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Global monkeypox threat upgraded to ‘moderate’ by World Health Organization

Another 71 cases of monkeypox have been spotted among Britons, as health chiefs urge anyone who develops a new rash to abstain from sex.

The UK Health Security Agency (UKHSA) said the new patients are all based in England. It brings the UK total to 179 since the first was detected on May 6, with the figure soaring 69 per cent since Friday — the biggest jump yet.

Almost all of the infections have been logged in England, apart from four logged in Scotland, two in Northern Ireland and one in Wales. 

UK health chiefs insist the risk to the public remains low. But they have urged everyone to be on the lookout for new rashes or lesions on any part of their body — which appear like spots, ulcers or blisters. 

The UKHSA has not shared the age, region or gender of those infected with monkeypox. But the majority are men who have sex with men, so it has told these groups to be particularly aware of the virus’s tell-tale signs.

UK health chiefs today published guidelines on how to limit the spread of monkeypox, including advising infected people to abstain from sex until they’re symptoms are gone and to use condoms for 2 months after their infection.

It comes as the World Health Organization today upgraded the threat from the virus to ‘moderate’.

The WHO said the explosion of cases with no links to each other or Africa means the current figure is ‘likely to be an underestimate’.

It has warned that if infections continue to happen then vulnerable people and children — who are more likely to die from the virus — could start to catch it. 

So far the outbreak, which was first detected in early May, has spread to 24 countries, with the UK, Spain and Portugal logging the most infections.

Timeline of monkeypox 

1958: Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research.

1970: The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.

2003: A Monkeypox outbreak occurred in the US after rodents were imported from Africa. Cases were reported in both humans and pet prairie dogs. All the human infections followed contact with an infected pet and all patients recovered.

SEPTEMBER 8, 2018: Monkeypox appeared in the UK for the first time in a Nigerian naval officer who was visiting Cornwall for training. They were treated at the Royal Free Hospital in London.

SEPTEMBER 11, 2018: A second UK monkeypox case is confirmed in Blackpool. There is no link with the first case in Cornwall. Instead, the patient is though to have picked up the infection when travelling in Nigeria. They were treated at Blackpool Victoria Hospital and Royal Liverpool University Hospital.

SEPTEMBER 26, 2018: A third person is diagnosed with monkeypox. The individual worked at Blackpool Victoria Hospital and treated the second Monkeypox case. They received treatment at the Royal Victoria Infirmary in Newcastle.

DECEMBER 3, 2019: A patient was diagnosed with monkeypox in England, marking the fourth ever case.

MAY 25, 2021: Two cases of monkeypox were identified in north Wales. Both patients had travel links to Nigeria.

A third person living with one of the cases was diagnosed and admitted to hospital, bringing the total number ever to seven.

MAY 7, 2022: A person was diagnosed with Monkeypox in England after recently travelling to Nigeria. The person received care at the expert infectious disease unit at Guy’s and St Thomas’ NHS Foundation Trust in London.

MAY 14, 2022: Two more cases were confirmed in London. The infected pair lived in the same household but had not been in contact with the case announced one week earlier.

One of these individuals received care at the expert infectious disease unit at St Mary’s Hospital in London. The other isolated at home and did not need hospital treatment.

MAY 16, 2022: Four more cases were announced, bringing the UK total to seven. Three of these cases are in London, while one of their contacts is infected in the north east of England.

The spate of cases was described as ‘unusual’ and ‘surprising’ as experts warn gay and bisexual men to look out for new rashes.

MAY 19, 2022: Two more cases were revealed, with no travel links or connections to other cases. The cases were based in the South East and London. Fears began to grow that infections are going undetected.

MAY 20, 2022: Eleven more cases are announced, meaning Britain’s monkeypox outbreak have doubled to 20. Minsters discuss the possibility of a public health campaign to warn gay men the disease may be more prevalent for them

MAY 23, 2022: Scotland logs its first ever monkeypox case and 36 more infectioned announced in England. It brings the UK total to 57.

MAY 24, 2022: England logs another 14 cases, bringing the UK total to 71.

MAY 25, 2022: Another seven infections are spotted in England, meaning 78 cases have been detected in the UK.

MAY 26, 2022: Wales and Northern Ireland detect their first monkeypox case in the recent outbreak, while Scotland spots two more cases and England logs eight, bringing UK total to 90. 

MAY 27, 2022: England detects 16 more cases, meaning 106 people in Britain have confirmed infections. 

MAY 29, 2022: World Health Organization (WHO) says risk of monkeypox is ‘moderate’, citing concerns about virus infecting children and immunosuppressed people if it becomes more widespread. 

MAY 30, 2022: The UK detects another 71 monkeypox cases, bringing the UK total to 179. Cases jumped 70 per cent in just three days. 

Dr Ruth Milton, senior medical advisor at UKHSA, said: ‘We are continuing to work closely with our colleagues in Scotland, Wales and Northern Ireland to ensure we are aligned in our approach to reducing the risk of transmission of Monkeypox in the UK.

‘We are reminding people to look out for new spots, ulcers or blisters on any part of their body. 

‘If anyone suspects they might have these, particularly if they have recently had a new sexual partner, they should limit their contact with others and contact NHS 111 or their local sexual health service as soon as possible, though please phone ahead before attending in person.

‘This will help us to limit the virus being passed on.’

Teams from the UK Health Security Agency are contacting high-risk contacts of confirmed cases and advising them to self-isolate at home for three weeks and avoid contact with children.

Both confirmed cases and close contacts are being offered the Imvanex vaccine to form a buffer of immune people around a confirmed case to limit the spread of the disease.

The strategy, known as ring vaccination, has been used in previous monkeypox outbreaks and is also being carried out in some EU countries.

It comes after the WHO published a risk assessment on Sunday, warning that its ‘moderate’ grading of the outbreak could be pushed to ‘high’ if the virus ‘exploits the opportunity to establish itself as a human pathogen’ and spreads to vulnerable groups.

The ‘sudden appearance’ and ‘wide geographic scope’ of cases suggests widespread human transmission of the virus — which spreads through skin-to-skin contact and an infected persons’ droplets — is underway, the WHO said.

It also warned the surge in monkeypox infections suggests the virus ‘may have been circulating unrecognised for several weeks or longer’.

Reported cases have so far been mild but there is a risk the virus has a ‘greater health impact’ if it spreads to at-risk people, including children and immunocompromised people, such as some HIV patients, who ‘may be especially at risk of more severe disease’.

Monkeypox can kill up to 10 per cent of people it infects. The milder strain causing the current outbreak kills one in 100 — similar to when Covid first hit. The virus death rate has been higher among children in previous outbreaks. 

The WHO warned there is a ‘high risk’ of further spread of the virus though skin-to-skin contact between families and sexual partners, as well as due to contact with contaminated materials, such as utensils, bedding and clothing. 

‘However, at present, the risk for the general public appears to be low,’ the agency said. 

It cautioned that a ‘large part’ of the population is vulnerable to monkeypox due to the discontinuation of the smallpox vaccination scheme.

Very few people under the age of forty have been vaccinated. In the UK, youngsters were routinely offered this jab until four decades ago, around the point at which the virus was eradicated. 

Because smallpox and monkeypox are so similar, those who received the jab are thought to have up to 85 per cent immunity against the circulating strain.

There is a ‘potential risk’ to health workers who treat someone infected with the virus if they are not wearing personal protective equipment (PPE) to prevent transmission, the WHO siad.

No monkeypox cases have been logged among medics in the current outbreak, it noted, but an NHS worker became infected in 2018 after treating a patient who had returned from NIgeria.

In its report, the WHO also warned that people who have recently had multiple sexual partners — either where they live or abroad — ‘may be at risk’ of having monkeypox.

It said health chiefs should reach out to at risk communities, which ‘at the present time’ includes men who have sex with men and their close contacts.

The WHO said it ‘would be prudent’ for people to limit the number of sexual partners they have during the early stage of this outbreak.

It comes as Dr Will Nutland, from the London School of Hygiene and Tropical Medicine, warned that festivals could fuel the spread of the virus.

The current outbreak, first detected in a traveller from Nigeria to the UK on May 6, has been linked to several super-spreader events, including a gay pride festival in Gran Canaria, a fetish festival in Belgium and a ‘sauna’ in Spain. 

Dr Nutland hosted a webinar for the LGBTQ+ community about the risks of monkeypox, as part of his roles as co-founder of Prepster, a volunteer group of HIV prevention activists in London. 

The doctor warned that it could spread at the Mighty Hoopla in Brockwell Park, south London, this Friday and Saturday. 

He told the Sunday Telegraph that the pop festival is ‘going to attract a lot of queer people’. 

A spokesperson for the Mighty Hoopla said that they ‘remain committed to working in line with government health guidance regarding public safety at events’.

Earlier this month, Dr Hans Kluge, regional director for Europe at the World Health Organisation, said he is concerned about ‘mass gatherings, festivals and parties’, which could accelerate transmissions.

He said that the cases being identified are ‘among those engaging in sexual activity’, and creates unfamiliar symptoms.

Mateo Prochazka, epidemiologist from the UK Health Security Agency (UKHSA), said that it is important people do not assume monkeypox is only a threat to the LGBTQ+ community

He told the BBC that it can spread to anyone through close contact — including contact with items used by someone infected, such as cutlery or their clothes.

Health chiefs have warned monkeypox, a virus endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions, could also spread to some pets and become endemic in Europe. Undated handout file image issued by the UK Health Security Agency of the stages of Monkeypox

Health chiefs have warned monkeypox, a virus endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions, could also spread to some pets and become endemic in Europe. Undated handout file image issued by the UK Health Security Agency of the stages of Monkeypox

Music festivals could be monkeypox super-spreader events in summer, experts warn after UK confirms 106 cases 

Music festivals could be monkeypox super-spreader events this summer, health experts have warned, after the UK confirms 106 cases.

Public health officials said that the spread of the virus suggests that there is community transmission, as numbers continue to climb.

Dr Will Nutland, from the London School of Hygiene and Tropical Medicine, is worried that monkeypox could spread at festivals.

 The doctor said that there are ‘potential dangers’ that could help the virus spread further, including ‘where people start making out’.

In the UK, a high proportion of the cases have been reported in gay and bisexual men.

He has hosted a webinar for the LGBTQ+ community about the risks of monkeypox, as part of his roles as co-founder of Prepster, a volunteer group of HIV prevention activists in London.

The doctor warned that it could spread at the Mighty Hoopla, a two-day festival in Brockwell Park, south London, on Friday and Saturday.

He told the Sunday Telegraph that the pop festival is ‘going to attract a lot of queer people’. 

Sylvie Briand, head of epidemic and pandemic preparedness and prevention at the WHO, last week warned the reported infections may be just the ‘peak of the iceberg’ and ‘many more cases’ could be going undetected.

In its report on Sunday, the WHO said it is ‘highly likely’ that even more countries will identify infections. 

But is said nations should not adopt any travel-related restrictions, like those brought in during the Covid pandemic, ‘based on available information at this time’. 

The WHO called for all countries, health authorities and medics to ‘respond quickly to stop the multi-country outbreak of monkeypox’. 

It said: ‘Rapid action must be taken before the virus can be allowed to establish itself as a human pathogen with efficient person-to-person transmission in both endemic and non-endemic contexts. 

‘Lessons learned from the eradication of smallpox and from the management of other emerging zoonotic diseases must be urgently considered in the light of these rapidly evolving events.’

Monkeypox, first discovered in lab monkeys in the late 1950s, is usually mild but can cause severe illness in some cases. It can kill up to 10 per cent of people it infects.

The milder strain causing the current outbreak kills one in 100 — similar to when Covid first hit.

Monkeypox has an incubation period of anywhere up to 21 days, meaning it can take three weeks for symptoms to appear.

Symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

A rash can develop, often beginning on the face, which then spreads to other parts of the body — including the genitals. The rash can look like chickenpox or syphilis, and scabs can form which then fall off.

In another step to control the monkeypox outbreak, a scientific group advising the UK Government last week called for the pet hamsters, rabbits and other rodents owned by infected patients to be isolated for three weeks.

The Human Animal Infections and Risk Surveillance (HAIRS) group said these animals were at the highest risk of catching the virus, and they could spread it into wild populations.

Experts fear that if the virus is unleashed into wild animal populations then it will become endemic and be hard to eradicate, as is the case in parts of western and central Africa.

In new guidance, the group said: ‘Based on current evidence, for pet rodents in households where there are infected people, temporary removal from the household for a limited quarantine period (21 days) and testing to exclude infection is recommended, particularly where there are infected human contacts who have had close direct and prolonged contact with the animal or its bedding and/or litter.’

The panel warned that hedgehogs, rats, mice, squirrels, rabbits and hares could all harbour the virus if monkeypox was to spill into Britain’s wildlife populations.

There were already fears before the report was released that the global outbreak of monkeypox may mean it can never be eradicated in the UK and Europe forever.

The concerns are centred around the virus leaking into animal populations, with rodents known harbourers of monkeypox.

The HAIRS group said that it was ‘unlikely’ that an infected pet could spread the disease to wild animals but added it ‘cannot be ruled out’.

It is recommending that rodent pets are removed from households where there are infected patients and put in ‘secure accommodation’, where they will be PCR tested and isolated for 21 days.

Dogs, cats and other pets will be allowed to stay in the home with their owner under HAIR’s recommendations but must undergo ‘regular vet checks’ after their isolation period to make sure they do not have the virus. 

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