There are more than 3,300 monkeypox cases in the UK as the vaccine rollout continues
(Picture: AFP via Getty Images)An Italian man has become the first person to simultaneously test positive for monkeypox, Covid-19 and HIV.
The 36-year-old spent five days in Spain from June 16 to 20. He is reported to have had unprotected sex during his stay.
Nine days after returning home he developed a fever, up to 39C, a sore throat, fatigue and headache among other symptoms.
On July 2 he tested positive for Covid, and on the afternoon of the same day developed a rash. The next day “small, painful vesicles...appeared on the torso, lower limbs, face and glutes”, the Journal of Infection said.
On July 5, “due to a progressive and uninterrupted spread of vesicles”, the man was rushed to hospital and transferred to the infectious diseases unit.
Only July 6 the man tested positive for monkeypox.
He was admitted and later returned to hospital on July 19, and initiated for HIV treatment.
“This case highlights how monkeypox and Covid-19 symptoms may overlap,” the journal said.
“Clinicians should be aware of the possibility of [Covid] and monkeypox virus co-infection, particularly in subjects with a recent history of travel to monkeypox-outbreak areas.
“As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient’s condition.
“Given the current pandemic and the daily increase of monkeypox cases, healthcare systems must be aware of this eventuality, promoting appropriate diagnostic tests in high-risk subjects.”
As of August 22, there were 3,207 confirmed and 133 highly probable monkeypox cases in the UK.
Of these, 2,232 confirmed or highly probable cases are in London.
Cases of monkeypox infection were confirmed in England from May 6.
The outbreak has mainly been in gay, bisexual, and men who have sex with men without documented history of travel to endemic countries, the UK Health Security Agency (UKHSA) said.
The vaccine rollout for monkeypox in England is underway, but supplies are limited.
Three NHS sites are set to begin a pilot offering eligible patients smaller but equally effective doses of the vaccine used for the UK’s monkeypox outbreak, stretching existing supplies to protect more people, UKHSA said.
The pilot was introduced in one sexual health clinic in Manchester on Monday, and a further two in London shortly.
Dr Mary Ramsay, Head of Immunisation at UKHSA, said: “Global supplies of the smallpox vaccine used to combat monkeypox are limited but we acted early to ensure the UK obtained the maximum number of doses available.
“Adopting this tried and tested technique will help to maximise the reach of our remaining stock, including the 100,000 doses due to arrive in the country next month, potentially enabling us to offer protection for many more thousands of people.”
Professor Sir Andrew Pollard, Chair of the JCVI, said: “The use of fractional dosing will allow more people to be vaccinated sooner by optimising use of the constrained vaccine supply, and this approach is expected to reduce the spread of monkeypox.”
The UKHSA has determined that, due to the limited vaccine supply, the post-exposure offer of vaccination should be reserved for those close contacts who are at highest risk of severe illness.
