Public health officials are due to announce more cases of monkeypox in the UK on Monday as efforts intensify to contain the first multinational outbreak of the virus that has resulted in cases in at least 14 countries.
The unusual outbreak of the rare disease has sparked a flurry of contact tracing and testing with the closest contacts of confirmed cases – such as partners and people from the same household – offered a vaccine and asked to s isolate at home for up to 21 days.
According to guidelines from the UK Health Security Agency, the same high-risk contacts are advised to avoid immunocompromised people, pregnant women and children under 12, as they are more vulnerable to serious infections.
While some monkeypox patients have been admitted to hospital, many confirmed cases that do not require specialist care are advised to self-isolate until local health protection teams are satisfied that are no longer infectious. “The vast majority of cases identified are isolated at home and do not require hospitalization,” said Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV.
Monkeypox does not spread easily, and most people infected develop only mild symptoms, including fever, rashes, and blisters, which may go away without treatment. But the virus can cause more serious illnesses in people with weakened immune systems, pregnant women and young children.
Dr Susan Hopkins, chief medical adviser to the UK Health Security Agency, said further cases identified over the weekend would be confirmed on Monday. Since the first was announced in the UK on May 7 – a person who arrived in London from Nigeria – the agency has confirmed 19 other cases, the majority among young men who have sex with men.
The outbreak is unusual because although the UK has had sporadic cases of monkeypox before – seven from 2018 to 2021 – all previous cases were linked to travel from Nigeria. Most of the latest cases in the UK and beyond have no known links to parts of West or Central Africa where the virus is endemic.
Globally, more than 180 confirmed or suspected cases are being investigated in at least 14 countries. More than half are in Spain and Portugal. Genetic analysis of three monkeypox viruses from the outbreak found it closely matches the virus that spread from Nigeria in 2018 and 2019. The same studies suggest a Belgian man contracted the virus during a recent trip to Portugal.
The pattern of the outbreak suggests that the virus is mainly spread through sexual networks. Infection can be transmitted through close contact with body fluids, infected ulcers, and contaminated materials such as towels and bedding. Superspreader events may have spurred the outbreak since it arrived in Europe.
“I think it’s possible that some of these outbreaks are driven by large spread events,” said Dr Michael Head, senior researcher in global health at the University of Southampton. “For example, the Spanish health authorities consider a sauna to be a single exposure site which has resulted in many secondary cases. Seemingly mild presentations of multiple cases may also be a factor, as people will be more mobile and potentially likely to socialize. However, we still need to know more about transmission dynamics. »
Hopkins told BBC One’s Sunday Morning program that community transmission in the UK was “largely centered in urban areas and we see it mainly among people who identify as gay or bisexual, or other men having sex with men”. When asked why the cases mainly belong to this group, she replied: ‘It’s because of the frequent close contact they may have.
“We are detecting more cases every day and I would like to thank all the people who come forward to be tested at sexual health clinics, GPs and the emergency department. We are finding cases that have no identified contact with an individual from West Africa, which we have seen previously in this country.
“We recommend anyone who regularly changes sexual partners or is in close contact with people they don’t know to come forward if they develop a rash.”
Dewsnap said sexual health clinics were already under massive pressure due to cuts and lack of support in recent years, when there was a “worrying number of unfilled genitourinary medicine specialist positions in sexual health clinics”.