Talk:Mpox/Archive 2

Monkey pox as a sexually transmitted disease
I recall from the early 1970s a case of Monkey pox in the UK that was reported in the popular press. A worker at Porton Down contracted the virus and was put into isolation. When he recovered, he returned to his wife and transmitted the virus to her, the implication in the press was that it had been transmitted sexually. This case happened about 50 years ago, and I accept that my memory may have distorted the facts. Has anyone any hard evidence on this case? There seems to be some discussion in the news that some cases in the current (May 2022) UK outbreak may have been transmitted sexually.

NOTE: My recollection was incorrect. The virus was Green Monkey Disease and NOT Monkeypox and the year was 1976. See this reference https://www.salisburyjournal.co.uk/news/16112305.heritage-green-monkey-incident-dominated-news-1976/


 * yes I want to find out everything I can because I am not going to panic..everyone panicked. about COVID..I worked all the way through and thankfully never got it Kroonm (talk) 05:43, 19 May 2022 (UTC)
 * Sources say it can be passed on through close contact, and sexual contact is (usually) that. So it would follow that's a scenario for transmission, as with many other diseases. Doesn't make it specifically a STD though. Alexbrn (talk) 05:47, 19 May 2022 (UTC)


 * The UK media are hinting that UK 2022 outbreak being spread (at least partly) by male gay sex, if this is permissible to repeat in these days of hate crime, transphobia and cancel culture. — Preceding unsigned comment added by 31.50.186.174 (talk) 02:59, 21 May 2022 (UTC)
 * We have clear MEDRS reporting saying the outbreak is connected to Men who have sex with men (MSM), but, as per, this is saying that spread is via close contact and sexual contact is usually that, rather than saying monkeypox is an STD (a disease only or largely spread through sexual contact). Bondegezou (talk) 09:18, 22 May 2022 (UTC)
 * It is too early to establish a connection. It may be that the first case was in this community by chance, so it spreads first among contacts who are likely to be a part of it as well. For decades, its pattern wasn't specifically linked to a sexual route. See .--Fernando Trebien (talk) 14:24, 23 May 2022 (UTC)
 * Agree with Ftrebien & Alexbrn, I have added a small clarification to the transmission section which should prevent further confusion. ArcMachaon (talk) 15:45, 23 May 2022 (UTC)
 * Removed. We don't need to say this and having it has weird/undue implications. Alexbrn (talk) 16:27, 23 May 2022 (UTC)
 * See MEDRS source below.
 * Monkeypox (MPX) does not spread easily between people. Human-to-human transmission occurs through close contact with infectious material from skin lesions of an infected person, through respiratory droplets in prolonged face-to-face contact, and through fomites. The predominance, in the current outbreak, of diagnosed human MPX cases among men having sex with men (MSM), and the nature of the presenting lesions in some cases, suggest transmission occurred during sexual intercourse.
 * Based on ECDC’s epidemiological assessment, the likelihood of MPX spreading in persons having multiple sexual partners in the EU/EEA is considered high. &#123;{u&#124;  Gtoffoletto  &#125;}  talk 16:49, 23 May 2022 (UTC)

Strange phrasing
“Monkeypox virus causes the disease in both humans and animals.”

This seems poorly written as humans are animals. 2600:1700:BA0:FC40:0:0:0:41 (talk) 05:20, 20 May 2022 (UTC)
 * It's idiomatic and understood to mean "non-human animals". Alexbrn (talk) 05:25, 20 May 2022 (UTC)
 * This is not poor English. It is standard English for a natural English speaker.  If there was another idiomatic way to make this statement, you could suggest one. 49.217.247.12 (talk) 07:12, 25 June 2022 (UTC)

What is Monkeypox ? the Cause, Symptoms and How dangerous is this virus
'''How far can it spread? ''' The cause of monkeypox infection is a virus of the same name, which is from the same family as common smallpox, but experts believe that it is less dangerous than it and that the chances of infection with it are small.

The disease spreads most often in remote areas of Central and West African countries near tropical rainforests.

There are two strains of this virus; They are the Central African breed and the West African breed.

What are the symptoms of the disease? Symptoms of monkeypox include fever, headache, bloating, backache, muscle aches, and lethargy.

Once the temperature rises, a rash appears beginning on the face and then moves to other parts of the body, but it is most often on the palms of the hands and soles of the feet.

The infection goes away without medical intervention after symptoms last for about 14 to 21 days.

'''How can you get sick? '''The disease is transmitted to a person when they come into contact with people with the virus. The virus may enter the body through cracks in the skin, the respiratory tract, or through the eyes, nose, or mouth.

It can also be transmitted from an infected animal, such as monkeys, rats and squirrels, to humans or from surfaces and objects contaminated with the virus such as bedding and clothing.

How dangerous is this virus?

Most infections with this virus are mild, sometimes similar to chickenpox, and disappear without medical intervention in a few weeks.

Sometimes the injury may be more serious. Deaths from the disease have also been recorded in West Africa.

'''How likely is the disease to spread? ''' The disease was discovered for the first time after a monkey infected with it in captivity, and since 1970 there has been an intermittent spread of the disease from time to time in ten African countries.

The virus spread to the United States in 2003, which was the first time that the disease had appeared outside Africa. The disease was transmitted to the United States at that time through contact with a prairie dog, to which the infection was transmitted from some mammals imported from abroad. The number of infected cases at that time was 81, but no deaths were recorded due to the virus.

In 2017, Nigeria experienced the largest documented outbreak in nearly 40 years since the country's last confirmed case. There were also 172 suspected cases. And 75 percent of those infected during this outbreak were men from the age group of 21 to 40 years.

'''what is the cure? ''' There is no cure for monkeypox, but the spread can be reduced by some restrictions that prevent transmission.

There is a vaccine against chickenpox that has been proven to be 85 percent effective in preventing infection, and it is still used occasionally.

'''vaccine against chickenpox ''' There is no cure for the virus that causes monkeypox so far, but its symptoms disappear within a few weeks without medical intervention

Is it cause for concern? Experts believe that Britain is not facing an imminent spread of the virus, according to Public Health England, which said that the disease does not pose a threat to public health.

"The fact that only one out of every fifty people who come into contact with people infected with monkeypox is infected reveals how low the chances of transmission," said Jonathan Ball, a professor of molecular virology at the University of Nottingham.

"It is wrong to think that we are on the verge of spreading the disease across the country," he added.

Nick Fane, deputy head of national infection control at Public Health England, said: "It is essential to stress that monkeypox does not spread easily between humans and that its public health risk is very low. The Public Health Authority in England is following up the cases of contacts of infected people who have been confirmed to be infected to provide medical advice and monitor them, as necessary. — Preceding unsigned comment added by Someone113 (talk • contribs) 23:10, 20 May 2022 (UTC)

genome
First draft genome from case in Portugal

Is monkeypox like cowpox in that those infected are immunized from smallpox? The literature seems to focus on the fact that smallpox vaccine immunizes against monkeypox, but not the other way around. — Preceding unsigned comment added by 2601:601:E00:7020:15B1:EF9E:F871:8AD3 (talk) 19:22, 21 May 2022 (UTC)

Clade fatality rates? (conflicting info)
Hi, I've been doing some research and periodically updating/editing this page. I've seen a lot of information about the different clades of monkeypox (Western/Central) and while its agreed that the Western clade has a much lower fatality rate than the Central one, some sources say its 1% while others say around 3%. Most say 1%, but I'd like to hear what others have to say. Maybe I'm reading the sources wrong. 3.3%: https://www.ecdc.europa.eu/en/news-events/epidemiological-update-monkeypox-outbreak#:~:text=The%20West%20African%20clade%2C%20which,at%20risk%20of%20severe%20disease. 3.6%: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010141 1%: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON383#:~:text=There%20are%20two%20clades%20of,disease%20is%20usually%20self%2Dlimiting. I figured I'd bring this up in case anyone was wondering about this as well. It seems like the West African clade fatality rate is typically about 1% in countries with better healthcare and 3%(ish) in countries with less access to healthcare. — Preceding unsigned comment added by NoviceStemFan (talk • contribs) 21:39, 21 May 2022 (UTC)


 * @NoviceStemFan We're talking about cfr's in a geographical area with poor health infrastructure. Therefore the number of cases is not considered reliable (were there cases with very mild symptoms which were missed?) neither is the number of deaths (no resources for a postmortem). Any statistic based on poor base data is little more than a guess, hence the variation. Bob (talk) 21:27, 13 August 2022 (UTC)

Important new source: Monkeypox multi-country outbreak - Risk Assessment by ECDC
Just published by the European Centre for Disease Prevention and Control and full of useful information: https://www.ecdc.europa.eu/sites/default/files/documents/risk-assessment-monkeypox-multi-country-outbreak.pdf We should digest it for the article as this is WP:MEDRS. &#123;{u&#124; Gtoffoletto  &#125;}  talk 16:12, 23 May 2022 (UTC)
 * Sexual transmission of monkeypox has been described, but infrequently, in the literature. Ogoima ... hypothesised that sexual transmission was a plausible route I think that part says it's plausible, although not confirmed. The question is whether the route was sexual intercourse itself or just contact in general. If you say that contact and exchange of fluids can transmit the disease, that includes sexual intercourse, but it also includes other forms of contact. So, for example, the virus can be transmitted by respiratory droplets during direct and prolonged face-to-face contact likely includes kissing or just talking for an extended period. --Fernando Trebien (talk) 17:27, 23 May 2022 (UTC)
 * Agree. Although the ECDC seems to think that the risk is concentrated among: "Persons with multiple sexual partners, including some MSM" (High probability) rather than the "Broader population" (very low probability). They seem to have a clear indication that some kind of sexual component is involved in transmission. -- &#123;{u&#124; Gtoffoletto  &#125;}  talk 17:30, 23 May 2022 (UTC)
 * MSM make up a considerable amount of current cases, especially in Europe. As it is early, this may be pointing more towards the superspreader event(s) than the mechanism. But it could be a new strain behaving differently too. The WHO does not seem to think this is a new strain. Also, it may be that the incidence is higher among MSM because they tend to seek sexual health screening, though uncertainty continues. --Fernando Trebien (talk) 17:46, 23 May 2022 (UTC)

Can this disease really be transmitted by respiratory (airborne) contact
The Wikipedia page states "the virus can also spread from human to human, by respiratory (airborne) contact"

However, the citation attached to that claim does not support that claim at all. Is there a citation that actually makes that claim? — Preceding unsigned comment added by 71.93.1.3 (talk) 00:59, 24 May 2022 (UTC)
 * I added a reference to support that. --Fernando Trebien (talk) 01:29, 24 May 2022 (UTC)

The CDC and WHO used to say MPX was spread via the airborne route (as do other poxviruses) but have recently scrubbed all such mentions from their documentation. They cite no sources for the change. Test35965 (talk) 05:57, 20 July 2022 (UTC)

add genomic comparison between smallpox and monkeypox
Here is a paper titled "Human monkeypox and smallpox viruses: genomic comparison", DOI: 10.1016/S0014-5793(01)03144-1.

In the abstract, the paper described the genetic difference between monkeypox and smallpox.

"The nucleotide sequence within the central region of the MPV genome, which encodes essential enzymes and structural proteins, was 96.3% identical with that of variola (smallpox) virus (VAR). In contrast, there were considerable differences between MPV and VAR in the regions encoding virulence and host-range factors near the ends of the genome."

I believe it's an important statement. — Preceding unsigned comment added by Kaimingtao (talk • contribs) 21:23, 24 May 2022 (UTC)

2022 Outbreak Blurb is very random
The specific cases covered seem like they're selected at random. 2 US cases, Australia and Canada are there, but nothing from Europe except the first mini-paragraph? I feel that this should be updated to more accurately represent a global worldview. If nobody has any issues with this, I'll resolve it in the morning. I know it's not "technically" our responsibility as editors, but this is page is currently seeing 3x as much traffic as the respective 2022 Monkeypox Outbreak page is, so pragmatically speaking, I believe it is critically important that we get the small blurb about the outbreak that *is* on this page right. DeVosMax [ contribs • talk • created media ] 09:44, 25 May 2022 (UTC)


 * Good point! (also, interesting to know this has more traffic than the outbreak page...).
 * Looking at the blurb, seems to me the best thing would be to do as we do for the "background" section in the outbreak page, just in the opposite direction: that is, transclude the lead from the outbreak page here as the blurb :). (rather than trying the hopeless + thankless task of keeping the blurb here in decent shape on top of everything else :P ).
 * Regards Sean Heron (talk) 10:58, 25 May 2022 (UTC)


 * ✅ ! Sean Heron (talk) 11:24, 25 May 2022 (UTC)

== Nice bit on the |2022 Outbreak page on the Nigerian outbreak - would do good to sync that up here. ==

Someone (thank you whoever!) has put quite some effort into collecting and writing up some more in depth info on the Nigerian outbreak (from 2017 onwards). I think it'd be great if that info could be reflected here as well. Not urgent, but I did want to point it out :).

Here is the sub-section I'm talking about: "Monkeypox_cases_in_Nigeria" (can't figure out how to native wiki-link to it right now...)

Regards Sean Heron (talk) 11:04, 25 May 2022 (UTC)

Uuuhhhh... "Treat monkeypox naturally" heading on the article page
The text under the heading reads like ad copy or pseudoscience and I'm not a confident editor to challenge it appropriately (it's not citation needed, as it is cited)... help? Ellenor2000 (talk) 11:43, 25 May 2022 (UTC)

Is this relevant enough to put next to footnote 17?
Though it's from 2010 it gives the incidences from 1981 to 1986 and after 2000 within the Democratic Republic of Congo, and mentions the bounty paid for monkeypox cases (US$90 equivalent), and details the the intergenerational transmission aspect (prior to this the smallpox vaccination meant that only small children were susceptible, and it mentions most cases were children under 11).

https://www.pnas.org/doi/10.1073/pnas.1005769107

Sorry if this isn't relevant or helpful. I hope you all stay safe, and look after one another. 49.183.10.84 (talk) 02:06, 26 May 2022 (UTC)

Semi-protected edit request on 26 May 2022
Whalesreality (talk) 09:39, 26 May 2022 (UTC) Cases of MonkeyPox have been found in UP,India. Source 
 * Red information icon with gradient background.svg Not done: please provide reliable sources that support the change you want to be made. Cannolis (talk) 09:57, 26 May 2022 (UTC)

Footnote 23 and 24 may be incorrect.
In each part of the body affected, the lesions evolve in the same stage.[23] It looks identical to the rash of smallpox.[24]

According to the 2003 United States outbreak, you may have bumps and rashes at multiple stages all at the same time, therefore it no longer should be considered always similar to smallpox signs.

https://web.archive.org/web/20080729020333/http://www.logicalimages.com/resourcesBTAgentsSmallpox.htm

"In disseminated varicella (chickenpox), lesions are in multiple stages of development. In the Congo, monkeypox has identical lesions, however, in a 2003 outbreak in the United States, this was not the case, as lesions were present at various stages simultaneously."

Also

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570942/#!po=6.25000

Suggests that someone who had previously had smallpox (they are also talking about monkeypox, so I'll leave it for an expert to judge) might not show any symptoms?!

"These symptoms can also vary among persons; most American patients in the 2003 monkeypox outbreak had a rash with 1 to >100 skin lesions (4–7), whereas others may have monkeypox infection without exanthem (8,9). Moreover, adults with preexisting immunity from childhood smallpox vaccinations may experience milder symptoms (5,6,10) or no symptoms (6)."

Sorry, if I'm wasting your time, as I said I'm not an authority, it just seemed a little jarring to read the symptoms, I hope that they get double checked, I'd rather look foolish, rather than see Wikipedia give bad advice, you know?

Tyvm. — Preceding unsigned comment added by 49.183.9.36 (talk) 01:28, 28 May 2022 (UTC)

Error in article: 2022 was NOT the first documented human to human transmission. For reference see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880088/
Please fix the error 74.109.2.177 (talk) 01:33, 28 May 2022 (UTC)

Monkeypox "outbreak"
There's only one (1) confirmed case of monkeypox in South Africa, why is it considered an outbreak already? 41.116.97.1 (talk) 17:32, 26 June 2022 (UTC)

Monkeys are not a natural reservoir of the virus.
Does this mean they are not carriers like Herpes-B? Jokem (talk) 03:05, 29 June 2022 (UTC)

Smallpox Vaccine provides 85% protection
I've been trying to get to the primary source of the 85% protection claim which appears in the article - and on web pages by WHO and CDC. The article cites but this is a textbook, not a primary source (and I can't access it - paywall?). It would be nice to add this in to the article. Can anyone help? Bob (talk) 15:06, 1 July 2022 (UTC) Bob (talk) 15:06, 1 July 2022 (UTC)


 * Update: I've found this but I can only access the abstract. Is there a way that I can see the full text? Bob (talk) 15:20, 1 July 2022 (UTC)
 * Goldman2020 is a reputable tertiary source... why replace it? Whispyhistory (talk) 19:33, 1 July 2022 (UTC)
 * The main problem is that it's not accessible - at least not to me, and therefore presumably not to general Wikipedia users. Is there a paywall around this source? Verifiability permits primary source when appropriate. One advantage of the primary source in this case is that it becomes evident that the 85% claim which is widely quoted by e.g. CDC and WHO is based on a very limited data set. Bob (talk) 18:10, 2 July 2022 (UTC)
 * ... completely understand frustrations on sources behind paywalls. Well done on all your effort's here. FYI...look out for Frank Fenner if interested in the history of those last years of smallpox. Best Whispyhistory (talk) 20:41, 2 July 2022 (UTC)

Preview when searching in DuckDuckGo contains racist term
I just used DuckDuckGo to search for the keywords ‘wiki monkey pox’ and the preview text in the results shows [n-word]pox as an allegedly alternative name for the disease. Can someone remove that please? (I have no Wikipedia editing experience so I don’t know how to do it.) It doesn’t show up in the Wikipedia article itself, or in the search preview when using Google, just on DuckDuckGo. Thank you all 150.143.147.226 (talk) 15:10, 23 July 2022 (UTC)< >< >:Wikipedia and DuckDuckGo are 100% completely different, separate entities--they are in no way, shape or form connected to each other. Wikipedia is a free online encyclopedia that anyone can edit (on unlocked articles; accounts are needed for direct rather than indirect editing of unlocked articles), while DuckDuckGo is a search engine, not a wiki--in other words, cannot be edited. While I personally don't believe in nor advocate for censorship, if this is important to you, you would want to take it up with DuckDuckGo, not Wikipedia.< >< >With that said, if you also have questions about editing Wikipedia articles, perhaps someone with more experience can chime in and link to Wikipedia pages that help introduce newcomers to editing. Just remember Wikipedia doesn't have anything to do with DuckDuckGo. I'm not sure if you were at all interested in Wikipedia editing as well, but I hope this all made sense. If not, others who are better at getting to the point (if I was too wordy) should be able to help. Cheers, 63.248.183.50 (talk) 09:36, 24 July 2022 (UTC) Sorry about the formatting. The hardware/browser I'm currently using doesn't have an ENTER button. And it appears I've forgotten the Wikipedia formatting for creating breaks as a substitute for pressing enter. 63.248.183.50 (talk) 09:40, 24 July 2022 (UTC)

Human sex with animals?
The article today reads:

"'The virus is thought to enter the body through broken skin, the respiratory tract, or the mucous membranes of the eyes, nose, or mouth... Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding... Humans can be infected by an animal via a bite, or by direct contact with an infected animal’s bodily fluids.'"

Surely human sex with animals is missing from this summation. It's all very well to be discreet, but better to be frank. Anna (talk) 19:12, 23 July 2022 (UTC)

Why don't you find a source that says so and then add it to the article along with your citation? Baller McGee (talk) 16:40, 1 August 2022 (UTC)

Transmission
There isn't any mention of how the disease is transmitted. There should be a whole section for it. It's one of the most important parts. 83.168.46.202 (talk) 20:22, 23 July 2022 (UTC)
 * I agree though I will note that it is mentioned in the lead of the article as well as under the cause section. Nevertheless, I take your point. TylerDurden8823 (talk) 20:37, 23 July 2022 (UTC)

This Article has been Vandalized
Some bloke Edited the First paragraph of this Wikipedia article and it’s very immature and insensitive given it’s supposed to provide information about an ongoing outbreak 2601:2C5:457E:310:C861:6492:ED1A:A3AE (talk) 07:26, 28 July 2022 (UTC)

Incorrect Statement on Transmission
Near the end of the section on transmission, it is stated that monkeypox cannot be transmitted by those without symptoms, citing source [49]. In the source (from CDC.gov) it does not state this, but in fact states that it is still being researched whether monkeypox can be transmitted this way or not. This needs to be corrected, as it is an inaccurate citation and also potentially dangerous misinformation. 2601:281:8200:94B0:A195:E5B8:A0E8:CBD6 (talk) 01:45, 1 August 2022 (UTC)


 * I have fixed it. Thank you for spotting this! Endwise (talk) 02:02, 1 August 2022 (UTC)

Request for more info to Outcome section
The current outbreak has a low case fatality rate, but what about long term scars?

Do we have any data on the odds of permanent scars, and the odds of it being a big area vs a small area?

If someone can get this data, I think it could be a good addition to the article. -- Arthurfragoso (talk) 02:15, 6 August 2022 (UTC)


 * @Arthurfragoso it's a bit early in the outbreak to have any idea of the long term consequences, isn't it? Maybe in a couple of years. Bob (talk) 21:15, 13 August 2022 (UTC)