Monkeypox

WHO Reconsiders considering calling a Public Health Emergency

https://www.medscape.co.uk/viewarticle/monkeypox-reaches-6000-globally-who-reconsiders-calling-2022a1001qnc?uac=127834AR&faf=1&sso=true&impID=4403342&src=mkm_ret_220707_mscpmrk_newsalertuk_int

UK

Level 2

Transmission within a defined sub-population with high number of close contacts.

https://www.gov.uk/government/....publications/monkeyp

https://www.gov.uk/government/....publications/monkeyp

Monkeypox is a zoonotic infection

Monkeypox virus

Endemic in West and Central Africa

UK, between 2018 and 2021

7 cases

Epidemiological links to imported cases

4 were imported

2 were cases in household contacts

1 health care worker

No documented community transmission until 6th May 2022

Outbreak mainly (96%) been in homosexual and bisexual men

(without history of travel to endemic countries)

Cases, history of a sexually transmitted infection (STI) in the last year (54.2%),

and 10 or more sexual partners in the last 3 months (31.8%)

Monkeypox is being transmitted in interconnected sexual networks that sustain STI transmission

UK, up to 4 July 2022

1,351 laboratory confirmed cases

(Rare and Imported Pathogens Laboratory,RIPL)

40 in Scotland

11 in Northern Ireland

15 in Wales

1,285 in England (77% in London)

6 confirmed cases in women

Median age, 36 years (interquartile range 31 to 43)

Monkeypox outbreak: vaccination strategy

https://www.gov.uk/guidance/mo....nkeypox-outbreak-vac

Smallpox Modified Vaccinia Ankara – Bavarian Nordic

For pre and post exposure

The committee

Using markers of high-risk behaviour,

Similar to those used to assess eligibility for HIV pre-exposure prophylaxis (PrEP)

These risk criteria would include

a recent history of multiple partners,

participating in group sex,

attending sex on premises venues,

or a proxy marker such as recent bacterial STI

European Centre for Disease Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe (WHO/Europe)

https://monkeypoxreport.ecdc.europa.eu

5,949 cases of monkeypox, from 33 European countries

99 cases where sequencing was available,

confirmed to be of the West African clade

Implications for HIV-Positive Men

40% of cases were also (364/917) HIV-positive

99% of those with known sexual orientation stated they were MSM or bisexual

ECDC and WHO/Europe

Reported cases presented with a rash (96.1%)

Systemic symptoms (69%)

fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat, or headache

Hospitalised, 9.9%

intensive care, 0.2%

Fifteen European cases, health workers

Dr Tedros Adhanom Ghebreyesus

I continue to be concerned by the scale and spread of the virus

Testing remains a challenge and it's highly probable that there are a significant number of cases not being picked up