2022–2023 mpox outbreak
| 2022 monkeypox outbreak | |
|---|---|
| File:Monkeypox.gif Electron micrograph of monkeypox virus | |
| Disease | Human monkeypox |
| Virus strain | West African clade of the monkeypox virus (MPV) |
| Source | Travel from Nigeria |
| Location | Worldwide |
| First outbreak | London, England |
| Date | 29 April 2022 – ongoing |
| Confirmed cases | 9 |
| Severe cases | at least 3 hospitalised |
Deaths | 0 |
An ongoing outbreak of monkeypox began in the United Kingdom began on 29 April 2022 with the presentation of monkeypox symptoms in a British resident who had travelled to Nigeria, where the disease is endemic. The individual subsequently returned to the United Kingdom on 4 May, importing the index case of the outbreak into the country.[1]
The source of several of the cases of monkeypox in the United Kingdom is unknown; however, it appears that community transmission is taking place in the London area as of mid-May.[2] Cases of the virus have also been reported in North East England as well as outside the UK: one in Portugal, two in the United States and five in Canada as of 18 May. The outbreak has particularly impacted the LGBT community.[2]
Background
Human monkeypox is a viral infection caused by the monkeypox virus (MPV), a relative of now-eradicated smallpox. Monkeypox generally presents with similar symptoms to smallpox, although usually milder; however, the case fatality rate for monkeypox may still be as high as 10% without prompt treatment.[3]
Monkeypox is endemic to West and Central Africa.[4] Prior to the 2022 outbreak, the United Kingdom had only recorded seven previous cases of monkeypox,[5] all of which were imported cases from Africa or healthcare workers involved in their treatment. The first three such cases were in 2018,[5] followed by a further case in 2019[6] and three more in 2021.[7] The only major monkeypox outbreak to be recorded in a Western country prior to 2022 was the 2003 Midwest monkeypox outbreak in the United States; however, this outbreak did not feature community transmission.[8][9]
Monkeypox is spread primarily through close contact with infectious individuals.[1] Prior to the 2022 outbreak, monkeypox was not considered to be a sexually transmitted infection. However, the rapid spread of the virus between sexual partners in the initial stages of the outbreak has prompted discussion that sexual intercourse may be a further route of transmission.[2]
Timeline
Index case
The index case was a British resident who travelled to Lagos and Delta State in Nigeria in late April 2022,[1] areas in which monkeypox is considered to be an endemic disease. The individual developed symptoms of monkeypox, including a rash, on 29 April while still in Nigeria. They subsequently flew back to the United Kingdom, arriving on 4 May. They presented to hospital later the same day; monkeypox infection was immediately suspected, and the individual was hospitalised at Guy's Hospital[5] and isolated after testing positive for the virus.[1] Testing of patient swab samples by polymerase chain reaction revealed the outbreak to be of the West African clade of monkeypox, which is the less deadly of the two known monkeypox variants with a case fatality rate of around 1%.[1]
Extensive contact tracing of people who had been in contact with the index case both on the international flight from Nigeria to the United Kingdom and within the country following their arrival was carried out, with potential contacts advised to remain aware of the symptoms of monkeypox and immediately isolate if any were to develop within 21 days of the contact event.[1] Following this contact tracing effort, the World Health Organization (WHO) considered further transmission of the virus within the United Kingdom to be of "minimal" risk.[1]
Contact tracing in response to the index case was extended to Scotland on 14 May according to Public Health Scotland. A "small number" of people in Scotland were ordered to self-isolate following close contact with the index case, although overall risk to the general public remained "very low".[5]
Community transmission
Two new cases of monkeypox were confirmed by the UK Health Security Agency (UKHSA) on 12 May, both of which were in London.[10] These two individuals lived together in the same household; however, there was no known link between either of them and either the index case or travel to endemic regions. One of the new cases was hospitalised at St Mary's Hospital, while the other case with milder symptoms was said to be self-isolating at home.[10]
Four additional cases of monkeypox were confirmed by the UKHSA on 17 May, three of which were in London plus one case in North East England who had previously travelled to London.[11] None of these new cases had any known contact history with the previous three confirmed cases, suggesting that wider community transmission of the virus was now underway in the London area. However, the UKHSA stated that the risk to the general public remained "very low".[11] All four of the newly-infected individuals self-identified as members of the LGBT community, and sexual intercourse between members of the community has been suggested as a potential transmission route.[2] Patients with active monkeypox infection were confirmed to be hospitalised at the Royal Victoria Infirmary in Newcastle upon Tyne and at the Royal Free Hospital and Guy's Hospital in London.[11]
Cases in Portugal, Spain, U.S. and Canada
On May 18 in Portugal, 14 cases of Monkeypox were reported by health authorities out of total of 20 suspected cases, with 2 samples still awaiting for test results.[12] In Spain, there are 7 confirmed cases as of May 18.[13] On the same day, the U.S. confirmed its first 2022 case of Monkeypox and Canada reported 13 suspected cases.[14][15]
References
- ^ a b c d e f g "Monkeypox - United Kingdom of Great Britain and Northern Ireland". World Health Organization. 16 May 2022. Retrieved 17 May 2022.
- ^ a b c d Pinkstone, Joe (17 May 2022). "Monkeypox 'spreading in sexual networks'". The Telegraph. Retrieved 17 May 2022.
- ^ "Signs and Symptoms Monkeypox". CDC. 11 May 2015. Archived from the original on 15 October 2017. Retrieved 17 May 2022.
- ^ Bunge, Eveline M.; Hoet, Bernard; Chen, Liddy; Lienert, Florian; Weidenthaler, Heinz; Baer, Lorraine R.; Steffen, Robert (11 February 2022). "The changing epidemiology of human monkeypox—A potential threat? A systematic review". PLOS Neglected Tropical Diseases. 16 (2): e0010141. doi:10.1371/journal.pntd.0010141. ISSN 1935-2735. PMC 8870502. PMID 35148313.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b c d "Monkeypox contact tracing extended to Scotland". BBC News. 14 May 2022. Retrieved 17 May 2022.
- ^ "Monkeypox case confirmed in England". GOV.UK. Public Health England. 4 December 2019. Retrieved 18 May 2022.
- ^ "Communicable disease threats report, Week 26, 27 June – 3 July 2021" (PDF). European Centre for Disease Prevention and Control. 2 July 2021. Retrieved 18 May 2022.
- ^ Linda Spice, "13 Sick After Prairie Dog Contact; Milwaukee Pet Store Employee, Two OthersRemain Hospitalized," Milwaukee Journal Sentinel, June 6, 2003.
- ^ Todd Richmond. Four Get Monkeypox Virus from Prairie Dogs." Associated Press. 6/11/2003.
- ^ a b "Monkeypox: Two more confirmed cases of viral infection". BBC News. 15 May 2022. Retrieved 17 May 2022.
- ^ a b c "Monkeypox: Four more cases detected in England". BBC News. 17 May 2022. Retrieved 17 May 2022.
- ^ "Monkeypox. Já há 14 casos de varíola dos macacos em Portugal". www.dn.pt (in European Portuguese). Retrieved 18 May 2022.
- ^ Güell, Oriol (18 May 2022). "Sanidad confirma que los análisis de los siete primeros casos sospechosos de viruela del mono han dado positivo". El País (in Spanish). Retrieved 18 May 2022.
- ^ "Massachusetts confirms rare monkeypox case, the first in the US this year". Boston Herald. 18 May 2022. Retrieved 18 May 2022.
- ^ ICI.Radio-Canada.ca, Zone Santé-. "Variole du singe : au moins 13 cas en cours d'examen à Montréal". Radio-Canada.ca (in Canadian French). Retrieved 18 May 2022.