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Investigation into monkeypox outbreak in England: technical briefing 4. 22 July 2022. UK Health Security Agency

Mary Wilson

Well-known member
This technical briefing includes limited data on cases confirmed UK-wide, where available.

The UK Health Security Agency (UKHSA) is working with the National Health Service (NHS) and the public health agencies of the 4 nations to investigate the monkeypox outbreak. This briefing is produced to share data useful to other public health investigators and academic partners undertaking related work. It includes early evidence and preliminary analyses which may be subject to change.

Data reported in the technical briefing is as of 18 July 2022 (or as specified in the text) to allow time for analysis.

Potential levels of the outbreak in England
The outbreak can be considered to fall into 1 of 4 potential levels of transmission:

Level 1
Incursions from rest of the world – small numbers of imported cases with limited onward transmission.
Level 2
Transmission within a defined sub-population.
Level 3
Transmission within multiple sub-populations or larger sub-population.
Level 4
Wider significant community transmission – with potential for endemic and local epi-zoonotic disease.

These may be refined with better understanding of modes of transmission.

At present, England is judged to be in Level 2 and is being closely monitored for any evidence of Level 3. ...


UK transmission

Outbreak level

Level 2 is defined as transmission within a defined sub-population, currently GBMSM connected by sexual networks. Enhanced surveillance data does not suggest a change in case mix, although it is available on only 28% (576 out of 2,070) of cases and may not be representative of the whole cohort. There are 13 female cases in England (out of 2,014 with known gender). There is no robust evidence of sustained transmission outside some sexual networks of GBMSM, although the increase in female cases requires close surveillance.

Assessment (confidence): level 2 (moderate).

Route of transmission

Whilst the 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. There are no confirmed instances of airborne transmission. Limited household transmission has been described in the UK.

Assessment (confidence): transmitting primarily through close or sexual contact (moderate).

Severity

Observed clinical severity

Hospitalisation data is currently being updated. There are no reported deaths in the UK. There is significant morbidity in the majority of people who are admitted to hospital for clinical care reasons, including severe pain and complications due to secondary bacterial infection.

Assessment (confidence): in current population group, low mortality but significant morbidity (moderate). In wider population, insufficient data. ...


https://www.gov.uk/government/publi...ypox-outbreak-in-england-technical-briefing-4
 
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