Health officials are investigating whether a number of cases of monkeypox in the UK were sexually transmitted – in what one expert fears could be the first recorded cases of their kind.
The UK Health Security Agency (UKHSA) has discovered a total of seven cases of monkeypox, all of which were diagnosed between 6 and 15 May. Four new ones were confirmed last week.
Three of the new cases are in London and one linked case is in the North East of England. All four patients are male.
Investigations are underway to establish links between these latest cases, all of which appear to be infected in the capital.
The affected men identify themselves as gay, bisexual or as having sex with men (MSM), according to the UKHSA. Common contacts were found for two of the last four cases.
Monkeypox is a rare infection mainly spread by wildlife in parts of West or Central Africa. The symptoms include a rash that can be confused with chickenpox.
However, with these seven cases, there is no link to traveling to a country where monkeypox is endemic.
It is usually thought that the virus is spread by rodents, such as rats, mice and squirrels, and that it is caught by a bite or contact with an infected animal or its fur, or by eating meat from an animal that has not been properly cooked. .
Exactly where and how these new infections were contracted is still under urgent investigation.
The UKHSA said the virus does not spread easily between people and the risk to the UK population is low.
However, the most recent cases have been in gay, bisexual and other MSM communities, and since the virus spreads through close contact, officials are advising these groups to be on the lookout for any unusual rashes or lesions on any part of their bodies, especially their genitals. and to contact a sexual health service if they are concerned.
dr. Mateo Prochazka, an infectious disease epidemiologist at UKHSA, said: “When monkeypox jumps from animal reservoirs to humans, the person-to-person spread is usually limited. Some of the longest documented chains of transmission involve six consecutive infections from person to person.
“This is because the virus is not really ‘fit’ to maintain the person-to-person spread. Transmission is not easy, but can occur from person to person through direct contact with lesions or respiratory secretions.
“The closer and longer the contact, the more likely it is to be transmitted. Close contact between two people (such as during sex) could also facilitate transmission, but this has never been described before.
“However, the high percentage of cases in the current outbreak in England that are gay or bisexual (4/7, 57 percent) strongly points to spreading in sexual networks. This is further suggested by the fact that common contacts were found for only two of the last four cases.”
dr. Prochazka said it is rare to find cases of monkeypox that lack travel links, suggesting imports followed by some degree of community transmission.
“What’s even more bizarre is finding cases that appear to have contracted the infection through sexual contact — this is a new transmission route that will have implications for response to and control of an outbreak,” he said.
What are the symptoms of monkey pox?
According to the NHS, it usually takes between five and 21 days for the first symptoms to appear after infection. The first symptoms include:
- high temperature
- headache
- muscle strain
- backache
- swollen glands
- chills (shivers)
- exhaustion
A rash usually appears one to 5 days after the first symptoms. It often starts in the face and then spreads to other parts of the body.
The rash is sometimes confused with chickenpox. It starts out as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs that later fall off.
Symptoms are usually mild and apparent in two to four weeks. However, patients usually need to stay in a specialist hospital so the infection doesn’t spread and symptoms can be treated, the NHS says.
However, officials stressed that there was still no confirmation of sexually transmitted cases of monkey pox. Some scientists have downplayed a possible link, as the virus can be transmitted through skin-to-skin contact.
Francois Balloux, director of the UCL Genetics Institute, said: “I would like to advocate some caution at this stage before concluding that monkeypox has turned into a sexually transmitted disease (STD).
“Monkeypox is not particularly transmissible and the number of cases to date where the route of transmission is known remains relatively small.
“What is known is that monkeypox is transmitted between people who are in close contact through bodily fluids, respiratory droplets, lesions or even contaminated materials such as bedding.
“’Sexual contact’ generally qualifies as ‘close contact’. So the recent sightings of apparent sexual transmission in the UK do not necessarily imply a recent change in the transmission route of the virus.”
Keith Neal, professor emeritus of infectious disease epidemiology at the University of Nottingham, said: “It cannot be transmitted through sexual intercourse, but rather through close contact that accompanies sexual intercourse. Further testing to see if the virus is found in semen is needed to be truly sexually transmitted.
The monkeypox patients in need of medical care are all in specialist infectious disease wards at the Royal Free Hospital in London, Royal Victoria Infirmary in Newcastle upon Tyne and Guys’ and St Thomas’ in London.
The individuals have the West African clade of the virus, which is mild compared to the Central African clade.
dr. Susan Hopkins, Chief Medical Officer at UKHSA, said: “This is rare and unusual. UKHSA is rapidly investigating the source of these infections as evidence suggests there may be community transmission of monkeypox virus spread through close contact.
“We particularly urge men who are gay and bisexual to be aware of any unusual skin rashes or lesions and to contact a sexual health service immediately. We are contacting all possible close contacts of the cases to provide health information and advice.”
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