at the University of Leeds where she first worked on bunyavirus gene regulation and later on hepatitis C virus-host interactions.

Dr Walter has continued her research at the University of Hull with a continued interest in virus-host interactions, using both model bunyaviruses and emerging flaviviruses systems.

She has extensive teaching experience both at undergraduate and postgraduate levels of study.

Here, she sheds some light on the current Monkeypox outbreak and what it could mean for you.

Exactly what is monkeypox and its symptoms?

Monkeypox is caused by a virus, Monkeypox virus. It was so named because it was originally discovered in a colony of monkeys kept for research. It has also been found in other animals before and can be passed on from an animal in endemic regions of Africa, or person to person. Symptoms include fever, extreme fatigue, muscle aches, swollen lymph nodes. After a few days following the onset of fever, a rash can appear which often begins on the face and spreads to the rest of the body.

Health experts have said monkeypox isn't easily transmissible. In Layman's terms, why is this?

Based on evidence from endemic monkeypox areas in Africa, it is i) not that common and ii) not that easy to spread from one infected person to someone else. We are not entirely sure why. It is not particularly prevalent in animals either so it might be to do with its R0 value, what receptors (proteins on cells) it binds to and/or how fast it replicates.

If you caught monkeypox, what are the chances you would get seriously ill?

It depends on the strain, but the strain currently being detected in various countries around the world has a case fatality rate of 1-5%, which means 1-5 in 100 people who get it could die. As with COVID-19, the risks of severe disease are higher for immunocompromised people, pregnant women but also, in this case, young children. The risk of getting seriously ill will be higher than the case fatality rate and depends on access to treatment, early diagnosis and any pre-existing health condition.

Is there a vaccine?

No, but some immunity can be acquired from using the Smallpox vaccine if it was deemed necessary to vaccinate particular communities or vulnerable individuals. However, there are also approved antivirals that can be used as well and very good antibody therapies, so a range of effective treatments are on hand.

There have been a lot of headlines which are understandably creating concerns and many people are worried this is just the press whipping up more anxieties in the wake of Covid - should we actually be worried?

In my opinion, this is not nearly as worrying as COVID. Monkeypox mutates very, very slowly so it is unlikely to change into new variants or become more difficult to treat and prevent. We have good treatments available and it is far less transmissible than COVID. The one issue that is of concern is why it appears to become more transmissible compared to in the past. While the severity of the disease, nor the genetic material of this virus remain unchanged by the looks of things, the numbers we are seeing outside of Africa are unprecedented.

There has also been evidence that monkeypox cases so far have predominantly been identified in men who are gay, bisexual or have recently had sex with other men. Why is this the case and not so between heterosexual partners?

While Monkeypox is not a sexually transmitted disease as such, it’s spread through close contact with an infected person. Transmission of Monkeypox to a range of different types of close contacts has been documented before and more recently, but because a large proportion of the cases identified in the UK were found in a cluster of men who have sex with men, some might think that it’s only this community who are at risk. Any close contact with someone who is infectious is at risk, including people who share towels or bedding, touching Monkeypox skin blisters or scabs or prolonged periods of being close to coughs and sneezes.

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