With monkeypox spreading around the world, the International Chamber of Shipping has issued an advisory.
Monkeypox is a viral zoonosis with symptoms like smallpox patients, although clinically less severe. It is caused by the monkeypox virus part of the orthopoxvirus genus. There are two clades of monkeypox virus: West African and Congo Basin. The name monkeypox originates from initial discovery in monkeys in Denmark in 1958. The first human case was identified in a child in the Congo in 1970.
Monkeypox virus transmits from one person to another by close contact with lesions, body fluids, respiratory droplets, and contaminated materials such as bedding. The incubation period of monkeypox is usually from six to 13 days but can range from five to 21 days.
Current available evidence suggests those most at risk have close physical contact with someone with monkeypox, while symptomatic.
To date, all case samples confirmed by PCR were of the West African clade. Genome sequence from a swab sample from a confirmed case in Portugal, indicated a close match of the monkeypox virus causing the current outbreak, to exported cases from Nigeria to the United Kingdom, Israel, and Singapore in 2018 and 2019.
Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic.
Monkeypox is usually self-limiting but may be severe in some individuals, such as children, pregnant women, or those with immune suppression due to other health conditions. Human infections with the West African clade appear to cause less severe disease than the Congo Basin clade, with a fatality rate of 3.6% and 10.6% for the Congo Basin clade.
Historically, vaccination against smallpox had protected against monkeypox. While a vaccine (MVA-BN) and tecovirimat were approved for monkeypox, in 2019 and 2022 respectively, these countermeasures are not yet widely available.
The World Health Organization (WHO) has said countries should identify signals related to patients presenting with an atypical rash that progresses in sequential stages – macules, papules, vesicles, pustules, scabs, at similar development over all affected body areas that may be associated with fever, enlarged lymph nodes, back pain, and muscle aches.
If people develop a rash, accompanied by fever or a feeling of discomfort or illness, they should contact their health care provider and assessed for monkeypox. Persons suspected or confirmed as having monkeypox should isolate until the scabs have fallen off
Based on current available information WHO does not recommend that countries adopt any international travel-related measure for both, incoming and outgoing travellers.