EU health chiefs tell nations to prepare vaccination strategies amid scramble to contain monkeypox


European countries will be told to prepare a vaccination plan to tackle the spiralling monkeypox outbreak, it was claimed today as Denmark became the latest country to be struck down.

EU authorities are set to publish a risk assessment, which will advise all member states to draw up an inoculation strategy to control the spread of the tropical virus.

No monkeypox-specific vaccine exists but smallpox jabs, which were routinely offered to Brits until the virus was eradicated four decades ago, are up to 85 per cent effective.

The strategy likely to be recommended is the same one already deployed in Britain. MailOnline last week revealed officials were attempting to contain the spread by vaccinating all close contacts of the 20 confirmed monkeypox cases, including NHS workers.

The strategy, called ring vaccination, involves jabbing and monitoring anyone around an infected person to form a buffer of immune people to limit the disease’s spread.

It comes as experts warn nations could bring in travel restrictions to control the spread of the illness, if the World Health Organization (WHO) declares the outbreak an emergency.

Monkeypox is usually only spotted within Africa, but 16 countries — including the US, France and Spain — have all now detected the virus this month. Denmark is latest to confirm an infection, in a man who recently returned from Spain. Greece and Argentina are probing suspected cases.

Health chiefs are alarmed about the ‘unprecedented’ cluster of cases, which has disproportionately struck gay and bisexual men. 

Boris Johnson today said it was important to ‘keep an eye’ on the situation as he sought to calm fears. On a visit to a school in south east London, the Prime Minister added: ‘So far the consequences don’t seem to be very serious.’

Despite growing alarm about the world’s growing outbreak, leading experts are adamant monkeypox won’t spiral out of control like Covid, which forced nations into economically-crippling restrictions.

EU health chiefs are publishing a risk assessment today which will advise member states to prepare a programme for rolling out jabs to control the spread. No monkeypox vaccine exists, but the smallpox vaccine, which was routinely offered to Britons until the virus was eradicated more than four decades ago, is 85 per cent effective at stopping a monkeypox infection

EU health chiefs are publishing a risk assessment today which will advise member states to prepare a programme for rolling out jabs to control the spread. No monkeypox vaccine exists, but the smallpox vaccine, which was routinely offered to Britons until the virus was eradicated more than four decades ago, is 85 per cent effective at stopping a monkeypox infection

Boris Johnson reveals No10 is ‘keeping an eye’ on monkeypox as virus hits Scotland 

Boris Johnson today claimed the Government is closely watching the monkeypox outbreak, as Scotland confirmed its first case of the tropical virus.

The Government has sought to calm fears over the outbreak as the UK’s infection toll today hit 21, with England set to confirm more cases this afternoon, MailOnline understands.

Visiting a school in south east London, the Prime Minister said: ‘So far the consequences don’t seem to be very serious but it’s important that we keep an eye on it and that’s exactly what the new UKHSA is doing.’

Meanwhile, Simon Clarke, chief secretary to the Treasury, said he is ‘cautious’ but ‘certainly not concerned’ about the UK’s ability to manage the outbreak.

Mr Clarke said: ‘We are certainly not in a position where I would in anyway 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.’

It comes as authorities in Scotland are desperately trying to trace anyone who may have been infected by the first ever case logged north of the border. No details about the patient were released.

 

The UK’s current monkeypox vaccination strategy relies on Imvanex, made by Denmark-based Bavarian Nordic. Data shows it prevents around 85 per cent of cases, and has been used ‘off-label’ in the UK since 2018. 

The jab, thought to cost around £20 per dose, contains a modified vaccinia virus, which is similar to smallpox and monkeypox but does not cause disease in people.

As part of its strategy, sources claim the UK has already ordered an extra 20,000. 

UKHSA bosses have not yet disclosed exactly how many close contacts have already been vaccinated.

The Financial Times reported today that the European Centre for Disease Prevention and Control (ECDC) is set to recommend a similar vaccine plan for EU member states.

But sources told the newspaper that it would not be ‘an easy decision’ to recommend Imvanex is rolled out to all close contacts at this stage.

It said nations should carry out a risk-benefit analysis for each contact before deciding whether to jab them.

The US is already stockpiling the jabs for future, ordering 13million for a reported $299million (£240million). 

Bavarian Nordic told MailOnline that it is experiencing an ‘overwhelming interest’ in its vaccine from ‘multiple countries’. 

It comes as WHO bosses had been informed of 92 confirmed cases by Saturday and 28 suspected infections, most of which have been detected in Europe. 

But the true toll will be many times higher, with top scientists warning community transmission means some of the spread is inevitably going undetected. 

A disproportionate number of cases are in gay and bisexual men. 

Monkeypox is usually only spotted within Africa. 

Denmark today became the latest nation to announce that it was probing a suspected case, in an adult male who had returned from a trip to Spain.

Eleven more Britons have been diagnosed with monkeypox and all but one of them appear to have contracted it in the UK. The original UK patient had brought the virus back from Nigeria, where the disease is widespread. The UK has now logged 20 cases

Boris Johnson today said it was important to 'keep an eye on it', as the Government sought to calm fears over the outbreak. Visiting a school in south east London, the Prime Minister said: 'So far the consequences don't seem to be very serious but it’s important that we keep an eye on it and that’s exactly what the new UKHSA is doing'

Boris Johnson today said it was important to ‘keep an eye on it’, as the Government sought to calm fears over the outbreak. Visiting a school in south east London, the Prime Minister said: ‘So far the consequences don’t seem to be very serious but it’s important that we keep an eye on it and that’s exactly what the new UKHSA is doing’

Undated handout file image issued by the UK Health Security Agency of the stages of Monkeypox

Undated handout file image issued by the UK Health Security Agency of the stages of Monkeypox

Monkeypox is a rare viral infection which causes unusual rashes or lesions (shown in a handout provided by the Centers for Disease Control and Prevention (CDC) in the US

Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)

Timeline of monkeypox in the UK 

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.

‘Health authorities do not expect widespread infection in Denmark, but we are following the situation closely to be prepared for a possible development in the infection situation,’ Health Minister Magnus Heunicke said in a statement.

The man is currently in isolation and authorities are in touch with any close contacts, the ministry said.

Argentina last night also revealed it was probing a possible case. 

Health chiefs there said individual with monkeypox symptoms lives in Buenos Aires and was in isolation while tests were being carried out. 

They had recently returned from Spain, which has seen 30 cases of the tropical virus, with most having links to single ‘sauna’ in Madrid.

The Gran Canarian pride festival, held between May 5 and 15 and attended by 80,000 people from Britain and across Europe, is also being investigated after being linked to numerous monkeypox cases in Madrid, Italy and Tenerife.

In Belgium, three cases have been linked with a large-scale fetish festival in Antwerp, which ran from May 5 to May 8. 

Organisers said there is ‘reason to assume that the virus has been brought in by visitors from abroad to the festival after recent cases in other countries’.

There were 20 cases of monkeypox in the UK as of Friday, but Dr Susan Hopkins, the UK Health Security Agency’s chief medical adviser, said officials were detecting more cases ‘on a daily basis’.

The first patient had returned from Nigeria, where the smallpox-like virus is endemic. None of the other cases are related to travel, suggesting there is community transmission.

One of the cases is reportedly a young child who is intensive care in a London hospital, the Sunday Telegraph reported.

There had previously been only seven cases in the UK since 2018, all related to travel from Africa.

Experts have warned a return to travel restrictions, previously brought in to limit the spread of new Covid variants, could be on the horizon. 

Professor Kathy Bergin, an expert on the workings of the WHO at Cornell Law School, claimed if the UN agency declares monkeypox a public health emergency of international concern (PHEIC), countries will almost certainly bring in travel restrictions. 

But she said it is unclear is this will happen. Only six PHEIC’s have ever been declared before, with Covid being the most recent.

The classification is based on the seriousness of a disease and whether it has spread across international borders. If it does go ahead, the WHO ‘will almost certainly caution against travel restrictions’.

Professor Bergin added: ‘However, travel restrictions have been the go-to response for many countries once an international emergency is declared, and the WHO doesn’t have a mechanism to force countries to comply with its recommendations beyond diplomacy or “naming and shaming”.’

It comes as a UK Government official insisted today that monkeypox is ‘not a repeat of Covid’.

Simon Clarke, chief secretary to the Treasury, claimed he is ‘cautious’ but ‘certainly not concerned’ about the UK’s ability to manage the outbreak, which has already sickened 20 Britons including a child.

Mr Clarke said: ‘We are certainly not in a position where I would in anyway 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.’

UK Health Security Agency bosses are set to announce even more cases today, after warning on Friday that the worst was still to come. 

High-risk close contacts of monkeypox sufferers are being told to self-isolate for three weeks and to avoid contact with children. 

That is twice as long as the quarantine advice for Covid contacts at the height of the pandemic because the virus’ incubation period is much longer.

How DO you catch monkeypox and what are the symptoms? EVERYTHING you need to know about tropical virus

Monkeypox is spreading globally for the first time, in an outbreak that has caught health officials off-guard.

The UK’s case count on Friday doubled to 20 but the majority of them are not linked — which suggests more are going undetected.

A disproportionate number of cases are in gay and bisexual men, authorities have said. Health chiefs say the pattern of transmission is ‘highly suggestive of spread in sexual networks’.

Here is everything we know about the monkeypox outbreak so far: 

How do you catch monkeypox?

Until this worldwide outbreak, monkeypox was usually caught from infected animals in west and central Africa.

The tropical virus is thought to be spread by rodents, including rats, mice and even squirrels. 

Humans can catch the illness — which comes from the same family as smallpox — if they’re bitten by infected animals, or touch their blood, bodily fluids, or scabs. 

Consuming contaminated wild game or bush meat can also spread the virus.

The orthopoxvirus can enter the body through broken skin — even if it’s not visible, as well as the eyes, nose and mouth.

Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people.

However, health chiefs insist it is very rare.

Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus’ tell-tale scabs. 

The virus can also spread through coughs and sneezes. 

In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.

How deadly is it?

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. 

Yet, the disease kills up to 10 per cent of cases. But this high rate is thought to be in part due to a historic lack of testing meaning that a tenth of known cases have died rather than a tenth of all infections.

However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.

The UK cases all had the West African version of the virus, which is mild compared to the Central African strain. 

It is thought that cases in Portugal and Spain also have the milder version, though tests are underway.

How is it tested for? 

It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox.

Monkeypox is confirmed by a clinical assessment by a health professional and a test in the UK’s specialist lab – the UKHSA’s Rare and Imported Pathogens Laboratory.

The test involves taking samples from skin lesions, such as part of the scab, fluid from the lesions or pieces of dry crusts. 

What are the symptoms?

It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.

Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.

But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.

The rash changes and goes through different stages before finally forming a scab, which later falls off.

How long is someone contagious?

An individual is contagious from the point their rash appears until all the scabs have fallen off and there is intact skin underneath.

The scabs may also contain infectious virus material.

The infectious period is thought to last for three weeks but may vary between individuals.

What do I do if I have symptoms?

Anyone with an unusual rash or lesions on any part of their body, especially their genitalia, should contact NHS 111 or call a sexual health service.

Britons are asked to contact clinics ahead of their visit and avoid close contact with others until they have been seen by a medic.

Gay and bisexual men have been asked to be especially alert to the symptoms as most of the cases have been detected in men who have sex with men. 

What even is monkeypox?

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

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.

Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent. 

The UK, US, Israel and Singapore are the only countries which had detected the virus before May 2022.

Monkeypox is a rare viral infection which causes unusual rashes or lesions (shown in a handout provided by the Centers for Disease Control and Prevention (CDC) in the US

Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)

Nurses and doctors are being advised to stay 'alert' to patients who present with a new rash or scabby lesions (like above)

Nurses and doctors are being advised to stay ‘alert’ to patients who present with a new rash or scabby lesions (like above)

Is it related to chickenpox?

Despite causing a similar rash, chickenpox is not related to monkeypox.

The infection, which usually strikes children, is caused by the varicella-zoster virus. 

For comparison, monkeypox — like smallpox — is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.  

Are young people more vulnerable?

Britons aged under 50 may be more susceptible to monkeypox, according to the World Health Organization.

This is because children in the UK were routinely offered the smallpox jab, which protects against monkeypox, until 1971.

The WHO also warns that the fatality rate has been higher among young children. 

Does it spread as easily as Covid?

Leading experts insist we won’t be seeing Covid-style levels of transmission in the monkeypox outbreak.

A World Health Organization report last year suggested the natural R rate of the virus – the number of people each patient would infect if they lived normally while sick – is two. 

This is lower than the original Wuhan variant of Covid and about a third of the R rate of the Indian ‘Delta’ strain. 

But the real rate is likely much lower because ‘distinctive symptoms greatly aid in its early detection and containment,’ the team said, meaning it’s easy to spot cases and isolate them.

Covid is mainly spread through droplets an infected person releases whenever they breathe, speak, cough or sneeze. 

How is the UK managing the outbreak?

MailOnline this week revealed close contacts of monkeypox cases, including NHS workers, are already being offered the Imvanex smallpox vaccine. 

The strategy, known as ring vaccination, involves jabbing and monitoring anyone around an infected person to form a buffer of immune people to limit the spread of a disease.

A spokesman for the UKHSA did not disclose how many have been vaccinated, but said: ‘Those who have required the vaccine have been offered it.’

Health chiefs are also contacting all close contacts of those who have been infected.

Additionally, close contacts of those with a confirmed monkeypox infection are being told to stay at home for 21 days and avoid contact under-12s, immunosuppressed people and pregnant women.

The Government said unprotected direct contact or high risk environmental contact includes living in the same house as someone with monkeypox, having sexual contact with them or even just changing their bedding ‘without appropriate PPE’. 

As with Covid, someone who has come within one metre of an infected person is classed as a monkeypox contact.

This lower category of contact, which also includes sitting next to a person with monkeypox on a plane, means a tracer will call the person every day for three weeks and they will be advised to stay off work for 21 days if their job involves children or immuno-suppressed colleagues.

The UK has stopped short of requiring people by law to quarantine if they develop monkeypox, but ministers are considering a public health campaign to alert gay and bisexual men, because of the number of cases in this group.

What if it continues to spread? 

Experts told MailOnline they ‘could see a role’ for a targeted jab rollout to gay men in the UK ‘if this isn’t brought under control quickly’.

Close contacts of the UK’s known cases are already being offered the jab, which was originally designed for smallpox. The two rash-causing viruses are very similar.

A health source told MailOnline ‘there would be a number of strategies we’d look at’ if cases continued to rise.

Professor Kevin Fenton, London’s public health regional director, said if the outbreak in the capital continues to grow then the rollout of vaccines and treatments could be broadened to more groups.

He said there are ‘plans in place’ to have more antivirals if the outbreak keeps growing. 

What other countries have spotted cases?

At least 16 countries — including the US, Spain and Italy — have now detected cases of monkeypox.

The World Health Organization (WHO) said it had been informed of 92 confirmed cases by Saturday and 28 suspected infections, most of which have been detected in Europe.

The most cases have been detected in Spain, Portugal, Canada and the UK.

Within Europe, France, Germany, Italy, Belgium, Austria, the Netherlands, Sweden and Switzerland have also confirmed cases.

Australia, Israel and the Canary Islands also have monkeypox patients, while health chiefs in Argentina are investigating a possible case. 

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related

Is there a vaccine for it? 

The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses causing the illnesses are related. 

 

Data shows it prevents around 85 per cent of cases, and has been used ‘off-label’ in the UK since 2018. 

The jab, thought to cost £20 per dose, contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people. 

Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.

Are thre any drugs? 

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox.

This includes the drug tecovirimat, which was approved for monkeypox in the EU in January.

Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus within the body. 

An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).

It also works by stopping the growth of the virus.

What is the situation with the UK outbreak?

Twenty cases were confirmed in the UK between May 6 and 20.

No details about the eleven confirmed on May 20 have been released yet. 

But six of the previous nine confirmed cases were in men who have sex with men — which officials say is ‘highly suggestive of spread in sexual networks’.

How worrying is it?

UK health chiefs say the risk of a major outbreak is low.

But experts not that the outbreak is ‘concerning’ and that it is ‘very unusual’ to see community transmission in Europe.  

Dr Michael Head, a global health expert at the University of Southampton, said the rise in cases is ‘undoubtedly worrying’.

But he noted that ‘a big monkeypox outbreak like this is still a very different situation to a Covid pandemic’.

Dr Head added: ‘Given 11 further cases have been announced today, it’s likely there will be more cases to come in the UK. 

‘There certainly will be further cases confirmed in other countries. The contact tracing efforts by public health teams will be crucial in containing the outbreak.’

Dr Charlotte Hammer, an infectious diseases expert at the University of Cambridge, said: ‘It is very unusual to see community transmission in Europe, previous monkeypox cases have been in returning travellers with limited ongoing spread.

‘Based on the number of cases that were already discovered across Europe and the UK in the previous days, it is not unexpected that additional cases are now being and will be found, especially with the contact tracing that is now happening.’

What is the situation in the US?

The US has confirmed two cases and is investigating more.

A Massachusetts man on May 18 became the first confirmed US case for this outbreak.

On May 19, officials in New York City announced they were probing a suspected monkeypox case as well.

And what about Australia?

Australia last week confirmed its first every monkeypox infections.

One is a man in his thirties who travelled from Britain to Melbourne with symptoms earlier this week.

The second case is a man in his forties who became mildly unwell days after returning to New South Wales from Europe. Both he and the person he lives with are isolating at home.

What do I do if I have symptoms? 

Anyone worried that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit. 

Health chiefs say their call or discussion will be treated sensitively and confidentially.

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