Two more UK cases of deadly mpox strain confirmed

Two more people have caught the new deadly strain of monkeypox in the UK.

The latest cases of Clade 1b mpox have been detected in household contacts of the first case, according to the UK Health Security Agency (UKHSA).

There are now three confirmed cases in the UK.

The two patients are under specialist care at Guy's and St Thomas' NHS Foundation Trust in London.

But the risk to the UK population remains low, the UKHSA added.

Professor Susan Hopkins, chief medical adviser at UKHSA, said: 'Mpox is very infectious in households with close contact and so it is not unexpected to see further cases within the same household.

'The overall risk to the UK population remains low. We are working with partners to make sure all contacts of the cases are identified and contacted to reduce the risk of further spread.'

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The UKHSA said all contacts will be offered testing and vaccination as needed and advised on any necessary further care if they have symptoms or test positive.

Last week Britain's first case of the new deadly strain of monkeypox was detected in London.

The unnamed patient was on holiday in Africa and returned to the UK on an overnight flight on October 21 before they developed a rash three days later. 

A global outbreak of mpox, previously known as monkeypox, began in Africa in May 2022.

But the latest Clade 1b strain is considered far deadlier, with Britain joining countries such as Sweden, Thailand, India and Germany in having cases outside of Africa.

The clade 1b mutation, which experts have called ' the most dangerous one so far' kills one in ten of those infected and is believed to be behind a wave of miscarriages.

Clade 1b spread globally in 2022 and primarily hit gay and bisexual men.

The strain is estimated to kill about 5 per cent of adults who contract it, but the mortality rate rises to one in 10 in children.

What is mpox?

Mpox, formerly known as monkeypox, is a viral infection once mainly confined to west and central Africa.

The WHO renamed monkeypox in 2022 to restrain what it called 'racist and stigmatising language' surrounding the infection.

Mpox was spread to humans through direct contact with animals such as squirrels, which are known to harbour the virus.

However, it can also be transmitted through very close contact with an infected person, most commonly via sex.

However, experts say fatality rates of clade 1b from central Africa are unlikely to be replicated in developed nations like the UK due to better access to higher quality healthcare.

Officials don't yet know how the first unidentified patient became infected with the strain — though skin-to-skin contact is suspected.

The first human case was recorded in 1970 in the Democratic Republic of Congo (DRC) and the infection has been reported in mainly central and western African countries since then.

In July, the World Health Organization (WHO) declared an ongoing mpox outbreak across several central African nations as a 'public health emergency of international concern'.

This is the same designation the WHO gave Covid in late January 2020, just a few weeks before the virus ripped across the world, and some scientists have compared the current outbreak to the 'early days of HIV'.

Mpox causes characteristic lumpy lesions, as well as a fever, aches and pains and fatigue.

However, in a small number of cases, it can enter the blood and lungs, as well as other parts of the body, when it becomes life-threatening.

Current mpox vaccines, which are designed to work on smallpox a close relative of the mpox virus, were used during the 2022 outbreak against the milder strain.

But they have yet to be widely tested against the more potent clade 1b strain.

Diseases like clade 1b mpox are treated at what are called 'high consequence infectious diseases' units in the NHS, like that at The Royal Free.

The Royal Free famously treated Ebola patients in this unit in 2015.

Dr Brian Ferguson, an expert in immunology at the University of Cambridge, said the mpox situation is concerning in part because of how many children it was infecting.

The WHO and the NHS recommends a vaccine within four days of contact with someone who has the virus or within up to 14 days if there are no symptoms.

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Healthcare workers and men who have sex with men are advised to receive a vaccine even if they have had no mpox exposure.

There are no direct treatments available with medics focused instead on supporting a patient to help their body fight off the virus.

A report from the World Health Organisation (WHO) and the Africa Centres for Disease Control and Prevention said there had been more than 40,000 mpox cases linked to almost 1,000 deaths in Africa as of the end of September 2024, with Clades Ia, Ib and II circulating in the region.

Health and Social Care Secretary Wes Streeting said last week that the Government is working with UKHSA and the NHS 'to protect the public and prevent transmission'.

'This includes securing vaccines and equipping healthcare professionals with the guidance and tools they need to respond to cases safely,' he added.

'We are also working with our international partners to support affected countries to prevent further outbreaks.'

Countries like the Democratic Republic of Congo have been hit especially hard with cases also spotted in Burundi, Rwanda, Uganda, Kenya.

Britain's cases mean it joins countries such as Sweden, Thailand, India and Germany in having cases outside of Africa.

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Immunology expert Dr Ferguson said: '40 per cent of cases are in children under 5 years old. As mpox disease is more severe in immunocompromised individuals, it is also a concern that the current outbreak is taking place in a region where HIV prevalence is relatively high but access to antiretroviral drugs is poor.

'There is further concern about the lack of access to vaccines and a globally slow response to vaccine production and distribution.

'Even though there are existing effective vaccines, there are not enough doses and they are not being getting to where they are needed.'

Steve Russell, NHS national director for vaccination and screening, insists 'the NHS is fully prepared to respond to this clade of mpox'.

Dr Jake Dunning, consultant in infectious diseases at the Royal Free, added: 'Our unit is run by a highly-trained and experienced team of doctors, nurses, therapists and laboratory staff and is specifically designed to ensure the safety of staff and other patients.'