UK’s monkeypox response is worthy of praise, says expert

The UK Health Security Agency will release updated figures on the situation in the UK on Monday, with 20 cases recorded to date.

23 May 2022

The UK’s response to monkeypox should be praised, an expert in infectious diseases has said, as he noted that superspreader events are likely to be behind the rise in global cases.

Sir Jeremy Farrar, the director of Wellcome, said “we have never seen anything like this before, with such a number of cases” in so many countries.

The UK Health Security Agency (UKHSA) will release updated figures on the situation in the UK on Monday, with 20 cases recorded to date.

Cases of monkeypox have been reported in 14 countries, according to epidemiologists at Harvard University who are tracking the spread, including 40 cases in Spain and 23 in Portugal.

Sir Jeremy told BBC Radio 4’s Today programme that there have been small outbreaks in the past, with cases recorded in the UK, but “this is different, something has changed”.

Monkeypox is usually found in West Africa, and the virus does not often spread elsewhere.

He added: “The virus may have changed, but I think that’s unlikely. More likely is, I think, that the niche that this virus now finds itself in has allowed for some superspreader events and those individuals involved in that have then travelled to other parts of the world and taken the infection with them.”

He said the fact that the virus has “spread across borders so quickly is different” from what has been seen before.

At a superspreading event, the number of cases transmitted will be disproportionately high compared with general transmission.

Sir Jeremy said he thinks the UKHSA “deserves great credit” for its “textbook example” response to the outbreak.

“The action is what’s happening in the UK at the moment, which is very detailed, very painstaking contact tracing, identifying people who come forward and identifying their contacts and tracking everybody to see that you can break those chains of transmission, and making sure that that’s done in a trusted way…

“The worst thing is if we have any stigma associated with these infections, and people are fearful or don’t want to come forward, and that’s when epidemics can really take off.”

Transmission between people is occurring in the UK, with a large proportion of cases identified in the gay, bisexual and men who have sex with other men community.

Monkeypox is not normally a sexually-transmitted infection, but it can be passed on by direct contact during sex.

It can also be spread through touching clothing, bedding or towels used by someone with the monkeypox rash, and through the coughs and sneezes of somebody with the infection.

The Government has stocks of the smallpox vaccine, which is being offered to very close contacts of those who have been affected.

Those at the highest risk of contracting the disease are being asked to self-isolate at home for 21 days, with others warned to be on the lookout for symptoms.

The disease is usually mild but can cause severe illness in some cases.

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 first case identified in the UK was in a person who had returned from Nigeria, but other cases are unrelated to travel.

UK monkeypox cases
The stages of monkeypox (UK Health Security Agency/PA)

According to the UKHSA, monkeypox does not usually spread easily between people and the overall risk to the UK population remains low.

Anyone with unusual rashes or lesions on any part of their body, especially their genitalia, should contact NHS 111 or call a sexual health service if they have concerns, it said.

Earlier, chief secretary to the Treasury Simon Clarke told Sky News that monkeypox is not a “repeat of” Covid-19.

“As with any new disease, and obviously after the Covid pandemic doubly so, we continue to monitor this very closely,” he said.

“I would say I am cautious but I am certainly not concerned about our ability to handle the situation.

“There is a vaccine which is available and works for monkeypox, and all the evidence is that it is spread by physical contact… If people present with symptoms or have very close contact, then we are advising that they quarantine for three weeks but the threshold for that is quite high – it really does have to be close physical or sexual contact.”

Mr Clarke added: “What I would say is we are cautious but we are certainly not in a position where I would in any way worry the public that this is some repeat of Covid, because it certainly does not appear to be anywhere near the same platform of seriousness.”

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