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UK monkeypox data, As of 4 August 2022, https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates Confirmed cases, 2,768 Highly probable, 91 In England, 2,730 A high proportion of cases in London Was 75% Latest, 66% Monkeypox outbreak: epidemiological overview https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview/monkeypox-outbreak-epidemiological-overview-5-august-2022 2018 to 2021 7 cases of monkeypox in the UK Rare and Imported Pathogens Laboratory (RIPL) Some NHS laboratories now testing, orthopox polymerase chain reaction (PCR) test Monkeypox outbreak: technical briefing 5 5th August https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-5 Over the past couple of weeks there has been approximately no change in the daily number of confirmed cases. Ascertainment Testing is freely available, it is likely that there is under ascertainment Atypical symptoms, single or scarce lesions, international reports of subclinical infection Level 2 is defined as transmission within a defined sub-population, currently gay, bisexual and men who have sex with men (GBMSM) connected by sexual networks. Data does not suggest a change in case mix (703 out of 2,638) 22 women with confirmed or highly probable monkeypox in England No robust evidence of sustained transmission outside some sexual networks of GBMSM Route of transmission Primary reported route is through close or sexual contact, monkeypox virus has been detected in air and environmental samples in the hospital room of infected patients. No confirmed instances of airborne transmission Limited household transmission has been described in the UK Small numbers with no known route of acquisition, (due to no sex or other potential exposures during incubation period) Assessment (confidence): transmitting primarily through close or sexual contact (moderate). Observed clinical severity No reported deaths in the UK Significant morbidity, severe pain, secondary bacterial infection Virological characterisation UK genomic data is now available. Mostly distinct lineage B.1 Has 61 mutations of unknown significance Two UK cases and some international cases, lineage A.2 No clear-cut evidence of adaptation for improved human transmission. Assessment (confidence): insufficient data. Metrics GBMSM, 95.3% History of STI in past year, 53.9% One or no sexual partners in past 3 months, 13.9% Ten + sexual partners in past 3 months, 30.4% Living with HIV, 26% https://monkeypoxreport.ecdc.europa.eu Cases, 15,926, from 38 countries, European region Laboratory confirmed, 15,524 West African clade, 203 (limited sequencing) Earliest date of symptom, 11 March 2022 Male, 99.1% HIV-positive, 36% Presentation Presented with a rash (9,126 / 9,626) 94.8% Systemic symptoms Such as fever, fatigue, muscle pain, chills, or headache (6,300 / 9, 626) 65% Hospitalised 399 (5.6%), of which 150 cases required clinical care. Three cases Admitted to ICU, 3 (1 unrelated) Two other cases admitted to ICU died of monkeypox Cases reported in health workers, 41 No occupational exposure Dear Secretary of State https://www.tht.org.uk/sites/default/files/2022-08/LGBT%20political%20groups%20letter%20on%20monkeypox%20August%202022_0.pdf Without urgent action, we risk monkeypox becoming endemic in the UK. GBMSM, Messaging must reach communities at high risk of acquiring monkeypox, through targeted messaging on apps, online and in the queer media. Vaccinating those most at risk of monkeypox must be a priority if we are to stand a chance of preventing the virus from becoming endemic in the UK. two doses to 125,000 people asking that the government treat the monkeypox outbreak as a public health emergency Luckily, we have the tools required to stop this outbreak and prevent further risk to health now. We ask that you do so urgently.

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