Monkeypox arrives in England

Monkeypox arrives in England

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Monkeypox case confirmed in England, with local spread, but it's not going to be another pandemic.


Cases, + 7

Unconnected cases, + 4 (no travel links)

All transmission in London so far

Came from Nigeria

Usually a mild self-limiting illness, 14 to 21 days

Most people recover within a few weeks

Mortality, 1%

Monkeypox strains

Milder west African strain

More severe central African, (Congo strain)

Current English cases, west African strain


there is a very low risk of transmission to the general population

does not spread easily between people

when someone is in close contact with an infected person

People without symptoms are not considered infectious

(those who have been in close proximity are being contacted)

Animal to human, (African rodents)

Human to human

Broken skin

Respiratory tract

Mucous membranes

Direct contact with body fluids or lesion material

Indirect contact with lesion material, contaminated bedding

Primarily through large respiratory droplets

Prolonged face-to-face contact

Dr Nicholas Price, Director NHSE High Consequence Infection Diseases (airborne) Network

Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

Rash, 1 to 5 days after first symptoms

A rash can develop, often beginning on the face,
then spreading to other parts of the body.

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

(can look like chickenpox or syphilis)

Starts as raised spots, forming into fluid filled blisters, then scabs which fall off

Incubation period of monkeypox

Usually from 6 to 13 days

Lesions can be very itchy or painful

Case fatality ratio

West African clade, 1%

Congo Basin clade, may be as high as 10%

Children are at higher risk

Monkeypox during pregnancy, complications, congenital monkeypox or stillbirth

A vaccine has been approved

Traditional smallpox vaccine also provides protection

(UK, 1971)

Post-exposure prophylaxis with vaccination is being offered to the higher risk contacts

Since September 2017, Nigeria

558 suspected cases reported from 32 states

241 were confirmed cases

eight deaths recorded

(Case Fatality Ratio: 3.3%)


Four of seven cases, in England, past two weeks, gay or bisexual men

If so this is new