The UK Health Security Agency (UKHSA) has published the latest technical briefing on the monkeypox outbreak in England.
Prof Paul Hunter, Professor in Medicine, UEA, said:
“The publication of this technical briefing on Monkeypox provides a lot of valuable information about the development of the UK epidemic. To my mind, the key observations from this briefing are:
1. The epidemic is continuing to grow. Up to the 22nd June there were 813 cases reported from England which was 47 more than the 766 cases reported up to the 20th June which was just 2 days earlier. Although figure 1 could be interpreted as case numbers decreasing this is probably down to delays in reporting.
2. Although about a half of cases develop symptoms in just over a week some are not developing symptoms for more than three weeks. 10% of cases are not developing symptoms till almost 20 days after contact, and so may not be controlled by the 21 days isolation period (Figure 6), though it is arguable how effective this self-isolation would be anyway.
3. Reassuring however, is that the lag between developing symptoms and that being reporting to public health has fallen with particularly long delays having almost disappeared (Figure 7).
4. Figure 8 A is important showing particularly rapid growth early in the epidemic consistent with initial cases being linked to a small number of overseas events. Fortunately, this rapid rate of growth has slowed as the epidemic has progressed. Though that does seem to have levelled off with a still positive growth rate in the recent two weeks. This does suggest that existing control strategies of contact tracing and ring vaccination will not be sufficient to bring the epidemic under control and the wider vaccination strategy to be implemented in the UK will be needed.
5. The epidemic still is almost entirely restricted to men with women making up less than 1% of cases. But as pointed out the infection is primarily spreading in defined sexual networks of men who have sex with men. The concern remains that there are heterosexual sexual networks1 and such networks can overlap with networks of MSM indicating a potential wider risk than at present. Hence UKHSA urging those with new or multiple sexual partners, whether MSM or heterosexual, to be vigilant.”
1 Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. The Journal of infectious diseases. 2005 Feb 1;191(Supplement_1):S115-22.
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