Intended for healthcare professionals


Seven monkeypox cases are confirmed in England

BMJ 2022; 377 doi: (Published 17 May 2022) Cite this as: BMJ 2022;377:o1239
  1. Elisabeth Mahase
  1. The BMJ

Seven cases of monkeypox, a viral infection that can cause a rash similar to chickenpox or syphilis, have been confirmed in England, the UK Health Security Agency (UKHSA) has said.

The update adds four new cases to the three already announced earlier this month. The four latest cases—three in London and one linked case in the north east—have no known connection to the three cases previously identified.

The UKHSA is still investigating where and how these cases were acquired but has said that they are not linked to travel to a country where monkeypox is endemic and that all four cases are in people who self-identify as gay, bisexual, or other men who have sex with men.

Clinicians have been told to be alert to people presenting with rashes without a clear alternative diagnosis and that they should contact specialist services for advice.

Susan Hopkins, UKHSA chief medical adviser, said, “This is rare and unusual. UKHSA is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact. We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”

Monkeypox is a viral infection usually associated with travel to west Africa. It is usually a mild, self-limiting illness spread by very close contact with someone with monkeypox, and most people recover within a few weeks. Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion. A rash can then develop, often beginning on the face before spreading to other parts of the body. The rash finally forms a scab and then falls off.

Jimmy Whitworth, professor of international public health at the London School of Hygiene & Tropical Medicine, said, “This outbreak of monkeypox is unprecedented in the UK and has provoked urgent public health action. There is a need to engage with the at-risk community of gay and bisexual men to ensure they know about the presence of this infection and report any sign and symptoms to health facilities.

“Cases need to be identified, isolated, and treated, either in hospital or at home, depending on severity and circumstances. Close contacts need to be identified and monitored for signs of infection. Monkeypox is not very transmissible, and with these measures the outbreak can be quickly brought under control.”