First Cases of Monkeypox Likely Diagnosed in Iceland

Chief Epidemiologist Iceland Þórólfur Guðnason

Two middle-aged men were diagnosed with monkeypox in Iceland yesterday on an initial test, according to a notice from the Directorate of Health. Samples will be sent abroad as soon as possible to confirm the diagnosis. There is an overwhelming probability that the diagnosis is correct. The infection can be traced to a trip to Europe and neither of the men is seriously ill.

“Monkey pox is not a highly contagious viral disease, but is transmitted mainly through close and prolonged contact such as sexual intercourse but also through droplets from the airway. Infections can also be transmitted through clothing, towels, and bedding,” the notice explains.

A person with monkeypox can be contagious for up to three weeks, with the risk of infection ending when the last blister on the skin has healed. While the person is contagious, they need to be in isolation. People exposed to the infection need to be for up to three weeks.

The Directorate of Health encourages anyone who experiences an outbreak of bumps or blisters on the skin, especially on or near the genitals to go into isolation and contact the National Hospital’s Dermatology and Sexual Infection Ward, the Infectious Diseases Ward, or their local health clinic for further advice on diagnosis and treatment. The Directorate of health encourages people to avoid close contact with strangers, including sex, especially during their travels abroad.

“The main way to prevent the widespread spread of monkey pox in Iceland is to avoid the transmission routes/risks that can lead to infection and to seek diagnosis as early in the disease’s development as possible.”

The Ministry of Health, in consultation with the Icelandic Medicines Agency, is working to obtain antiviral drugs and vaccines that could benefit selected individuals against the infection.

Rabbit Deaths in Reykjavík Caused by Infectious Disease

rabbit Iceland

Rabbit haemorrhagic disease appears to be the cause of widespread death among rabbits in Elliðárdalur valley in Reykjavík. It is the first time the disease is detected in Iceland outside of a rabbit farm or home. The virus that causes the disease is not transmissible to humans or other animals.

After the rabbit deaths were noticed in Elliðárdalur, the Food and Veterinary Authority sent rabbit carcasses from the valley to the Institute for Experimental Pathology at the University of Iceland (Keldur) for study. Preliminary results indicate rabbit haemorrhagic disease to be the cause of the fatalities. The virus was found in Iceland previously in 2002, but at that time infections were limited to rabbit farms and pet rabbits, and response measures succeeded in wiping it out.

Vaccine will be ordered

Rabbit Haemorrhagic Disease is a highly infectious and often fatal disease that affects both domestic and wild rabbits. The rabbits that live in Icelandic nature are classified as semi-wild animals. There are three known types of the virus, RHDV1, RHDV1a, and RHDV2. Mortality rates differ greatly between the strains, ranging from as low as 5% to as high as 90%. Samples from Elliðárdalur have been sent abroad to determine which type is spreading among rabbits in the area. Results are expected next week, and once they arrive, the appropriate vaccine will be ordered to the country.

Directions for rabbit owners

The virus spreads through contact between animals. Although humans cannot contract the disease, they can carry the virus in their hair, clothes, and shoes and thus spread it between animals. In order to kill the virus on clothes, they must be washed at a temperature over 50°C (122°F) for longer than one hour. A 10% bleach solution works to disinfect surfaces that may house the virus.

In order to protect their animals, pet rabbit owners are directed to avoid visiting natural areas where rabbits are known to live and take care to ensure their pets avoid contact with other animals and people who could potentially be carriers of the virus.

Municipal workers are conducting daily monitoring of areas where rabbits are known to live. Rabbits that are visibly ill are captured and taken to a veterinarian.

Coronavirus Contingency Plan Activated

Keflavík Airport

Icelandic authorities have activated a contingency plan for infectious diseases due to the outbreak of the coronavirus. The Chief Epidemiologist for the Directorate of Health along with the Department of Civil Protection and Emergency Management are already working according to the plan, following on-hand contingency plans. A plan for disease prevention at international airports has also been activated specifically for Keflavík International Airport. The Icelandic Tourist Board will assist with ensuring that information about the virus reaches travellers around the country. 

Airport control

The operations at Keflavík airport are focused on detecting diseased individuals as well as those possibly infected. Passengers arriving in Iceland via Keflavík airport will be asked to report whether they have signs of respiratory disease. Passengers who have been in Wuhan, China in the past fourteen days, or have been in contact with individuals who have contracted the disease or are suspected of it are also asked to report. If arriving passengers fulfill any of these three requirements, a medical will take place at the airport. The results from the medical will determine the next course of action, but the quarantine of individuals is a possibility. 

The operations aim to find the diseased or possibly infected, to stop the spread of the disease in Iceland as soon as possible. Past experiences show it to be too costly and ineffective to measure every passenger using a thermometer, as well as placing a questionnaire. 

Health institutions activated

All health institutions in Iceland have been alerted about the new virus. They have been encouraged to update their contingency plans and look into other ways to prepare, such as creating quarantine facilities. Instructions for the public have been issued by the Directorate of Health on their website. The instructions specifically cover how individuals should act if suspicion of infection arises.

Coronavirus

The coronavirus is believed to have originated in a food market in Wuhan, China. The infection has now been confirmed in about 600 people, but the number of infected persons is probably significantly higher. Human to human transmission has been confirmed but does not yet appear to be common. No individual has yet been diagnosed in Europe, but the virus has been detected in a person in the United States that travelled from Wuhan city. There have been unconfirmed reports of infection in Scotland and Finland.

The current contingency plan that has been activated in Iceland is largely based on the 2002 outbreak of SARS

Further information on the Directorate of Health website (in English). Updates on the situation will be posted there, along with further instructions.