"We do have a certain level of concern, which is very different from what we usually think of monkeypox. I think we have some concerns that it may spread outside the UK," Jennifer mcquiston, a senior CDC official, told stat in an interview.
Since early May, seven confirmed cases of monkeypox and one suspected case have been found in the UK. Human cases of monkeypox are uncommon and are particularly rare outside West and Central Africa. Although one case recently travelled to Nigeria, where monkeypox is endemic, the other cases appear to have been infected in the UK. Among those infected in the UK, no one had any known connection with the traveler, and the time of onset showed that he was not the source of these infections.
Complicating the situation, the other cases are composed of two different groups with no obvious connection with each other, which also exacerbates people's concerns. Two confirmed cases and one possible case are a family unit, who expert Maria van kerkhove said at a news conference on Tuesday. Four other confirmed cases recently disclosed have been identified as gay, bisexual or other men who have sex with men by the UK health and Safety Authority - three from London and a fourth from Newcastle, nearly 300 miles north. The agency said all four people could have been infected in London.
It is not known how any of these people contracted the virus. Transmission is believed to occur mainly through droplets with viruses, but direct contact with infected lesions or body fluids, or indirect contact through contaminated clothes or sheets, may also lead to transmission.
The fact that there are two apparently unrelated clusters suggests that there may be more than one transmission chain in the country, and each transmission chain may contain additional cases that have not yet been found. Van kerkhove, who heads the Department of emerging diseases and zoonotic diseases in the WHO health emergency plan, said that virus sequencing was being carried out in the UK to try to determine whether there was a genetic link between these cases.
There is no indication that monkeypox is spreading to large numbers of people in the UK. However, there is evidence that there may be some undetected cases, which exacerbates concerns about how much transmission there may be and whether the virus has spread further.
"You have two clusters that are not associated with travel or other people known to be associated with a recognized epidemic. This indicates that an unknown transmission chain occurs," mcquiston said. "If there is an unknown transmission chain, it just makes us stay vigilant and think. Will it spread outside the UK?"
Although there are few cases of human monkeypox outside Africa, some cases have been exported to the United States (two in 2021), the United Kingdom, Israel and Singapore in recent years. The British health service said that the four recent cases were infected with the West African monkeypox strain, which caused less disease than the Central African strain.
The symptoms of monkeypox are similar to smallpox, but milder than smallpox. The World Health Organization announced the successful elimination of smallpox in 1980. In addition to flu like symptoms, infection can cause a unique rash. Many diseases can cause rashes, but monkeypox rashes have some unusual features, especially blisters on the palm.
One vaccine was licensed in the United States in 2019 for people aged 18 and over to prevent smallpox and monkeypox, jynneos of Bavarian Nordic. The second vaccine, acam2000 produced by emergency product development, can prevent smallpox and is considered to provide some protection against monkeypox. But both vaccines are licensed only to people at high risk of contracting the disease. Smallpox vaccine was used in an outbreak involving 47 people in the United States in 2003.
In Africa, about one in ten monkeypox cases are fatal, and children are more likely to have serious diseases and deaths.
Public health authorities in the UK have alerted sexual health clinics to people with unexplained rashes due to cases found in gay, bisexual or other men who have sex with men. Mcquiston said the CDC is considering issuing health alerts to the country's medical industry and sexually transmitted infection clinics.
"There is a lot of travel between the UK and the US and other parts of the world. So I think we are concerned that, given that you do have four cases of MSM, we may need to consider sending a message to our STI clinic... About what to watch out for and what to be vigilant about," she said.
Van kerkhove said that who has contacted European countries through its European office in Copenhagen to raise awareness of the risk of monkeypox cases.
Mcquiston said communication around the epidemic must be carefully formulated. "This is certainly a group that has been stigmatized in the past due to sexually transmitted infections (such as HIV)." "I think we have learned something from these experiences about how to deal with this issue with the required sensitivity," she said
Public health investigators in the UK are trying to track who these confirmed cases contacted before they became ill in an attempt to find their source of infection. But they are also seeking to identify contacts of infected people to see if they spread the virus to others.
So far, the CDC has not been informed that any Americans appear on ukhsa's contact list for these cases, mcquiston said. But she did reveal that six people in the United States were being monitored because they were on the same flight as the man who left Nigeria for Britain on May 4. She said that although there was no indication that these people had direct contact with the man - they were sitting within a three row radius of his seat - the six people would be monitored for 21 days.
Ibrahima SOC é fall, who assistant director general for emergency response, said the outbreak in the UK reminded us of the need to pay more attention to monkeypox and little is known about the disease dynamics of monkeypox.
"Obviously, the main issue we need to investigate is to really understand the true extent of monkeypox transmission in Africa and ensure that we invest in prevention and treatment tools to help the people most exposed in Africa," he said