First confirmed case of monkeypox identified in Ireland

A suspected case of monkeypox in the country is also being investigated.

The HSE has said that the first confirmed case of monkeypox has been identified in Ireland. In a statement on Saturday (28 May), it revealed that the Health Protection Surveillance Centre (HPSC) was notified on Friday night of a confirmed case in the east of the country. The health service stated that the person has not been hospitalised and that the arrival of the virus into Ireland was "not unexpected" given the presence of monkeypox cases in the UK and many European countries. "Public Health is following up on those who had close contact with the person with monkeypox while they were infectious," the HSE added. "In order to maintain patient confidentiality, no further information about this person will be provided." On top of this, another suspected case of monkeypox is also being investigated with test results awaited. "A public health risk assessment has been undertaken, and those who were in contact with the person are being advised on what to do in the event that they become ill," the HSE also said. The case in Ireland comes after the reporting of more than 200 other confirmed cases of monkeypox worldwide over recent weeks. This includes one case confirmed earlier in the week in Northern Ireland. The vast majority of cases in this multi-country outbreak do not have a travel link to a country where the virus is endemic. Monkeypox is a rare disease that occurs primarily in remote parts of Central and West Africa. There are two types: West African monkeypox and Congo Basin monkeypox. The Congo Basin type is more severe, though the milder West African type is causing the current outbreak. The HSE has said monkeypox is usually a self-limiting illness and that most people recover within weeks but that severe illness can occur in people with very weak immune systems, pregnant women and in very small babies. However, it also added that cases of severe illness and death outside of Africa are "unlikely". "Monkeypox spreads through close contact, including contact with the skin rash of someone with monkeypox," the HSE said. "People who closely interact with someone who is infectious are at greater risk for infection: this includes household members, sexual partners and healthcare workers. "The risk of spread within the community, in general, is very low." Symptoms of monkeypox include:

• Itchy rash
• Fever (>38.50C)
• Headache
• Muscle aches
• Backache
• Swollen lymph nodes
• Chills
• Exhaustion.

The rash starts as raised red spots that quickly change into little blisters and usually develops within one to three days of the start of the fever or other symptoms. However, some people may only have a rash. Sometimes the rash first appears on the face and spreads to the mouth, palms of the hands and soles of the feet. However, following sexual contact, the rash may be found initially in the anogenital areas. In the recent cases seen internationally, systemic symptoms have not always been a feature and a rash in the anogenital area may be the main symptom. The rash goes through different stages before finally forming scabs which later fall off. The HSE has said many of the cases in this multi-country outbreak of monkeypox are in men who self-identify as gay, bisexual or other men who have sex with men (gbMSM). "Many of these cases were diagnosed at sexual health clinics," it stated. "The reason we are currently hearing more reports of cases of monkeypox in gbMSM communities may be because of positive health-seeking behaviour in this community and increased awareness since this outbreak was alerted to the public and to healthcare workers across the world. "Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may explain why these cases are being picked up at sexual health clinics. "As the virus spreads through close contact, the HSE is advising those who self-identify as gbMSM (especially if they have undertaken international travel in the past month), to be alert to any unusual rashes or vesicular lesions on any part of their (or their partner’s) body, especially their genitalia. "If they do notice any such changes, they should contact their local STI Clinic or their General Practitioner (GP) for advice."