The UK Health Security Agency (UKHSA) has confirmed that two more people have tested positive for an infectious strain of mpox in the UK.
The country’s first case of Clade Ib mpox was detected in London last week, in a person who had been on holiday in Africa and travelled back to the UK on an overnight flight on October 21.
UKHSA announced that the two new patients, who are currently under specialist care at Guy’s and St Thomas’ NHS Foundation Trust in London, are household contacts of the first UK case.
But what is mpox and should we be worried about it?
What is mpox?
“Mpox is a disease caused by a virus known as monkeypox, which was first seen in the late 1950’s in laboratory monkeys with a human case noted in 1970,” explains Dr Jon Roberts, professor of Health Protection at the University of the West of England. “The virus is ‘zoonotic’ – meaning it can affect different animals, including humans, although cases in humans have been rare.”
Mpox spreads through close physical contact with an infected person.
“It spreads through skin-to-skin contact with rashes or blisters, touching their clothing, bedding or towels, or when they cough or sneeze near you,” explains Dr Kathryn Basford at ASDA Online Doctor. “It can also be transmitted by infected animals through bites but this is less common in the UK.”
The virus commonly has two types or ‘clades’ which present with differing clinical severity if seen in humans.
“Clade I can be associated with more severe disease and in the UK is currently designated a high consequence infectious disease (HCID),” highlights Roberts. “Clade II is no longer designated a HCID and was associated with a global outbreak of infection in 2022-2023, including cases in the UK.”
Why are people worried about it now?
“Cases of Clade I mpox disease have been uncommon and limited to a small number of central African countries, however more recently cases have been reported in a wider set of surrounding countries,” explains Roberts. “There have also been some imported cases in countries outside of Africa where people have had recent travel to an affected area and contact with a case.
“The change in epidemiology of the infection has resulted in the World Health Organisation this year declaring a ‘public health emergency of international concern’ requesting countries to work together to prevent and respond to the outbreak.”
What are the symptoms?
“If you get infected with mpox, it usually takes between five and 21 days for the first symptoms to appear,” says Basford. “Symptoms to look out for include a fever, headache, muscle aches, swollen lymph nodes, and fatigue, followed by a rash that typically starts on the face and spreads to other parts of the body.
“The rash progresses from flat lesions to raised bumps, then fluid-filled blisters, and finally, scabs that eventually fall off.
“The illness usually lasts two to four weeks and is generally mild, but in some cases, it can be severe.”
People often mistake the rashes for chicken pox.
“It is very important to note these symptoms can also be associated with more common infections such as chickenpox so it is important to discuss with a healthcare professional and if required, be tested,” adds Roberts.
Who is most at risk?
“Those most at risk are in close contact with someone with mpox, including household members, sexual partners, as well as healthcare workers, men who have sex with men, people with weakened immune systems, and individuals in regions where mpox is spreading,” says Basford.
“People who have recently travelled to, or who have been in close contact with someone who has recently travelled to, areas of central or east Africa where there are outbreaks of mpox, are at higher risk of catching mpox.”
Can it be treated?
Most treatments for mpox focus on reducing the symptoms.
“If mpox is caused by Clade I, which is a designated HCID, the patient will likely need to be treated in a specialist hospital,” notes Roberts. “For Clade II cases symptoms will likely be self-limiting and resolve within a few weeks but it is important to follow advice to reduce the risk of spread to others.
“In certain situations such as to prevent or control outbreaks (Clade I or II), vaccination will be offered to some individuals based on a public health risk assessment.”
How likely am I to catch it in the UK?
“The risk to members of the public in the UK is low,” clarifies Roberts. “Returning travellers from countries experiencing cases should be mindful and report symptoms to a healthcare professional, especially if they have been in direct contact with a known or suspected case.”
Should I be worried about mpox while travelling?
“It is important to follow general advice on safe travel to the country visiting,” says Roberts. “If travelling to an affected country there are specific precautions recommended and can be found on the NaTHNac website.
“Anyone travelling to work in healthcare in an affected country should register with the UKHSA returning workers scheme.“
