High risk UK contacts of monkeypox cases told to self-isolate and avoid children for three weeks


British holidaymakers have been urged to stay ‘alert’ to the dangers of monkeypox as the number of cases is set to rise today and the Government is urging high-risk contacts to self-isolate for three weeks. 

The UK Health Security Agency (UKHSA) guidance is now advising high-risk close contacts to self-isolate for 21 days, stay away from work, and avoid contact with immunosuppressed people, pregnant women, and children aged under 12 where possible.

So far the agency has confirmed 20 cases in the UK.

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’. 

When asked about the risk to Britons going to summer festivals and children on sunshine holidays, chief medical adviser for UKHSA Dr Susan Hopkins said: ‘The risk to the general population [from monkeypox] remains extremely low… People need to be alert to it, and we really want clinicians to be alert to it.’

Dr Hopkins warned anyone who feels ill with any symptoms to ‘stay at home’ and urged those with a suspicious rash to ‘immediately seek medical care, either by calling your GP or a sexual health clinic’ during a BBC interview on Sunday. 

She said updated figures for the weekend will be given on Monday as she warned of more cases ‘on a daily basis’.

Meanwhile, Austrian health authorities declared today that the country had recorded its first confirmed case of monkeypox in the capital Vienna, making Austria the latest of 15 nations to confirm outbreaks.

One of the first known cases of the monkeypox virus are shown on a patient’s hand on June 5, 2003, via a picture released by the Centers for Disease Control and Prevention

A 2003 electron microscope image issued by the Centers for Disease Control and Prevention showing mature, oval-shaped monkeypox virions

A 2003 electron microscope image issued by the Centers for Disease Control and Prevention showing mature, oval-shaped monkeypox virions

The Government urged high risk contacts of monkeypox in the UK to self-isolate for three weeks as cases rise across Britain

The Government urged high risk contacts of monkeypox in the UK to self-isolate for three weeks as cases rise across Britain

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)

Dr Susan Hopkins, a chief medical adviser to the UK Health Security Agency, today also warned that monkeypox is spreading through community transmission in the UK with more cases being detected daily

Dr Susan Hopkins, a chief medical adviser to the UK Health Security Agency, today also warned that monkeypox is spreading through community transmission in the UK with more cases being detected daily

WHAT IS MONKEYPOX?

Monkeypox – often caught through handling monkeys – is a rare viral disease that kills around 10 per cent of people it strikes, according to figures.

The virus responsible for the disease is found mainly in the tropical areas of west and central Africa.

Monkeypox was first discovered in 1958, with the first reported human case in the Democratic Republic of Congo in 1970. Human cases were recorded for the first time in the US in 2003 and the UK in September 2018.

It resides in wild animals but humans can catch it through direct contact with animals, such as handling monkeys, or eating inadequately cooked meat. 

The virus can enter the body through broken skin, the respiratory tract, or the eyes, nose or mouth.

It can pass between humans via droplets in the air, and by touching the skin of an infected individual, or touching objects contaminated by them. 

Symptoms usually appear within five and 21 days of infection. These include a fever, headache, muscle aches, swollen lymph nodes, chills and fatigue.

The most obvious symptom is a rash, which usually appears on the face before spreading to other parts of the body. This then forms skin lesions that scab and fall off.

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. Yet, the disease can often prove fatal.

There are no specific treatments or vaccines available for monkeypox infection, according to the World Health Organization. 

It comes as Belgium became the first country to introduce a compulsory 21-day monkeypox quarantine, as doctors warn of a ‘significant rise’ in UK cases. 

Those who contract the virus will now have to self-isolate for three weeks, Belgian health authorities have said, after three cases were recorded in the country. 

The infections, the first of which was recorded on Friday, are all linked to a festival in the port city of Antwerp. 

Health officials in Britain have warned the UK faces a ‘significant’ rise in infections and the government’s response is ‘critical’ in containing its spread.

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, has also said the outbreak could have a ‘massive impact’ on access to sexual health services in Britain.

Dr Dewsnap told Sky News: ‘Our response is really critical here. 

‘There is going to be more diagnoses over the next week. 

‘How many is hard to say. What worries me the most is there are infections across Europe, so this has already spread.

‘It’s already circulating in the general population. 

‘Getting on top of all those people’s contacts is a massive job.

‘It could be really significant numbers over the next two or three weeks.’

She says she expects more cases to be identified around the UK, with a ‘significant rise over this next week’.

It comes as Dr Hopkins, a chief medical adviser to the UK Health Security Agency, also warned that monkeypox is spreading through community transmission in the UK with more cases being detected daily.

The rare viral infection, which people usually pick up in the tropical areas of west and central Africa, can be transmitted by very close contact with an infected person.

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

However, the disease can prove fatal with the strain causing the current outbreak killing one in 100 infected.

The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact – as well as sexual intercourse – and is caused by the monkeypox virus.

Dr Hopkins said updated figures for the weekend will be released on Monday as she warned of more cases ‘on a daily basis’.

Speaking to BBC One’s Morning Show, Dr Hopkins said: ‘We will be releasing updated numbers tomorrow – over-the-weekend figures.

‘We are detecting more cases on a daily basis and I’d like to thank all of those people who are coming forward for testing to sexual health clinics, to the GPs and emergency department.’

When asked if there is community transmission in the UK, she said: ‘Absolutely, we are finding cases that have no identified contact with an individual from west Africa, which is what we’ve seen previously in this country.

‘The community transmission is largely centred in urban areas and we are predominantly seeing it in individuals who self-identify as gay or bisexual, or other men who have sex with men.’

Asked why it is being found in that demographic, she said: ‘That’s because of the frequent close contacts they may have.

‘We would recommend to anyone who’s having changes in sex partners regularly, or having close contact with individuals that they don’t know, to come forward if they develop a rash.’

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

An image created during an investigation into an outbreak of monkeypox, which took place in the Democratic Republic of the Congo, 1996 to 1997, shows the arms and torso of a patient with skin lesions due to monkeypox, in this undated image obtained on May 18, 2022

An image created during an investigation into an outbreak of monkeypox, which took place in the Democratic Republic of the Congo, 1996 to 1997, shows the arms and torso of a patient with skin lesions due to monkeypox, in this undated image obtained on May 18, 2022

And asked to confirm reports that someone is being treated for monkeypox in intensive care, she said: ‘We don’t confirm individual reports and individual patients.’ 

Dr Dewsnap also said she is concerned about the impact of monkeypox on the treatment of other infections as staff are diverted to tackle the outbreak.

She added: ‘Some clinics that have had cases have had to advise people not to walk in.

‘They’ve primarily done that because if somebody has symptoms consistent with monkeypox, we don’t want people sat in waiting rooms potentially infecting other people.

‘They’ve implemented telephone triage to all of those places.’

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, warns of a 'significant' rise in infections across the UK in the coming weeks

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, warns of a ‘significant’ rise in infections across the UK in the coming weeks

In Britain, authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed.

Portugal has 14 confirmed cases and 20 suspected infections. And across the Atlantic, there are two confirmed cases in Canada, with 20 suspected cases. 

There are also cases in Italy, Sweden, Belgium, Germany, The Netherlands, France, Israel, Switzerland and Australia.

The World Health Organisation said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox have been reported from 12 member states that are not endemic for the virus, the UN agency said, adding it will provide further guidance and recommendations in coming days for countries on how to mitigate the spread of monkeypox.

No one has died of the viral disease to date. 

 Professor David Heymann, an expert on infectious disease epidemiology at The London School of Hygiene & Tropical Medicine, said: ‘What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world.

He said close contact was the key transmission route, as lesions typical of the disease are very infectious.

For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.

Many of the current cases have been identified at sexual health clinics.

Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.

Heymann said it was ‘biologically plausible’ the virus had been circulating outside of the countries where it is endemic, but had not led to major outbreaks as a result of COVID-19 lockdowns, social distancing and travel restrictions.  

It comes as it emerged some of the country’s top disease experts warned that monkeypox would fill the void left by smallpox three years ago.

 Scientists from leading institutions including the University of Cambridge and the London School of Tropical Hygiene and Medicine argued the viral disease would evolve to fill the ‘niche’ left behind after smallpox was eradicated.

According to the Sunday Telegraph, the experts attended a seminar in London back in 2019 and discussed how there was a need to develop ‘a new generation vaccines and treatments’.

The seminar heard that as smallpox was eradicated in 1980, there has been a cessation of smallpox vaccinations and, as a result, up to 70 per cent of the world’s population are no longer protected against smallpox.

This means they are also no longer protected against other viruses in the same family such as monkeypox.

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