What you need to know about the virus that causes monkeypox.
Video / AP / Getty
New Zealand can expect more cases of monkeypox in the coming weeks, an expert warns, following the news a person in Auckland has tested positive for the viral disease.
The Ministry of Health announced the country's first known case just after 7pm yesterday.
The infected person was in their 30sand was isolating at home in Auckland, after returning from overseas travel in a country with reported cases of monkeypox. There was no evidence of community transmission here, but a very small number of contacts were being advised to watch for symptoms.
The ministry and infectious disease experts have reassured the public that monkeypox is safely manageable but say it's likely new cases will pop up shortly.
Dr Arindam Basu, an associate Professor of Epidemiology at Canterbury University, said over the next few weeks more cases would likely emerge.
That meant it was important to be careful about protection measures, he said.
"Monkeypox and Covid-19 are different diseases and spread through somewhat different pathways, but at a personal level, personal hygiene measures and protection with masks are super important for both diseases, especially as Covid-19 cases will continue to rise.
"Being watchful about contacts, keeping a diary, and getting the tests at the first instances of common cold-like symptoms may be helpful."
Otago University infectious diseases physician Professor Kurt Krause said people didn't need to panic.
"We will likely get more cases but numbers will be nothing like Covid-19. People will need to be on the lookout if they may have been exposed. And affected people will need to isolate, but almost everyone affected will recover very well."
Public health expert Professor Michael Baker also told the Herald last night there was no need to panic, as the disease was very manageable - "nothing like Covid-19".
"It generally has a very good outcome, particularly in adults in high-income countries like New Zealand.
"It's a case of recognising and managing cases effectively."
The ministry said most people with monkeypox could be safely managed at home and there had been very few deaths globally.
Here's what the experts say you need to know about the disease.
What is monkeypox?
Monkeypox is a virus that originates in wild animals like rodents and primates and sometimes jumps to people - mostly in central and west Africa, where the disease is endemic.
Scientists first identified the disease in 1958 after two outbreaks of a "pox-like" disease in research monkeys.
The first known human infection was in 1970, in a 9-year-old boy in Congo.
Monkeypox belongs to the same virus family as smallpox but it has milder symptoms.
The ministry said some smallpox vaccines can provide protection against the virus.
The ministry is working with Pharmac to explore options for access to smallpox vaccines that can be used as part of the targeted prevention of spread of monkeypox in certain situations. Anti-viral drugs are also being developed.
The first symptoms of monkeypox include one or more of the following: headache, acute onset of fever (>38.0C), chills, swollen lymph nodes, muscle and body aches, backache and tiredness. The characteristic rash, which typically looks similar to chickenpox, appears after a few days.
"Anyone with lesions that look like chickenpox who have been in contact with a case or have been to Africa should be wary," Baker said.
Dorsal surfaces of the hands of a monkeypox patient, showing a rash during the recuperative stage. Photo / CDC via AP
There are at least two strains of monkeypox. The most deadly version can kill one in 10 people it infects, while the other has a fatality rate of about 1 per cent.
The current global outbreak is thought to involve a less severe strain.
The US Centres for Disease Control and Prevention said incubation - from infection to symptoms - usually lasted one week to a fortnight but could be as short as five days and as long as three weeks.
But most people recover within about two to four weeks without being hospitalised.
Belgium has introduced a compulsory three-week quarantine for anyone infected with monkeypox.
"We certainly have to be prepared for the scenario because it has been in other Western countries," Verrall said of New Zealand's own response.
Since reports of monkeypox emerged internationally, the ministry has provided information about the virus on its website.
The ministry has also provided advice to public health units, primary health organisations and sexual health clinics to assist with identifying potential cases.
How many monkeypox cases have there been in the past?
The World Health Organisation estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6000 cases annually, and Nigeria, with about 3000 cases a year.
However, many infected people are likely missed because of poor health monitoring systems in various countries.
Isolated cases of monkeypox are spotted outside Africa, including in the US and Britain, but the cases have typically been associated with travel to Africa or contact with animals from areas where the disease is more common.
The Associated Press reported that in 2003, 47 people in six US states had confirmed or probable cases. They caught the virus from pet prairie dogs housed near imported small mammals from Ghana.
What is different about this outbreak?
It's the first time monkeypox appears to be spreading among people who didn't travel to Africa. Most of the cases involve men who have had sex with men.
In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden.
Britain's Health Security Agency said its cases are not all connected, suggesting there are multiple chains of transmission happening. The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.
Is monkeypox spread through sex?
The ministry said cases of monkeypox outside endemic countries have primarily been identified among gay and bisexual men and men who have sex with men, and international cases have been clustered around events where this occurs.
Monkeypox had not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people's body fluids and clothing.
The Auckland case was detected through a monkeypox PCR test which is available in New Zealand labs. Photo / Getty Images
Covid-19 Response Minister Dr Ayesha Verrall said monkeypox lesions were distinctive but the disease could incubate undetected at first.
"It can be transmitted by close physical contact or by droplets ... But the suspicion is that the cluster that's emerging in Europe has been spread by sexual contact," she said.
Dr Michael Skinner, a virologist at Imperial College London, told the Associated Press in May it's still too early to determine how the men in the UK were infected.
"By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person's sexual orientation and irrespective of the mode of transmission."
