UK Health Security Agency (UKHSA) have updated the case definition for monkeypox to include new symptoms.
In light of clinical experience during the outbreak, the symptom list has been expanded to include a single lesion or lesions on the genitals, anus and surrounding areas, lesions in the mouth, and symptoms of proctitis, which include anal or rectal pain or bleeding, especially if the individual has had a new sexual partner recently. It is believed this will help both individuals and clinical professionals identify monkeypox symptoms.
The majority of people with monkeypox can "safely manage their symptoms at home" and there have been no deaths in the UK. Most people experience "mild disease" but it can cause a significant illness in some, requiring hospitalisation, including severe pain.
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Meera Chand, director of clinical and emerging infections at UKHSA, said: "We continue to see new diagnoses of monkeypox, passed on primarily through close or sexual contact. We have updated our case definitions to reflect the clinical presentations that have been seen during this outbreak.
"It is important to recognise that just one or two genital or anal lesions or lesions in the mouth can be signs of monkeypox, especially if you have had a new sexual partner. If you think you have monkeypox stay at home and contact 111 or your local sexual health service for advice. There is still a need to be cautious, and stay alert for symptoms. For many people, symptoms can be mild but for some people, hospital treatment may be required."
Monkeypox is a rare infection which is mainly spread by wild animals in parts of west or central Africa. The risk of catching it in the UK tends to be low, however, recently the total number of cases reported by the (UKHSA) has risen to over 2,000. Gay men, bisexual men or men who have sex with other men, in particular, have been urged to pay extra attention to the symptoms of the virus as the UKHSA claims “the majority of the cases” identified to date have been among this group.
Early symptoms of Monkeypox include high temperature, headache, muscle aches, backache, swollen glands, shivering and exhaustion, with a rash usually appearing up to five days after the first symptoms. Monkeypox rarely passes between people but can be passed on via close person-to-person contact or contact with items used by a person who has the virus, such as clothes, bedding or utensils.
It can be treated with the smallpox vaccine along with antiviral drugs. The British Association of Sexual Health & HIV estimates it will cost £62.63 to deliver two vaccine doses, with a further estimation of 125,000 people being eligible to receive the dosages 28 days apart.
UKHSA guidance for close contacts of a confirmed monkeypox case was also recently updated, meaning close contacts won’t need to isolate at home if they don’t have symptoms. The change is being implemented in response to the latest data showing that a relatively small number of close contacts have gone on to develop monkeypox and a lack of evidence of transmission outside of close intimate or sexual contact.
For category 2 and category 3 close contacts, the UKSHA now recommend people:
contact NHS 111 or a sexual health clinic if they develop a fever or any of the other symptoms described below
avoid skin-to-skin contact with others, such as hugging and kissing
refrain from sexual or intimate contact
avoid international travel if possible. Travel insurance may also not be valid for people advised not to travel.
let health or dental facility staff know they’re a close contact before attending for health or dental care.
For category 3 close contacts they also recommend:
avoid close contact with children aged under five years, pregnant women and those who have an impaired immune system.
If they work with children aged under five years, pregnant women or those who have an impaired immune system, UKHSA or their employer might inform them if they need to take time off. This decision will be based on a personalised clinical assessment.
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