Between 6 May 2022 and 12 September 2022, 3552 cases of monkeypox have been confirmed in the United Kingdom.7 The international dispersion of the virus has resulted in the largest outbreak of monkeypox reported outside of Africa. The 2022 monkeypox outbreak in the United Kingdom is part of the larger outbreak of human monkeypox caused by the West African clade (type) of the monkeypox virus. In early August, the Biden administration declared monkeypox a public health emergency with several states such as California and Illinois, and cities like New York and San Francisco following suit. Results The mean age of participants was 37.8 years and 95% reported being gay, bisexual, and other men who have sex with men (1160 out of 1213 reporting). Monkeypox is a misnomer that results from the fact that it was discovered at the Statens Serum Institut in Copenhagen in 1958, when outbreaks of a pox-like disease occurred in monkeys kept for. A Weibull distribution gave the best fit to the data for both models (see supplementary material A for results of the lognormal and gamma models). [1], On 22 May, Education Secretary Nadhim Zahawi said "we're taking it very, very seriously" and that the UK government had already started purchasing smallpox vaccines. The story of monkeypox feels to experts frustratingly like a replay of the first months of the COVID-19 pandemic in 2020. . [36], Confirmed cases by countries in the United Kingdom during the 2022 outbreak (as of 12 July), The first three paragraphs an excerpt from, 20222023 monkeypox outbreak in the United Kingdom, Number of cases confirmed in constituent countries. [5][7] The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common to all outbreaks. Infection control precautions for contacts (vaccination, daily monitoring, staying home from work) were implemented. In other populations and with different disease severity, the incubation periods are likely to differ.29303132. Participants 2746 people with polymerase chain . Since the international epidemic began in May, the U.S. has recorded 201. The mean incubation period and mean serial interval were found to range from 6.6 to 9.2 days and 7.4 to 12.3 days, respectively, when adjusted for right truncation and epidemic phase bias. The maximum time that transmission was detected before symptoms manifested was nine days. Adjustments for interval censoring, right truncation, and epidemic phase bias are essential for data that are coarsely collected28 and linked to probable, not deterministic, exposure events. Such spread has resulted in divergence of the virus, with two distinct clades circulating in different regions of Africa. There has recently been an increase in cases in the UK, but the risk of catching it is low. Doubling and halving times and log scale model fit of case numbers of monkeypox by reporting date. A high proportion of England cases were London residents (69%, 2,397 of 3,467 with location information). To expand the UKs capability to detect monkeypox cases, some NHS laboratories are now testing suspected monkeypox samples with an orthopox polymerase chain reaction (PCR) test (orthopox is the group of viruses which includes monkeypox). Cases were modelled as a smooth function of time using a generalised additive model with a negative binomial error distribution. The UK has seen 82 new monkeypox cases this week and a total of 190 cases so far. [35], Furthermore, to combat the continued spread of the outbreak, the UKHSA has offered doses of the Imvanex smallpox vaccine, also effective against monkeypox, to people having had close contact with people confirmed to having been infected. Of the 30 primary cases, 19 had a symptom onset date recorded in the line list. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. health, 13, 14. Onset to exposure, serial interval, and incubation period for 13 primary cases with monkeypox who had matching personal identifiable information or were matched but without such information. The posterior estimate for the mean incubation period of monkeypox from the UK sampling was 7.6 days (95% credible interval 6.5 to 9.9) for the ICC model and 7.8 days (6.6 to 9.2) (fig 2 and table 2) for the ICRTC model. The primary strength of this analysis is the large sample size, obtained from the UKHSA surveillance and contact tracing data, enabling the distributions to be estimated with reasonably narrow credible intervals. This is combined with case information recorded by local Health Protection Teams in the UKHSA national case management system. These figures are used for official reporting of monkeypox confirmed case counts in the UK. A week later monkeypox was identified in two more people, with no links to the first patient. WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. The data sharing section includes a link to a repository containing the code for the model and the trace results from the MCMC sample. If clinical symptoms occurred before patients recognised they had symptoms, however, then the true incubation period could be shorter than the patients recognised incubation period. Accessed August 3, 2022. https://monkeypoxreport.ecdc.europa.eu. We refer to this model as the double interval censoring corrected model (ICC). The median incubation period for the ICC model was 6.6 days (95% credible interval 5.5 to 7.7) and for the ICRTC model was 6.6 days (5.5 to 7.9). Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over. The estimated mean serial interval was 8.0 days (95% credible interval 6.5 to 9.8) using the ICC model and 9.5 days (7.4 to 12.3) using the ICRTC model. 10 out of 13 linked patients had documented pre-symptomatic transmission. For the more reliable sample where personal identifiable information was available for linkage, this time decreased to four days, with three out of the four more reliable (ie, personal identifiable information available) case-contact pairs showing pre-symptomatic transmission. The DRC reported more than 18,000 confirmed or suspected monkeypox cases from 2010 to 2019, up from about 10,000 from 2000 to 2009, and more than 6,000 suspected cases in 2020. From the perspective of public health policy, this transmission before the detection of symptoms is equivalent to pre-symptomatic transmission, as it concerns when individuals might become aware of their infection. Instead, within our model we included estimated event times for each patient, z*[z1, z2] for z{e, s}, as an unobserved variable. Goodrich B, Gabry J, Ali I, et al. Principles for monkeypox control in the UK: 4 nations consensus statement. [29], On 30 May, the four main public health agencies published a consensus statement describing the principles they will put in use, with the aim of limiting community transmission. Considerations for contact tracing during the monkeypox outbreak in Europe, 2022. Growth rates of cases by reporting date, when monkeypox virus was confirmed and reported to UKHSA, were estimated using generalised additive models. However, this overestimation of the serial interval will bias the data away from pre-symptomatic transmission, which further supports the evidence of pre-symptomatic transmission we identified. A side effect of this is that, assuming the linked pair are a genuine transmission event, we cannot directly ascertain the direction of transmission. Joint ECDC-WHO Reginal Office for Europe monkeypox surveillance bulletin. For instance, even though monkeypox can be prevented, detected, and treated with the use of vaccines, medicines, and diagnostics, further studies are required to help establish the appropriate use of these . Information criteria and cross-validation, 2020. News stories, speeches, letters and notices, Reports, analysis and official statistics, Data, Freedom of Information releases and corporate reports. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Data requests can be made to the Office for Data Release (https://www.gov.uk/government/publications/accessing-ukhsa-protected-data/accessing-ukhsa-protected-data) and by contacting DataAccess@ukhsa.gov.uk. To obtain data on the incubation period we analysed completed case questionnaires and linked infected individuals to probable exposure dates. In late May, cases started to be reported in the other constituent countries, with Public Health Scotland reporting its first case on 23 May. The United Kingdom was the first country, outside of the endemic African areas, to experience an outbreak. Monkeypox - Democratic Republic of the Congo. 2 The ongoing outbreak was first reported from the United Kingdom by the UK Health Security Agency on May 7, 2022. A milder West African strain of the virus is driving the. [6] There may be mild symptoms, and it may occur without any symptoms being apparent. You have accepted additional cookies. After excluding the primary cases who did not match on personal identifiable information, 13 case-contact pairs remained. The right truncation primarily affects recent observations and has less of an influence on older observations. We defined a confirmed case as an individual with a positive polymerase chain reaction (PCR) test result for monkeypox virus, and a highly probable case as an individual with a positive PCR test result for orthopoxvirus. Firstly, we linked case-contact pairs to questionnaire records for each secondary contact, which enabled the primary case and the exposure date to be identified for the secondary contact. Monkeypox is a re-emerging zoonotic infection caused by the monkeypox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family 1 and was first identified in the Democratic Republic of the Congo in 1970. Surveillance and laboratory studies have found the Congo Basin clade to the more severe of the two, with higher transmissibility.34 In May 2022, the World Health Organization reported a monkeypox outbreak in several originally non-endemic countries,5 since linked to the Western African clade.6 These cases were of considerable concern as they could not be clearly linked to recent travel from an endemic area. Furthermore, the effectiveness of contact tracing will be affected because when contacts are traced, they might already have generated secondary cases. This relies on the assumption that the primary case identified by the secondary contact in the questionnaire is the same primary case identified in case-contact pair. WHO have projected that more cases of monkeypox will be identified as surveillance expands in non-endemic countries. Dont worry we wont send you spam or share your email address with anyone. As of 25 July 2022, both definitions were recognised in the UK as representing a case of monkeypox. With the emergence of COVID-19 and the recent surge in monkeypox cases, scientists and doctors who specialize in infectious disease are issuing increasingly dire warnings, saying wealthy countries can no longer afford to ignore small outbreaks abroad. We have assumed that transmission follows the direction of symptom onset dates. The 2022 monkeypox outbreak in the United Kingdom is part of the larger outbreak of human mpox caused by the West African clade (type) of the monkeypox virus. Incubation periods and serial intervals are examples of time delay distributions, which describe the distribution of times between two coupled events. 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