First case of MPOX detected in UK

We have detected a single confirmed human case of Clade Ib mpox. This is the first detection of this Clade of mpox in the UK, the wider risk to the UK population remains low’.

The UK Health Security Agency (UKHSA) has detected a single confirmed human case of Clade Ib mpox. The risk to the UK population remains low.

This is the first detection of this Clade of mpox in the UK. It is different from mpox Clade II that has been circulating at low levels in the UK since 2022, primarily among gay, bisexual and other men-who-have-sex-with-men (GBMSM).

UKHSA, the NHS and partner organisations have well tested capabilities to detect, contain and treat novel infectious diseases, and while this is the first confirmed case of mpox Clade Ib in the UK, there has been extensive planning underway to ensure healthcare professionals are equipped and prepared to respond to any confirmed cases.

The case was detected in London and the individual has been transferred to the Royal Free Hospital High Consequence Infectious Diseases unit. They had recently travelled to countries in Africa that are seeing community cases of Clade Ib mpox. The UKHSA and NHS will not be disclosing any further details about the individual.

Close contacts of the case are being followed up by UKHSA and partner organisations. Any contacts will be offered testing and vaccination as needed and advised on any necessary further care if they have symptoms or test positive.

UKHSA is working closely with the NHS and academic partners to determine the characteristics of the pathogen and further assess the risk to human health.

While the existing evidence suggests mpox Clade Ib causes more severe disease than Clade II, we will continue to monitor and learn more about the severity, transmission and control measures. We will initially manage Clade Ib as a high consequence infectious disease (HCID) whilst we are learning more about the virus.

Professor Susan Hopkins, Chief Medical Adviser at UKHSA, said: “It is thanks to our surveillance that we have been able to detect this virus. This is the first time we have detected this Clade of mpox in the UK, though other cases have been confirmed abroad.

“The risk to the UK population remains low, and we are working rapidly to trace close contacts and reduce the risk of any potential spread. In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases.”

Health and Social Care Secretary Wes Streeting, said: “I am extremely grateful to the healthcare professionals who are carrying out incredible work to support and care for the patient affected.

“The overall risk to the UK population currently remains low and the government is working alongside UKHSA and the NHS to protect the public and prevent transmission.

“This includes securing vaccines and equipping healthcare professionals with the guidance and tools they need to respond to cases safely.

“We are also working with our international partners to support affected countries to prevent further outbreaks.”

Steve Russell, NHS national director for vaccination and screening, said: “The NHS is fully prepared to respond to the first confirmed case of this clade of mpox.

“Since mpox first became present in England, local services have pulled out all the stops to vaccinate those eligible, with tens of thousands in priority groups having already come forward to get protected, and while the risk of catching mpox in the UK remains low, if required the NHS has plans in place to expand the roll out of vaccines quickly in line with supply.”

Clade Ib mpox has been widely circulating in the Democratic Republic of Congo (DRC) in recent months and there have been cases reported in Burundi, Rwanda, Uganda, Kenya, Sweden, India and Germany.

Clade Ib mpox was detected by UKHSA using polymerase chain reaction (PCR) testing.

Common symptoms of mpox include a skin rash or pus-filled lesions which can last 2 to 4 weeks. It can also cause fever, headaches, muscle aches, back pain, low energy and swollen lymph nodes.

The infection can be passed on through close person-to-person contact with someone who has the infection or with infected animals and through contact with contaminated materials. Anyone with symptoms should continue to avoid contact with other people while symptoms persist.

The UK has an existing stock of mpox vaccines and last month announced further vaccines are being procured to support a routine immunisation programme to provide additional resilience in the UK. This is in line with more recent independent JCVI advice.

Working alongside international partners, UKHSA has been monitoring Clade Ib mpox closely since the outbreak in DRC first emerged, publishing regular risk assessment updates.

The wider risk to the UK population remains low.

UKHSA has published its first technical briefing on clade I mpox which provides further information on the current situation and UK preparedness and response.

Ensuring Scotland is prepared as mpox cases increase in Central and Eastern Africa

With the World Health Organization declaring a recent rise in mpox cases in Central and Eastern Africa a Public Health Emergency of International Concern, Dr Kirsty Roy and Dr Kate Smith, Consultants in Public Health at PHS, explain more about the current international situation and what is being done to prepare for any cases seen in Scotland: 

The recent rise of mpox cases in Central and Eastern Africa is of global concern due to the potential for the virus to spread beyond the affected countries. It’s therefore important that we’re prepared in the event a case is identified in Scotland. 

Mpox is an uncommon viral infection compared to viruses like influenza or COVID-19.  

It typically causes a blistering rash which can last 2 to 4 weeks and can be accompanied by fever, headaches, muscle and back aches, tiredness and swollen lymph nodes.   

There are two main types of mpox – clade 1 and clade 2 that are then further divided into clade 1a, clade 1b and clade 2b. Each type can differ in who they affect, how they spread, and the severity of the outcomes.  

Clade 1 mpox is more serious than clade 2, as it can be passed on more easily, can make people more severely ill, and has a higher fatality rate. This is why clade 1 is classified as a high consequence infectious disease (HCID). HCIDs are rare in the UK, and established protocols and guidance are in place to manage these.  

What’s the current global situation? 

Historically, clade 1 mpox has been associated with Central Africa and linked with more severe disease and higher death rates. Recently, a new type (clade 1b) has emerged and is circulating, particularly in sexual networks in the Democratic Republic of Congo (DRC) and neighboring countries.  

It was the emergence and rapid spread of clade 1b that prompted the World Health Organization to declare the outbreak as a Public Health Emergency of International Concern (PHEIC) in August 2024.  

Although most cases are currently confined to Central and Eastern Africa, there is the potential for the virus to spread out with the continent to other countries, as we saw with the global outbreak of mpox clade 2 in 2022. 

It’s therefore important to be aware of the above symptoms. Anyone with these should stay at home, avoid close contact with others and get medical help by phone. More information can be found on NHS inform

How is mpox passed on? 

Mpox is not passed on very easily between people. However, you can get it from close contact with an infected person, including during sex or by contact with contaminated materials (for example bedding or towels).  

It’s possible that mpox may also be passed on through close and prolonged contact that can include talking, breathing, coughing or sneezing. There is currently limited evidence around this, and information will be updated when new evidence becomes available. 

What’s the current situation in Scotland? 

Currently, no cases of clade 1 mpox have been confirmed in Scotland. The UK Health Security Agency (UKHSA) confirmed it had detected the first case of mpox clade 1b in England on 30 October, however, the risk to the UK population is still considered low.   
 
PHS is working closely with public health partners across the UK, as well as NHS boards, to monitor the situation and prepare for any cases of clade 1 mpox in Scotland.  

As part of this, we have rapidly put testing in place to ensure suspected cases can be quickly tested in Scotland at the Edinburgh Specialist Virology Centre (SVC) and the West of Scotland Specialist Virology Centre (WoSSVC) Glasgow. 

What’s the travel advice? 

Currently the risk to most travellers is small. A list of countries where cases of Clade 1 mpox have been identified can be found on the UK Government website  

Anyone travelling to an affected country is encouraged to take precautions, such as minimising physical or sexual contact – especially with individuals showing signs of a rash – to reduce the risk of infection. 

Working in partnership with Scottish airports, we have ensured that information about the clade 1b international situation is visible to travellers in Scottish Airports. These signpost to key information on affected countries and how to access healthcare services in Scotland if an individual develops mpox symptoms. 

Is there a vaccine to protect against mpox? 

Mpox belongs to a family of viruses that includes smallpox and a vaccine that was developed to protect against smallpox is also considered effective against mpox. 

This vaccine was used as part of the response to the 2022 outbreak of clade 2 mpox, which mainly affected gay, bisexual or other men who have sex with men (GBMSM), and Scotland continues to offer mpox vaccination to those at greatest risk. 

On behalf of Scotland, and other devolved nations, the UK Government has procured more mpox vaccine doses to strengthen the UK preparedness against clade 1 mpox. More information about vaccine eligibility can be found on NHS inform

Scotland has a robust public health intelligence system, is now able to rapidly identify and test potential cases and has a supply of effective vaccines. There is also public health information available to ensure people are prepared if they are visiting an area of higher risk. These should all ensure Scotland is prepared should cases emerge within the country. 

PUBLIC HEALTH SCOTLAND

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davepickering

Edinburgh reporter and photographer