Monkeypox infections in London are rising, the capital’s public health chief warned on Monday as contacts of cases at high risk of having caught the disease were advised to self-isolate for 21 days.
Professor Kevin Fenton, London’s Director of Public Health, also urged people to watch out for “unusual rashes or lesions” and to contact NHS 111 before going to a hospital, GP surgery or other health setting.
New monkeypox figures, due to be published on Monday afternoon, are expected to show a significant rise in the number of confirmed cases in the UK, currently at 20.
Prof Fenton told The Standard: “Monkeypox cases are increasing in London and I’m expecting this to continue in the days ahead as awareness grows about symptoms and more cases are identified.
“The cases we are seeing both in the UK and Europe are predominantly in gay, bisexual and other men who have sex with men, suggesting that transmission is taking place within sexual networks, so we are asking men from these communities to be particularly alert to the symptoms and to seek help immediately.”
He added: “I’d like to thank everyone who has come forward so far to get help for symptoms and also the staff working hard in sexual health services throughout the city.
“The monkeypox virus spreads through close contact and we are advising everyone to be aware of any unusual rashes or lesions and to contact NHS 111 or to phone ahead before attending any healthcare settings.”
Latest guidance from the UK Health Security Agency urges contacts of monkeypox cases at high risk of having caught the infection to self-isolate for three weeks.
It recommends that people who have had “unprotected direct contact or high-risk environmental contact” should take such action to restrict their contact with other people.
This includes no travel, providing details for contact tracing and avoiding direct contact with immunosuppressed people, pregnant women and children under 12.
Those who are considered at high risk of having caught monkeypox may have had household contact, sexual contact, or have changed an infected person’s bedding without wearing appropriate PPE.
UKHSA also advises that they are offered a smallpox vaccine.
The disease, first found in monkeys, can be transmitted from person to person through close physical contact, including sexual intercourse, and is caused by the monkeypox virus.
It is a mild disease in most people and normally goes without treatment in two to four weeks. But it can be more dangerous in vulnerable people, such as those with weakened immune systems, pregnant women and young children.
One child was reportedly admitted to intensive care in London.
The first case was confirmed in the UK on May 7.
Public health chiefs say the virus has been detected in 15 nations outside Africa, including Spain, Portugal, Germany, Belgium, France, Austria, Switzerland, the Netherlands, Italy and Sweden, as well as the US, Canada, Australia and Israel.
Belgium was the first country to announce a three-week quarantine for infected persons.
Dr Susan Hopkins, chief medical adviser for UKHSA, warned that doctors are seeing community transmission in the UK, with cases predominantly being identified in individuals who self-identify as gay or bisexual or men who have sex with other men.
Speaking to BBC One’s Sunday Morning, she 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.”
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 is 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.”
Asked if people will need to to be vaccinated, she said: “There is no direct vaccine for monkeypox but we are using a form of smallpox vaccine - a third-generation, smallpox vaccine that is safe in individuals who are contacts of cases.
“So we’re not using it in the general population.
“We’re using it in individuals who we believe are at high risk of developing symptoms, and using it early, particularly within four or five days of the case developing symptoms.
“For contacts, (this) reduces your risk of developing disease, so that’s how we’re focusing our vaccination efforts at this point.”
It comes as US president Joe Biden said that recent cases of monkeypox which have been identified in Europe and the United States are something “to be concerned about”.
In his first public comments on the disease, Mr Biden added: “It is a concern in that if it were to spread it would be consequential.”
