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Monkeypox is caused by the monkeypox virus, a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low. The disease does not tend to spread easily between people but can be transmitted through close physical contact. There are two main strains of virus - west African and central African, and it's thought that the recent cases that have been found in the US, Canada, Europe, Australia and the UK are of the milder, west African strain.

However, an outbreak of the more serious strain of monkeypox has broken out in an area of the Democratic Republic of Congo that has no experience of the disease. Professor Wim van Damme of the the Institute of Tropical Medicine in Antwerp, Belgium, explains how the oubreak took hold in Maniema, a rural DRC province that has reported more than 500 cases and 50 deaths. He says the community there were not familiar with the disease and the steps necessary to curb its spread, and that will have contributed to its very "intensive transmission". The population there have now been advised on how isolation and distancing can contain the infection. He says initial transmission can be from eating diseased monkey, and that he has identified cases where this has occurred. This then led to a rapid person-to-person infection, mainly via touching the skin lesions. He is concerned that more outbreaks of this kind will happen in the future given the extent of human encroachment into the forest and fact that alongside the human epidemic, there is a parallel epidemic among the monkeys. However, he says where the communities are aware of the monkeypox, infections are lower as they are aware of the steps they need to take to prevent its spread.

"There are serious conerns, with more and more human-animal interface, and encroachment of the forest and disturbance of the wildlife, this might become more and more frequent, and more and more provinces will have outbreaks."

Photo: The palms of a monkeypox case patient from DRC Credit: Reuters

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