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Monkeypox WHO Reconsiders considering calling a Public Health Emergency https://www.medscape.co.uk/viewarticle/monkeypox-reaches-6000-globally-who-reconsiders-calling-2022a1001qnc?uac=127834AR&faf=1&sso=true&impID=4403342&src=mkm_ret_220707_mscpmrk_newsalertuk_int UK Level 2 Transmission within a defined sub-population with high number of close contacts. https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview/monkeypox-outbreak-epidemiological-overview-5-july-2022 https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings Monkeypox is a zoonotic infection Monkeypox virus Endemic in West and Central Africa UK, between 2018 and 2021 7 cases Epidemiological links to imported cases 4 were imported 2 were cases in household contacts 1 health care worker No documented community transmission until 6th May 2022 Outbreak mainly (96%) been in homosexual and bisexual men (without history of travel to endemic countries) Cases, history of a sexually transmitted infection (STI) in the last year (54.2%), and 10 or more sexual partners in the last 3 months (31.8%) Monkeypox is being transmitted in interconnected sexual networks that sustain STI transmission UK, up to 4 July 2022 1,351 laboratory confirmed cases (Rare and Imported Pathogens Laboratory,RIPL) 40 in Scotland 11 in Northern Ireland 15 in Wales 1,285 in England (77% in London) 6 confirmed cases in women Median age, 36 years (interquartile range 31 to 43) Monkeypox outbreak: vaccination strategy https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy Smallpox Modified Vaccinia Ankara – Bavarian Nordic For pre and post exposure The committee Using markers of high-risk behaviour, Similar to those used to assess eligibility for HIV pre-exposure prophylaxis (PrEP) These risk criteria would include a recent history of multiple partners, participating in group sex, attending sex on premises venues, or a proxy marker such as recent bacterial STI European Centre for Disease Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe (WHO/Europe) https://monkeypoxreport.ecdc.europa.eu 5,949 cases of monkeypox, from 33 European countries 99 cases where sequencing was available, confirmed to be of the West African clade Implications for HIV-Positive Men 40% of cases were also (364/917) HIV-positive 99% of those with known sexual orientation stated they were MSM or bisexual ECDC and WHO/Europe Reported cases presented with a rash (96.1%) Systemic symptoms (69%) fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat, or headache Hospitalised, 9.9% intensive care, 0.2% Fifteen European cases, health workers Dr Tedros Adhanom Ghebreyesus I continue to be concerned by the scale and spread of the virus Testing remains a challenge and it's highly probable that there are a significant number of cases not being picked up

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