The UK Health Security Agency (UKHSA) has published the latest technical briefing, which shows early signs that the outbreak is plateauing.
As of 4 August, there are 2,859 confirmed and highly probable cases of monkeypox in the UK.
Analyses of the current UK outbreak shows that monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM). The median age of confirmed cases in the UK was 37 years old. In England, 73% are known to be London residents over the course of the outbreak.
In the past few weeks, there have been a small number of women confirmed to have monkeypox but there is not enough evidence currently to suggest that there is sustained transmission outside of interconnected sexual networks. Twenty-two cases in women have been identified and 99% of all UK cases are male.
A small number of cases with no known travel history during their incubation period have been detected prior to 6 May, pre-dating the previous first-known report of a monkeypox case in the UK. This is not unexpected given our understanding of the outbreak to date.
Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA, said: “While the most recent data suggests the growth of the outbreak has slowed, we cannot be complacent. Be vigilant of and check yourself for monkeypox symptoms, including rashes and blisters.
“If you are concerned that you may have monkeypox symptoms, take a break from events, meeting with friends or having sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice.
“The smallpox vaccine is being offered to individuals at higher risk of coming into contact with monkeypox in order to offer them protection and to reduce the spread of disease.”
The briefing now includes monkeypox genomic surveillance data from the UK. As is described globally, the majority of outbreak cases in the UK belong to a distinct genetic lineage (B.1) which has mutations of unknown significance when compared with the closest previously characterised monkeypox virus genomes.
UKHSA will continue to publish regular technical briefings as the response to the outbreak continues.
Latest UKHSA data shows monkeypox transmission continuing primarily in interconnected sexual networks of gay, bisexual and men who have sex with men (GBMSM).
The latest UK Health Security Agency (UKHSA) technical briefing on the current UK monkeypox outbreak shows no signs of a decline in the outbreak. In line with global observations, there is no evidence of sustained transmission beyond these networks.
The outbreak continues to grow and information from cases strongly suggests the virus is passing primarily via close or sexual contact. UKHSA Health Protection teams in all regions of England continue to identify and risk assess close contacts of confirmed cases.
The majority of people with monkeypox can be safely managed at home and there have been no deaths in the UK. Most people experience mild disease but it can cause a significant illness in some that requires hospitalisation, including severe pain.
A vaccination programme is beginning, and sexual health services will offer the vaccine to anyone considered to be at higher risk of exposure. This includes people with a recent history of multiple partners, participating in group sex, attending sex on premises venues, or have recently had a bacterial sexually transmitted infection.
Up to 6 July 2022, there were 1,517 laboratory confirmed cases in the UK. The median age of confirmed cases in the UK was 36 years old. In England, 99% of cases are male and 74% are known to be London residents. 16% (226) of England cases reported recent foreign travel, with 176 of these reporting travel within Europe.
The briefing includes a breakdown of events that cases reported attending, 572 in total. 17% of those who provided information had been to a sex-on-premises venue and while this does not confirm transmission occurred there, UKHSA continues to conduct outreach work with event organisers and to provide guidance on how to minimise risk across a range of settings.
Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA said: “It’s concerning that we are continuing to see the outbreak grow and we urge the public to do all they can to help us slow the spread.
“If you’ve recently had new or multiple sexual partners, please be vigilant to the symptoms of monkeypox, and be aware that many of the cases we’re seeing are finding only a single, or few, lesions.
“If you are concerned that you may have monkeypox, take a break from events, meeting with friends or having sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice. Please contact the clinic ahead of your visit and avoid close contact with others until you’ve been reviewed by a clinician.
“To assist with our contact tracing, we encourage everyone to ensure they exchange contact details with sexual partners.
“If you are called forward for vaccination, we strongly recommend that you take it.”
UKHSA will continue to publish regular technical briefings as the response to the outbreak continues.
UKHSA published the latest epidemiological overview for the ongoing monkeypox outbreak yesterday.
It shows that as of 7 July, there were 1,552 confirmed cases in the UK. Of these, 1,482 are in England with a significant majority of cases in London.
Latest UKHSA data shows monkeypox transmission continuing primarily in interconnected sexual networks of gay, bisexual and men who have sex with men (GBMSM).
Further epidemiological data and additional analysis can be found in UKHSA’s regular monkeypox technical briefings.
Outbreak continues to grow and cases remain primarily in gay, bisexual, or men who have sex with men (GBMSM), within interconnected sexual networks.
The UK Health Security Agency (UKHSA) has published its second technical briefing on the ongoing monkeypox outbreak. The briefing shares UKHSA analyses with public health investigators and academic partners.
The latest epidemiological data, findings from interviews with patients and preliminary analyses are included to understand how the outbreak is evolving and to inform timely and effective public health interventions.
Investigations and modelling continue to show that the outbreak is growing and cases remain primarily in gay, bisexual, or men who have sex with men (GBMSM), within interconnected sexual networks.
UKHSA continues to work with partners including the Terrence Higgins Trust, Stonewall and the GBMSM community to raise awareness of the signs and symptoms of monkeypox. The LGBT Consortium and Pride organisers across the UK have been encouraged to help share public health messaging during Pride month.
79% of England cases are known to be London residents and 99% of all confirmed cases are male, with 5 confirmed female cases. The median age of confirmed cases in the UK was 37 years old.
Of the 813 cases identified in England up to 22 June, 321 (39.5%) had enhanced surveillance questionnaires. The majority (96%) of cases were GBMSM, with further data to indicate transmission is occurring in some sexual networks both internationally and domestically.
Cases frequently reported history of a sexually transmitted infection (STI) in the last year (54.2%) and 10 or more sexual partners in the last 3 months (31.8%). Existing links between cases and sexual health services will be used to identify those at highest risk who are eligible for pre-exposure vaccination.
Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA said: “If you’ve recently had new or multiple sexual partners, please be vigilant to the symptoms of monkeypox. Currently the majority of cases have been in men who are gay, bisexual or have sex with men. However, anyone who has had close contact with an individual with symptoms is also at increased risk.
“If you are concerned that you may have monkeypox, don’t go to events, meet with friends or have sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice. Please contact the clinic ahead of your visit and avoid close contact with others until you’ve been reviewed by a clinician.
“To assist with our contact tracing, we encourage everyone to ensure they exchange contact details with sexual partners, to help us limit further transmission where cases occur.
“We are grateful to all those who have come forward for testing and who help us understand the outbreak through participating in studies and investigations.”
UKHSA will continue to publish regular technical briefings as the response to the outbreak continues.
UK Health Security Agency publishes new guidance on offering the Imvanex vaccine to men considered to be at higher risk of exposure.
A strategy published today by the UK Health Security Agency (UKHSA) recommends that some gay and bisexual men at higher risk of exposure to monkeypox should be offered vaccines to help control the recent outbreak of the virus.
Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within – but not exclusive to – the sexual networks of gay, bisexual and other men who have sex with men.
The virus is not currently defined as a sexually transmitted infection, but it can be passed on by close and intimate contact that occurs during sex.
In response, the UK Health Security Agency’s (UKHSA) vaccination strategy recommends offering the smallpox vaccine Imvanex, which is shown to be effective against monkeypox, to men considered to be at higher risk of exposure.
The strategy is endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), which was consulted on the eligibility criteria for the vaccine.
An individual’s eligibility would depend on a number of factors but would be similar to the criteria used to assess those eligible for HIV pre-exposure prophylaxis (PrEP) – but applied regardless of HIV status.
The strategy states that a clinician may advise vaccination for someone who, for example, has multiple partners, participates in group sex or attends ‘sex on premises’ venues.
NHS England is due to set out details on how eligible people can get vaccinated shortly. People are advised not to come forward for the vaccine until contacted.
Dr Mary Ramsay, Head of Immunisation at UKHSA, said: “Our extensive contact tracing work has helped to limit the spread of the monkeypox virus, but we are continuing to see a notable proportion of cases in gay, bisexual and other men who have sex with men. By expanding the vaccine offer to those at higher risk, we hope to break chains of transmission and help contain the outbreak.
“Although most cases are mild, severe illness can occur in some people, so it is important we use the available vaccine to target groups where spread is ongoing. The NHS will soon set out details on how this will be delivered – so do not come forward for the vaccine yet.
“In the meantime, everyone should continue to be alert to any new spots, ulcers or blisters on any part of their body, particularly if they’ve had close contact with a new partner. If you think you have these symptoms, avoid close contact with others and call NHS 111 or your local sexual health centre, though please phone ahead before attending.”
Alex Sparrowhawk, Health Promotion Specialist at Terrence Higgins Trust, said: “This targeted vaccination programme is a positive move forward while the data still shows monkeypox is disproportionately affecting gay and bisexual men in the UK.
“We encourage everyone, regardless of their sexuality, to be vigilant about new spots, ulcers and blisters. We are continuing to closely monitor the latest data in order to play our part in providing the latest guidance and health information on monkeypox, to empower the communities most affected to best protect their health.”
Robbie de Santos, Director of Communications and External Affairs at Stonewall, said: “While we know anyone can catch monkeypox, we welcome the vaccine being offered to those gay and bi men who are eligible and currently at a higher risk of getting the virus.
“It is important that gay and bi men get the vaccine when offered to protect themselves and others. Let’s help get the outbreak under control so we can all have a safe and happy pride season.”
UKHSA is now publishing a regular data report on monkeypox in the UK. The report will be published every Tuesday and Friday.
Dr Sophia Makki, Incident Director at UKHSA, said: “We continue to see a steady increase in monkeypox cases. We’re reminding everyone to be aware of the symptoms of monkeypox, particularly if you’ve recently had new or multiple sexual partners, to help prevent further spread and protect others.
“If you have a rash with blisters, or any other monkeypox symptoms, don’t go to events, meet with friends or have sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice.
“Please contact the clinic ahead of your visit and avoid close contact with others until you’ve been reviewed by a clinician.”
The UK Health Security Agency (UKHSA) has detected 46 additional cases of monkeypox in England, 3 additional cases in Scotland and 1 in Wales since the last update on 15 June.
This brings the total number confirmed in the UK to 574, as of 16 June.
There are currently 550 confirmed cases in England, 16 in Scotland, 2 in Northern Ireland and 6 in Wales.
Anyone can get monkeypox, particularly if you have had close contact, including sexual contact, with an individual with symptoms. Currently most cases have been in men who are gay, bisexual or have sex with men.
Contact a sexual health clinic if you have a rash with blisters and you’ve been either:
in close contact, including sexual contact, with someone who has or might have monkeypox (even if they’ve not been tested yet) in the past 3 weeks
to West or Central Africa in the past 3 weeks
Dr William Welfare, Incident Director at UKHSA, said: “As case numbers of monkeypox continue to rise and with many summer events and festivals ahead, we’re reminding people to be aware of the symptoms of monkeypox, particularly if you’ve recently had new or multiple sexual partners, to help prevent further spread and protect others.
“If you have a rash with blisters, or any other monkeypox symptoms, don’t go to events, meet with friends or have sexual contact. Instead, stay at home and contact 111 or your local sexual health service for advice. Please contact the clinic ahead of your visit and avoid close contact with others until you’ve been seen by a clinician.
“UKHSA is working closely with partners across the country, including event organisers and venues, to raise public awareness of monkeypox symptoms so everyone has a safe, happy and healthy summer.”
The UK Health Security Agency (UKHSA) has published its first technical briefing on the ongoing monkeypox outbreak. The briefing shares UKHSA analysis with other public health investigators and academic partners.
This first publication includes updated epidemiological data, with evidence from anonymised detailed interviews with patients which are helping us to understand transmission and to determine how to target interventions.
Of the cases interviewed, 81% were known to be London residents and 99% were male. The median age of confirmed cases in the UK was 38 years old.
152 cases participated in more detailed questionnaires. In this data, 151 of the 152 men interviewed identified as gay, bisexual, or men who have sex with men, or reported same sex contact. Recent foreign travel, within 21 days prior to symptom onset, was reported by 75 cases, with 59 of these reporting travel within Europe.
We also share preliminary assessment of the genomic differences between the outbreak virus and previous monkeypox viruses. In any emerging infection outbreak we assess the virus or bacteria for any changes. We will be working to investigate the significance of the mutations identified so far to determine if they will have any impact on the virus’ behaviour
Dr Meera Chand, Director of Clinical and Emerging Infections, UKHSA said: “We are working, both in the UK and together with global partners, to progress the investigations that we need to help us better understand the virus, its transmission and the best use of mitigations such as vaccines and treatments. We use the new data rapidly to inform the public health response and we continue to work to reduce transmission.
“We are grateful to all those who have come forward for testing and the patients who continue to help us understand the outbreak through participating in studies and investigations.”
UKHSA has identified a number of aspects of this outbreak which require further investigation. We will release the results of our ongoing investigations in subsequent technical briefings – these will be published regularly.
Monkeypox has been confirmed in an individual in Scotland. The individual is receiving care and treatment appropriate to their condition and contact tracing is underway.
Monkeypox is a viral infection usually found in West and Central Africa. The West African strain that has been recently detected in the UK is generally a mild self-limiting illness, spread by very close contact with someone already infected and with symptoms of monkeypox. Most people recover within a few weeks.
Public Health Scotland (PHS) is working with the UK Health Security Agency (UKHSA), Public Health Wales and Northern Ireland HSC Health Protection Agency to monitor and respond to potential and confirmed cases of monkeypox in the UK.
As of Friday 20 May, the UKHSA has identified 20 cases in England but more are expected.
Dr Nick Phin, Director of Public Health Science and Medical Director, PHS explains: “Public Health Scotland is aware of an individual in Scotland who is confirmed to have monkeypox. The affected individual is being managed and treated in line with nationally agreed protocols and guidance.
“We have well established and robust infection control procedures for dealing with such cases of infectious disease and these will be strictly followed.
“We are working with NHS Boards and wider partners in Scotland and the UK to investigate the source of this infection. Close contacts of the case are being identified and provided with health information and advice. This may include the offer of vaccination.
“The overall risk to the general public is low.
“Anyone with an unusual blister-like rash or small number of blister-like sores on any part of their body, including their genital area, should avoid close contact with others and seek medical advice if they have any concerns.”
Symptoms
Initial symptoms of monkey pox include fever or high temperature, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.
A blister-like rash or small number of blister-like sores can develop, often beginning on the face, then spreading to other parts of the body, including the genital area.
The rash changes and goes through different stages, before finally forming a scab, which typically falls off over the course of a couple of weeks. Individuals are infectious from the point symptoms start until all the scabs fall off. During this time close contact with others must be avoided.
UKHSA identifies thirty-six more cases of monkeypox in England
The UK Health Security Agency (UKHSA) has detected 36 additional cases of monkeypox in England.
The latest cases bring the total number of monkeypox cases confirmed in England since 7 May to 56.
The virus does not usually spread easily between people, but it can be passed on through close person-to-person contact or contact with items used by a person who has monkeypox, such as clothes, bedding or utensils. Monkeypox is usually a self-limiting illness and most people recover within a few weeks.
While the current outbreak is significant and concerning, the risk to the UK population remains low.
Anyone with unusual rashes or lesions on any part of their body, especially their genitalia, should immediately contact NHS 111 or their local sexual health service.
A notable proportion of cases detected have been in gay and bisexual men, so UKHSA continues to urge this community to be alert to monkeypox symptoms.
People should notify clinics ahead of their visit and can be assured their call or discussion will be treated sensitively and confidentially.
Dr Susan Hopkins, Chief Medical Adviser, UKHSA, said: Alongside reports of further cases being identified in other countries globally, we continue to identify additional cases in the UK. Thank you to everyone who has come forward for testing already and supported our contact tracing efforts – you are helping us limit the spread of this infection in the UK.
“Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact a sexual health service if they have any symptoms.
“A notable proportion of recent cases in the UK and Europe have been found in gay and bisexual men so we are particularly encouraging these men to be alert to the symptoms.”
UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases and are advising those who have been risk assessed and remain well to isolate at home for up to 21 days.
In addition, UKHSA has purchased supplies of a safe smallpox vaccine (called Imvanex) and this is being offered to identified close contacts of someone diagnosed with monkeypox to reduce the risk of symptomatic infection and severe illness.
We continue to engage with partners across the sector to ensure people are aware of the signs and symptoms and what action to take.
The vaccination of high-risk contacts of cases is underway. As of 10am on 23 May 2022, over 1,000 doses of Imvanex have been issued, or are in the process of being issued, to NHS Trusts. There remain over 3,500 doses of Imvanex in the UK.
The UK Health Security Agency (UKHSA) has detected 2 additional cases of monkeypox, one in London and one in the South East of England.
The latest cases bring the total number of monkeypox cases confirmed in England since 6 May to nine, with recent cases predominantly in gay, bisexual or men who have sex with men (MSM).
The 2 latest cases have no travel links to a country where monkeypox is endemic, so it is possible they acquired the infection through community transmission.
The virus spreads through close contact and UKHSA is advising individuals, particularly those who are gay, bisexual or MSM, to be alert to any unusual rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service if they have concerns.
Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. It can also be passed on through other close contact with a person who has monkeypox or contact with clothing or linens used by a person who has monkeypox.
The 2 new cases do not have known connections with previous confirmed cases announced on 16, 14 and 7 May.
UKHSA is working closely with the NHS and other stakeholders to urgently investigate where and how recent confirmed monkeypox cases were acquired, including how they may be linked to each other.
The virus does not usually spread easily between people. The risk to the UK population remains low.
Anyone with concerns that they could be infected with monkeypox is advised to contact NHS 111 or a sexual health clinic. People should notify clinics ahead of their visit. We can assure them their call or discussion will be treated sensitively and confidentially.
Monkeypox is a viral infection usually associated with travel to West Africa. It is usually a mild self-limiting illness, spread by very close contact with someone with monkeypox and most people recover within a few weeks.
Dr Susan Hopkins, Chief Medical Adviser, UKHSA, said: “These latest cases, together with reports of cases in countries across Europe, confirms our initial concerns that there could be spread of monkeypox within our communities.
“UKHSA has quickly identified cases so far and we continue to rapidly investigate the source of these infections and raise awareness among healthcare professionals.
“We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay if they have concerns. Please contact clinics ahead of your visit.
“We are contacting any identified close contacts of the cases to provide health information and advice.
“Clinicians should be alert to individuals presenting with rashes without a clear alternative diagnosis and should contact specialist services for advice.”
Symptoms
Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. A rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals.
The rash changes and goes through different stages, and can look like chickenpox or syphilis, before finally forming a scab, which later falls off.
Investigations are underway to establish links between the latest 4 cases, who all appear to have been infected in London. All 4 of these cases self-identify as gay, bisexual or other men who have sex with men (MSM).
Currently, common contacts have been identified for 2 of the 4 latest cases.
There is no link to travel to a country where monkeypox is endemic, and exactly where and how they acquired their infections remains under urgent investigation, including whether they have further links to each other.
Those patients needing medical care are all in specialist infectious disease units at the Royal Free Hosptial, Royal Victoria Infirmary in Newcastle upon Tyne and Guys’ and St Thomas’. The individuals have the West African clade of the virus, which is mild compared to the Central African clade.
These latest cases mean that there are currently 7 confirmed monkeypox cases in the UK, diagnosed between 6 and 15 May.
Due to the recent increase in cases and uncertainties around where some of these individuals acquired their infection, we are working closely with NHS partners to identify if there may have been more cases in recent weeks, as well as international partners to understand if similar rises have been seen in other countries.
Monkeypox is a viral infection usually associated with travel to West Africa. It is usually a mild self-limiting illness, spread by very close contact with someone with monkeypox and most people recover within a few weeks.
The virus does not spread easily between people and the risk to the UK population is low.
However, the most recent cases are in gay, bisexual and other MSM communities, and as the virus spreads through close contact, we are advising these groups to be alert to any unusual rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service if they have concerns.
Anyone with concerns that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit. We can assure them their call or discussion will be treated sensitively and confidentially.
Dr Susan Hopkins, Chief Medical Adviser, UKHSA, said: “This is rare and unusual. UKHSA is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact.
“We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.
“We are contacting any potential close contacts of the cases to provide health information and advice.
“Clinicians should be alert to individuals presenting with rashes without a clear alternative diagnosis and should contact specialist services for advice.”
Symptoms
Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. A rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals.
The rash changes and goes through different stages, and can look like chickenpox or syphilis, before finally forming a scab, which later falls off.
Two individuals have been diagnosed with monkeypox in London, confirms the UK Health Security Agency (UKHSA).
The cases live together in the same household. They are not linked to the previous confirmed case announced on 7 May. Where and how they acquired their infection remains under investigation.
Monkeypox is a rare viral infection that does not spread easily between people. It is usually a mild self-limiting illness and most people recover within a few weeks. However, severe illness can occur in some people.
The infection can be spread when someone is in close contact with an infected person, however, there is a very low risk of transmission to the general population.
One of the cases is receiving care at the expert infectious disease unit at St Mary’s Hospital, Imperial College Healthcare NHS Trust, London. The other case is isolating and does not currently require hospital treatment.
As a precautionary measure, UKHSA experts are working closely with the individuals and NHS colleagues and will be contacting people who might have been in close contact to provide information and health advice.
People without symptoms are not considered infectious but, as a precaution, those who have been in close proximity to the individuals are being contacted to ensure that, if they do become unwell, they can be treated quickly.
Dr Colin Brown, Director of Clinical and Emerging Infections, UKHSA, said: “We have confirmed 2 new monkeypox cases in England that are not linked to the case announced on May 7.
“While investigations remain ongoing to determine the source of infection, it is important to emphasise it does not spread easily between people and requires close personal contact with an infected symptomatic person. The overall risk to the general public remains very low.
“We are contacting any potential close contacts of the case. We are also working with the NHS to reach any healthcare contacts who have had close contact with the cases prior to confirmation of their infection, to assess them as necessary and provide advice.
“UKHSA and the NHS have well established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed.”
Professor Julian Redhead, medical director at Imperial College Healthcare NHS Trust, said: “We are caring for a patient in our specialist high consequence infectious diseases unit at St Mary’s Hospital.
“All of the necessary infectious control procedures have been followed and we are working closely with UKHSA and NHS England.”
Symptoms
Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.
A rash can develop, often beginning on the face, then spreading to other parts of the body, particularly the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
