UK Health Officials Issue New guidance as Monkeypox Cases Continue to Surge

The UK Health Security Agency (UKHSA) has issued new guidance as monkeypox cases surge to more than 2,000. There are now 2,137 confirmed monkeypox cases in the UK, with 2,050 detected in England, according to the latest figures from UKHSA. However, updated UKHSA guidance for close contacts of a confirmed monkeypox case means close contacts won’t need to isolate at home if they don’t have symptoms.

The new guidance is line with advice from the WHO, other European countries and the CDC. The change in guidance is in response to latest data showing that a relatively small number of close contacts have gone on to develop monkeypox and a lack of evidence of transmission outside of close intimate or sexual contact, now that more epidemiological information is available. It means the latest guidance is proportionate to the latest transmission risks identified.

For category 3 close contacts, it recommends avoiding close contact with children aged under 5 years, pregnant women and those who have an impaired immune system. For category 2 close contacts, UKHSA now recommends that people:

• contact NHS 111 or a sexual health clinic if they develop a fever or rash.
• avoid skin to skin contact with others, such as hugging and kissing.
• refrain from sexual or intimate contact.
• avoid international travel if possible; travel insurance may also not be valid for people advised not to travel.
• let health or dental facility staff know they’re a close contact before attending for health or dental care.

A smallpox vaccine is still being offered to close contacts with higher risk exposure on a case-by-case basis. The UKHSA said it has purchased a further 100,000 doses of the vaccine. People currently eligible for vaccination against monkeypox, include gay and bisexual men and other men who have sex with men, who are at the highest risk of coming into contact with monkeypox, and those who are likely to be exposed to monkeypox because of their work, for example those who work at sexual health clinics, in the sex industry or in saunas.

“While anyone can get monkeypox, the majority of cases in the UK continue to be in gay, bisexual and other men who have sex with men (GBMSM), with the infection being passed on mainly through close contact between people in interconnected sexual networks,” highlighted Dr Merav Kliner, Deputy Incident Director at UKHSA. “The vaccine will be offered to some GBMSM who are more likely to acquire the virus, with eligibility based on a number of factors, similar to the criteria used to assess those eligible for HIV pre-exposure prophylaxis (PrEP), even if they are already living with HIV.”

Adding to her comments, Health and Social Care Secretary Steve Barclay said: “Monkeypox is a rare and usually mild disease that does not spread easily between people, but we are taking action to help further manage the outbreak in the UK by procuring over 100,000 additional doses of vaccine. The NHS is already contacting those eligible for the vaccine, and I would urge people to take up the offer as soon as they are contacted. In the meantime, please contact a sexual health clinic if you notice any unusual rashes or lesions.”

“Anyone can get monkeypox and we continue to urge anyone with a rash with blisters, or any other monkeypox symptoms, to take a break from events, meeting with friends or having sexual contact,” stressed Dr Gayatri Amirthalingam, Head of Immunisation at UKHSA. “Instead, stay at home and contact 111 or your local sexual health service for advice.”

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