Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, a human being, or materials contaminated with the virus. The virus enters the body through injured skin (even if it is not visible), airways, or mucous membranes (eyes, nose, or mouth). Animal-to-human transmission can occur through biting or scratching, preparation of bushmeat, direct contact with bodily fluids or injured material, or indirect contact with injured material, for example, through contaminated bedding. It is believed that person-to-person transmission occurs mainly through large respiratory droplets.
Respiratory droplets are usually unable to travel more than a few feet, so prolonged face-to-face contact is required. Other methods of person-to-person transmission include direct contact with bodily fluids or injury material, and indirect contact with injury material, such as through contaminated clothing or bedding. People usually get monkeypox from animals in West or Central Africa and import the virus to other countries. Person-to-person transmission is not common, as it requires close contact with bodily fluids, such as saliva from cough or pus from lesions.
Therefore, the risk to the general population is low, monkeypox in the United Kingdom is a transmissible disease in humans. In the past, only limited person-to-person spread has been reported, with transmission rates estimated at 3.3 to 30 per cent; however, during a recent outbreak in the Democratic Republic of the Congo, the transmission rate was estimated at 73 per cent. Infected people can be contagious from 1 day before the rash appears and up to 21 days after initial symptoms, or until all skin lesions have crusted and no other symptoms are present. Infections have also been reported in languids, baboons, chimpanzees, orangutans, marmosets, gorillas, gibbons, owl-faced monkeys (Cercopithecus hamlyn) and squirrel monkeys.
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