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2022–2023 mpox outbreak in the United Kingdom
Confirmed cases by countries in the United Kingdom during the 2022 outbreak (as of 12 July)
  101–1,660
  26–100
  1–25
Disease Mpox
Virus strain Monkeypox virus (West African clade)
Location United Kingdom
Index case London
Arrival date6 May 2022
(1 year, 10 months and 3 weeks ago)
DateAs of 29 August 2022
Confirmed cases3,279 (and 134 highly probable cases) [1]
Deaths
0
Government website
UK Government

The 2022–2023 mpox outbreak in the United Kingdom is part of the larger outbreak of human mpox caused by the West African clade (type) of the monkeypox virus. The United Kingdom was the first country, outside of the endemic African areas, to experience an outbreak. As of 22 July 2022, there were 2,208 confirmed cases in the United Kingdom, with 2,115 in England, 54 in Scotland, 24 in Wales, and 15 in Northern Ireland. [2]

Background

Mpox (formerly known as monkeypox) [3] is an infectious viral disease that can occur in humans and some other animals. [4] Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. [4] The illness is usually mild and most of those infected will recover within a few weeks without treatment. [5] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. [6] Cases may be severe, especially in children, pregnant women or people with suppressed immune systems. [7]

The disease is caused by the monkeypox virus, [a] a zoonotic virus in the genus Orthopoxvirus. The variola virus, the causative agent of the disease smallpox, is also in this genus. [4] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact. [4] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. [7] It may spread from infected animals by handling infected meat or via bites or scratches. [7] Diagnosis can be confirmed by PCR testing a lesion for the virus' DNA. [4]

An ongoing outbreak of mpox was confirmed on 6 May 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on 29 April 2022. The resident returned to the United Kingdom on 4 May, creating the country's index case of the outbreak. [8] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, [9] but it has been suggested that cases were already spreading in Europe in the previous months. [10]

Transmission

Stages of lesion development.

A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. [11]

In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes. [12]

History

Mpox cases in the United Kingdom  ()
     Deaths        Confirmed cases
MayMayJunJunJulJul
Last 15 daysLast 15 days
Date
Cases (rise)
Deaths (rise)
2022-05-06
1(n.a.)
2022-05-07
1(=)
2022-05-08
1(=)
2022-05-09
1(=)
2022-05-10
1(=)
2022-05-11
1(=)
2022-05-12
1(=)
2022-05-13
1(=)
2022-05-14
3(+2)
2022-05-15
3(=)
2022-05-16
7(+4)
2022-05-17
7(=)
2022-05-18
9(+2)
2022-05-19
9(=)
2022-05-20
20(+11)
2022-05-21
20(=)
2022-05-22
56(+36)
2022-05-23
71(+15)
2022-05-24
78(+7)
2022-05-25
90(+12)
2022-05-26
106(+16)
2022-05-27
106(=)
2022-05-28
106(=)
2022-05-29
106(=)
2022-05-30
179(+73)
2022-05-31
190(+11)
2022-06-01
197(+7)
2022-06-02
208(+11)
2022-06-03
227(+19)
2022-06-04
227(=)
2022-06-05
227(=)
2022-06-06
303(+76)
2022-06-07
322(+19)
2022-06-08
322(=)
2022-06-09
366(+44)
2022-06-10
366(=)
2022-06-11
366(=)
2022-06-12
471(+105)
2022-06-13
471(=)
2022-06-14
524(+53)
2022-06-15
524(=)
2022-06-16
574(+50)
2022-06-17
574(=)
2022-06-18
574(=)
2022-06-19
574(=)
2022-06-20
574(=)
2022-06-21
793(+219)
2022-06-22
793(=)
2022-06-23
793(=)
2022-06-24
910(+117)
2022-06-25
910(=)
2022-06-26
910(=)
2022-06-27
910(=)
2022-06-28
1,076(+166)
2022-06-29
1,076(=)
2022-06-30
1,076(=)
2022-07-01
1,235(+159)
2022-07-02
1,235(=)
2022-07-03
1,235(=)
2022-07-04
1,235(=)
2022-07-05
1,351(+116)
2022-07-06
1,351(=)
2022-07-07
1,351(=)
2022-07-08
1,552(+201)

The first known case was detected in the beginning of May 2022, in a British resident who had travelled to Lagos and Delta State in Nigeria, [13] in areas where mpox is considered to be an endemic disease. The person developed a rash on 29 April while in Nigeria and flew back to the United Kingdom, arriving on 4 May, [14] and presented to hospital later the same day. Mpox infection was immediately suspected, and the patient was hospitalised at Guy's Hospital [14] and isolated, then tested positive for the virus on 6 May.

In late May, cases started to be reported in the other constituent countries, with Public Health Scotland reporting its first case on 23 May. [15] [16] Public Health Wales and the Public Health Agency of Northern Ireland each reported one case on 26 May. [15] [17] [18]

On 1 June, a case was reported in Gibraltar, a British Overseas Territory. [19]

On 30 August 2022, 3413 cumulative cases (3,279 confirmed and 134 highly probable cases) of human mpox up to (and including) 29 August were reported for the UK. [1]

UK cumulative and weekly cases

Responses

On 22 May, Education Secretary Nadhim Zahawi said "we're taking it very, very seriously" and that the UK government had already started purchasing smallpox vaccines. [20]

The UK Health Security Agency (UKHSA) advised people who have had close contact with a person infected with mpox to self-isolate for 21 days. Self-isolation is not mandatory. [21]

Furthermore, to combat the continued spread of the outbreak, the UKHSA has offered doses of the Imvanex smallpox vaccine, also effective against mpox, to people having had close contact with people confirmed to having been infected. [15]

On 30 May, the four main public health agencies published a consensus statement describing the principles they will put in use, with the aim of limiting community transmission. [22]

Number of cases confirmed in constituent countries

Cases of mpox
Constituent country Case(s)
  Northern Ireland 15
  Scotland 54
  Wales 24
  England 2,115
Total 2,208

See also

Notes

  1. ^ The World Health Organization (the authority on disease names) announced the new name "mpox" in November 2022. But virus naming is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), which is currently reviewing all orthopoxvirus species. As of March 2023, the official name of the virus remains "monkeypox virus". [3]

References

  1. ^ a b "Monkeypox outbreak: epidemiological overview, 30 August 2022".
  2. ^ "Monkeypox outbreak: epidemiological overview". GOV.UK. Retrieved 8 July 2022.
  3. ^ a b "WHO recommends new name for monkeypox disease" (Press release). World Health Organization (WHO). 28 November 2022. Retrieved 29 November 2022.
  4. ^ a b c d e "WHO Factsheet – Mpox (Monkeypox)". World Health Organization (WHO). 18 April 2023. Archived from the original on 21 April 2022. Retrieved 21 May 2023.
  5. ^ "Monkeypox". GOV.UK. 24 May 2022. Archived from the original on 18 May 2022. Retrieved 28 May 2022.
  6. ^ "Mpox Symptoms". U.S. Centers for Disease Control and Prevention (CDC). 2 February 2023. Archived from the original on 21 May 2023. Retrieved 21 May 2023.
  7. ^ a b c "Mpox (monkeypox)". World Health Organization. 12 May 2023. Archived from the original on 23 May 2023. Retrieved 24 May 2023.
  8. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  9. ^ Pinkstone, Joe (17 May 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  10. ^ Nsofor, Ifeanyi (2 June 2022). "Opinion: Media coverage of monkeypox paints it as an African virus. That makes me mad". NPR. Retrieved 2 June 2022.
  11. ^ Vargas, Ramon Antonio (7 June 2022). "US raises monkeypox alert level but says risk to public remains low". the Guardian. Retrieved 9 June 2022.
  12. ^ "Monkeypox update: Where the outbreak stands now".
  13. ^ "Monkeypox – United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  14. ^ a b "Monkeypox contact tracing extended to Scotland". BBC News. 14 May 2022. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  15. ^ a b c "Monkeypox cases confirmed in England – latest updates". Gov.uk. Retrieved 2 June 2022.
  16. ^ "First case of monkeypox confirmed in Scotland". Archived from the original on 24 May 2022. Retrieved 23 May 2022.
  17. ^ "Monkeypox spread continues with first case reported in Wales". Metro. 26 May 2022. Retrieved 26 May 2022.
  18. ^ "Monkeypox: First case identified in NI". BBC News. 26 May 2022. Retrieved 26 May 2022.
  19. ^ "GHA confirms first case of monkeypox in Gibraltar". Gibraltar Chronicle. Retrieved 1 June 2022.
  20. ^ "UK Confirms Local Transmission of Monkeypox". Eyewitness News (South Africa). Archived from the original on 24 May 2022. Retrieved 22 May 2022.
  21. ^ Taylor, Chloe (23 May 2022). "People coming into contact with monkeypox are now being advised to quarantine for 3 weeks". Fortune. Retrieved 24 May 2022.
  22. ^ "Principles for monkeypox control in the UK: 4 nations consensus statement".

External links