Monkeypox, emerging data

UK monkeypox data, As of 4 August 2022,

Confirmed cases, 2,768

Highly probable, 91

In England, 2,730

A high proportion of cases in London

Was 75%

Latest, 66%

Monkeypox outbreak: epidemiological overview

2018 to 2021

7 cases of monkeypox in the UK

Rare and Imported Pathogens Laboratory (RIPL)

Some NHS laboratories now testing, orthopox polymerase chain reaction (PCR) test

Monkeypox outbreak: technical briefing 5

5th August

Over the past couple of weeks there has been approximately no change in the daily number of confirmed cases.

Ascertainment

Testing is freely available,

it is likely that there is under ascertainment

Atypical symptoms, single or scarce lesions, international reports of subclinical infection

Level 2 is defined as transmission within a defined sub-population, currently gay, bisexual and men who have sex with men (GBMSM) connected by sexual networks.

Data does not suggest a change in case mix (703 out of 2,638)

22 women with confirmed or highly probable monkeypox in England

No robust evidence of sustained transmission outside some sexual networks of GBMSM

Route of transmission

Primary reported route is through close or sexual contact,

monkeypox virus has been detected in air and environmental samples in the hospital room of infected patients.

No confirmed instances of airborne transmission

Limited household transmission has been described in the UK

Small numbers with no known route of acquisition, (due to no sex or other potential exposures during incubation period)

Assessment (confidence): transmitting primarily through close or sexual contact (moderate).

Observed clinical severity

No reported deaths in the UK

Significant morbidity, severe pain, secondary bacterial infection

Virological characterisation

UK genomic data is now available.

Mostly distinct lineage B.1

Has 61 mutations of unknown significance

Two UK cases and some international cases, lineage A.2

No clear-cut evidence of adaptation for improved human transmission.

Assessment (confidence): insufficient data.

Metrics

GBMSM, 95.3%

History of STI in past year, 53.9%

One or no sexual partners in past 3 months, 13.9%

Ten + sexual partners in past 3 months, 30.4%

Living with HIV, 26%

Cases, 15,926,

from 38 countries, European region

Laboratory confirmed, 15,524

West African clade, 203 (limited sequencing)

Earliest date of symptom, 11 March 2022

Male, 99.1%

HIV-positive, 36%

Presentation

Presented with a rash (9,126 / 9,626) 94.8%

Systemic symptoms

Such as fever, fatigue, muscle pain, chills, or headache (6,300 / 9, 626) 65%

Hospitalised 399 (5.6%), of which 150 cases required clinical care. Three cases

Admitted to ICU, 3 (1 unrelated)

Two other cases admitted to ICU died of monkeypox

Cases reported in health workers, 41

No occupational exposure

Dear Secretary of State

Without urgent action, we risk monkeypox becoming endemic in the UK.

GBMSM, Messaging must reach communities at high risk of acquiring monkeypox, through targeted messaging on apps, online and in the queer media.

Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK.

two doses to 125,000 people

asking that the government treat the monkeypox outbreak as a public health emergency

Luckily, we have the tools required to stop this outbreak and prevent further risk to health now.

We ask that you do so urgently.