An overview of the situation
On 13 May 2022, WHO received notification of two laboratory confirmed cases and one suspected case of monkeypox in the United Kingdom from the same home. On May 15, four further laboratory confirmed cases of vesicular rash sickness in males who have sex with men were reported among Sexual Health Services attendance (MSM).
An incident team has been formed to coordinate contact tracing activities as part of the reaction measures.
Unlike infrequent instances with travel linkages to endemic countries (see Disease outbreak news on Monkeypox in the United Kingdom published on 16 May 2022), no source of infection has been identified. Based on existing evidence, the illness appears to have been acquired locally in the United Kingdom. At this point, the extent of local transmission is unknown, but other instances could be identified.
What causes monkeypox?
Monkeypox can be contracted via infected wild animals in western and central Africa. It is believed that rodents such as rats, mice, and squirrels transmit it.
If you are bitten or handle an infected animal’s blood, bodily fluids, spots, blisters, or scabs, you can contract monkeypox.
It is also possible to contract monkeypox by consuming raw meat from an infected animal or by contacting other items from sick animals (such as animal skin or fur).
Monkeypox can also be transmitted by:
contacting monkeypox skin blisters or scabs on clothing, beds, or towels used by someone with the monkeypox rash
coughing or sneezing of a person with monkeypox
On the TravelHealthPro website, you can check the risks of a place you’re visiting.
Monkeypox in the UK
In the United Kingdom, just a few people have been diagnosed with monkeypox.
If you meet the following criteria, you are extremely unlikely to develop monkeypox:
- You have not recently travelled to West or Central Africa.
- You have not been in close contact with a monkeypox carrier (such as touching their skin or sharing bedding)
When infected with monkeypox, the first symptoms usually develop between 5 and 21 days later.
The following are the early signs of monkeypox:
- a scorching heat
- a migraine
- backache and muscle aches
- glandular swelling
- shuddering (chills)
A rash often emerges 1 to 5 days following the onset of the first symptoms. The rash usually starts on the face and extends to other parts of the body.
The rash is occasionally mistaken for chickenpox. It begins as elevated patches that develop into tiny blisters filled with fluid. These blisters eventually develop into scabs, which come off.
Symptoms normally go away in 2 to 4 weeks.
The goal of monkeypox treatment is to alleviate symptoms. Most people recover in 2 to 4 weeks if the disease is mild.
However, because monkeypox can spread through intimate contact, you will need to be isolated if you are diagnosed.
You may need to stay in a specialised hospital to treat your symptoms and prevent the virus from spreading to others.
For either the family or MSM clusters, no source of infection has been identified. Based on existing evidence, the illness appears to have been acquired locally in the United Kingdom. At this point, the extent of local transmission is unknown, but other instances could be identified. However, once monkeypox was detected, officials in the United Kingdom quickly implemented proper public health precautions, such as case isolation and comprehensive forward and backward contact tracing to enable source identification.
There have been eight previous cases of monkeypox documented in the United Kingdom; all importations were linked to a travel history to or from Nigeria. In 2021, the United States of America reported two independent human monkeypox cases imported from Nigeria. During a monkeypox outbreak in the United States of America in 2003, exposure was traced back to interaction with pet prairie dogs who had been co-housed with monkeypoxvirus-infected small mammals imported from Ghana.
In the United Kingdom, intensive public health measures should be maintained. In addition to continued forward and backward contact tracing and source tracing, case seeking and local rash-illness surveillance in the MSM and wider community, as well as in basic and secondary health care settings, should be increased. During the hypothesised and known infectious periods, that is, the prodromal and rash stages of the illness, any patient with suspected monkeypox should be evaluated and isolated with supportive care. Contact tracing, surveillance, and raising awareness among health care providers, including sexual health and dermatology clinics, are critical for preventing secondary cases and managing the current outbreak effectively. Pharmaceutical countermeasures used under investigational protocols can also be explored.
Health care workers and other caregivers caring for patients with suspected or confirmed monkeypox should use basic infection control procedures such as contact and droplet isolation. Samples collected from persons suspected of having monkeypox or from animals suspected of having monkeypox virus infection should be handled safely by skilled personnel working in appropriately equipped laboratories.
Any sickness contracted while travelling or after returning from an endemic location should be reported to a health practitioner, together with details about all recent travel and immunisation history. Residents and visitors to endemic nations should avoid contact with sick animals (dead or alive) that may carry the monkeypox virus (rodents, marsupials, primates), and they should avoid eating or handling wild game (bush meat). Hand hygiene with soap and water or an alcohol-based sanitizer should be stressed.
International travel or trade: Based on current information, WHO does not propose any restrictions on travel to or trade with the United Kingdom.
WHO will continue to closely watch the situation as it evolves.
- WHO factsheet on monkeypox.
- WHO monkeypox outbreak tool kit.
- The UK Health Security Agency News story on 16 May 2022, Monkeypox cases confirmed in England – latest updates
- WHO disease outbreak news, monkeypox, United Kingdom of Great Britain and Northern Ireland, 16 May 2022.
- WHO disease outbreak news, monkeypox, United Kingdom of Great Britain and Northern Ireland, 8 July2021.
- WHO disease outbreak news, monkeypox, all items.
Contact your GP or call 111 if:
If you have a rash with blisters and one of the following:
- You’ve had close contact with someone who has monkeypox symptoms you’ve been to West or Central Africa in the last 6 weeks
If you’ve had close contact with someone who has monkeypox symptoms, or
- If you’ve recently travelled to Central or West Africa, tell the person you’re speaking with.
Stay at home and avoid contact with others until you are advised what to do.
If you are still abroad, get medical attention as soon as possible.