Smallpox outbreak: epidemiological update
The current outbreak is the first time the virus has been transmitted from person to person in England where no travel links to an endemic country have been identified.
Of the 190 confirmed cases identified from 6 to 30 May, 183 were in England, 4 in Scotland, 2 in Northern Ireland and 1 in Wales.
In England, 86% of cases are resident in London (132 out of 153) and only 2 were women. Most cases of smallpox have occurred in people between the ages of 20 and 49 (87%). One hundred and eleven cases are known to be gay, bisexual, or other men who have sex with men (GBMSM).
34 confirmed cases (18%) reported recent foreign travel to various European countries within 21 days of the onset of symptoms. Research has so far identified links to gay bars, saunas and the use of dating apps in the UK and abroad. Investigations are ongoing but no single factor or exposure has been identified to link the cases.
UKHSA has worked quickly with partners such as the British Sexual and HIV Health Association (BASHH), the British HIV Association, the Terrence Higgins Trust, Stonewall and the Grindr Dating App to communicate with sexual health services. and the GBMSM community. The LGBT Consortium and Pride organizers across the UK have been encouraged to help share public health messages over the coming weeks.
Dr Meera Chand, UKHSA’s Director of Clinical and Emerging Infections, said:
We are working to break the chains of transmission, even through contact tracking and vaccination. We are grateful to everyone who showed up for the test and it is extremely important that everyone continues to know the symptoms and seek advice if they have any concerns.
We are reminding people to take care of new spots, ulcers or blisters on any part of their body. If anyone suspects that they may have monkeypox, especially if they have recently had a new sexual relationship, they should limit contact with other people and contact NHS 111 or the local sexual health service as soon as possible. and please call before attending in person.
In London, outreach has included working with venue owners and event organizers.
Professor Kevin Fenton, London’s regional director of public health, said:
Smallpox can affect anyone, but we know that many of the most recent diagnoses are found in gay, bisexual, and other men who have sex with men, many of whom live in London or have sex with her. We remind everyone of the symptoms of monkeypox, and especially gay and bisexual men, who are especially attentive and seek advice immediately by calling NHS111 or your local sexual health clinic if you have any questions.
As with any new disease outbreak, the risk of stigma and uncertainty is high. That is why we are working hand in hand with the NHS, sexual health, voluntary and community sector organizations in London to share accurate information on monkeypox, especially with people and groups at greater risk through representative voices.
UKHSA health protection teams are contacting people who may be high-risk contacts in confirmed cases. The risk of such contacts will be assessed and, if maintained properly, it will be advisable to isolate yourself at home for up to 21 days. In addition to isolating, UKHSA offers the Imvanex vaccine to people who have had or may have had contact (for example, healthcare workers) with a confirmed case of monkeypox to reduce the risk of infection and serious illness.
Investigations continue and UKHSA will publish weekly updates for partners and the public, with the latest numbers of cases and findings.
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Table 1: Number of cases of monkeypox confirmed in the laboratory by region of residence, England, from 6 to 30 May 2022 (n = 183)
Region of residence Total confirmed East of England 5 East Midlands <5 London 132 North-east <5 North-west <5 South-east 10 South-west <5 West Midlands <5 Yorkshire and the Humber <5 Unknown * 27 Total 183
* address not yet confirmed
Prior to this outbreak, there had been 7 cases of monkeypox in the UK between 2018 and 2021. Four of them were imported, 2 cases were in domestic contacts of confirmed cases and 1 case was in a health worker involved in the care of an imported case.