Monkeypox: The sign that may ‘appear before any other symptoms’ – unique to this outbreak

Monkeypox: UK patient discusses his symptoms

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The UK is currently in the midst of an outbreak of monkeypox – a rare infection that’s mainly found in parts of west or central Africa. There have been more than 500 confirmed UK cases in recent weeks. Although monkeypox is usually mild and most people recover within a few weeks without treatment, the symptoms can be unpleasant.

Speaking to, Doctor Kathrine O’Reilly, Medical Director at International SOS, provided an overview of the symptoms, which include one that’s unique to this outbreak.

“In this current outbreak, symptoms have been variable,” she said.

The “classical presentation” of monkeypox is a flu-like illness, the doc said. This takes the form of a fever with headaches, chills, exhaustion, muscle aches, backache and swollen lymph nodes (prodromal illness).

This is followed by a rash one to three days later, Doctor O-Reilly added.

However, the current outbreak appears to be bucking this trend in certain cases.

The doc explains: “Some cases have also been described where pustules appear before any other symptoms such as fever and lesions.”

This is a “different stage of the development rather than the rash we have seen historically which progresses through a number of sequential stages”, she said.

What does the rash look like?

According to Doctor O’Reilly, the rash often progresses through several stages.

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“It can be flat at first, then becomes raised, develops into pus-filled blisters like lesions before crusting and falling off.

“Classically the rash begins on the face and then spreads, however it may start and involve any part of the body, including the mouth, genital and peri-genital area.”

Doctor O’Reilly said that people are thought to be infectious until all the crusts have fallen off, however some authorities advise sexual precautions (using condoms) for a further eight weeks.

How long does it take for symptoms to show and how long will they last?

The doc said: “Symptoms don’t usually develop until seven to 14 days, and can take up to 21 days, after contact with the monkeypox virus.

“The clinical history and history of contact with known cases will help determine when the patient came into contact with the virus and how long they have had the disease.”

She continued: “As mentioned previously cases are presenting with a range of different symptoms and at different times.

“Most cases do not require hospitalisation and are mild to moderate.”

Doctor O-Reilly added: “As mentioned previously cases are presenting with a range of different symptoms and at different times. Most cases do not require hospitalisation and are mild to moderate.”

Monkeypox outbreak – UK latest

The first case of monkeypox was confirmed in Cornwall, England, on Thursday.

The UK Health Security Agency (UKHSA) said the patient was self-isolating and the risk to others was low.

Specialists from the UKHSA were providing expert advice and support to partner organisations following the recent case, a spokesperson said.

Statistics showed there were two cases confirmed in the south west of England in the recent UK outbreak, up to 10 June, with a high proportion of cases in London residents.

The total number confirmed in the UK is 524, as of 14 June.

However, the first case of monkeypox in the UK was identified in Cornwall back in 2018, the UKHSA said.

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