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A smattering of monkeypox cases in Britain has prompted authorities to offer a smallpox vaccine to some healthcare workers and others who may have been exposed, as a handful more cases were confirmed in parts of Europe. Monkeypox is a usually mild viral illness, characterised by symptoms of fever as well as a distinctive bumpy rash. There are two main strains: the Congo strain, which is more severe - with up to 10 per cent mortality - and the West African strain, which has a fatality rate of about one per cent First identified in monkeys, the viral disease typically spreads through close contact and largely occurs in west and central Africa. It has rarely spread elsewhere, so this fresh spate of cases outside the continent has triggered concern. In the United Kingdom, nine cases of the West African strain have been reported so far. There isn't a specific vaccine for monkeypox, but a smallpox vaccine does offer some protection, a UK Health Security Agency (UKHSA) spokesperson said. Data shows that vaccines that were used to eradicate smallpox are up to 85 per cent effective against monkeypox, according to the World Health Organisation.

The UK Health Security Agency (UKHSA) said last week (Aug 5) there were "early signs" that the monkeypox outbreak was plateauing across the country and that its expansion had slowed. "While the most recent data suggests the growth of the outbreak has slowed, we cannot be complacent," Dr Meera Chand, director of clinical and emerging infections at UKHSA, said. There were 2,859 confirmed and highly probable cases of monkeypox in the UK as of Aug. 4, with nearly 99 per cent of the cases among men, the country's health authority said in a statement. The recent analysis by the UKHSA showed that "monkeypox continues to be transmitted primarily in interconnected sexual networks of gay, bisexual, or other men who have sex with men", it added. British authorities in June were recommending gay and bisexual men at higher risk of exposure to monkeypox be offered a vaccine, as the outbreak of the viral disease had gathered pace, mostly in Europe.

The UK Health Security Agency (UKHSA) has said that monkeypox is to be listed as a notifiable disease in law from Wednesday (June 8). The new legislation means all doctors in England are required to notify their local council or local Health Protection Team (HPT) if they suspect a patient has monkeypox. Laboratories must also notify the UKHSA if the monkeypox virus is identified in a laboratory sample. Wendi Shepherd, monkeypox incident director at UKHSA, said: "Rapid diagnosis and reporting is the key to interrupting transmission and containing any further spread of monkeypox. This new legislation will support us and our health partners to swiftly identify, treat and control the disease. "It also supports us with the swift collection and analysis of data which enables us to detect possible outbreaks of the disease and trace close contacts rapidly, whilst offering vaccinations where appropriate to limit onward transmission."

British health agencies have secured funding to develop a standardised approach to test the performance of vaccines being used or in development against monkeypox, days after the World Health Organization labelled the growing outbreak a global health emergency. The Coalition for Epidemic Preparedness Innovations (CEPI) said it would give up to $375,000 to the Medicines and Healthcare products Regulatory Agency (MHRA) and Health Security Agency (UKHSA) to develop standard tools to assess the strength and duration of immune responses generated by current vaccines, and for tests used to detect monkeypox antibody levels. Apart from administration fees, these tools will be made freely available to the global scientific community, paving the way for a common standardised assessment between countries documenting vaccine performance against monkeypox, CEPI said. Until this year, the viral disease has rarely spread outside Africa where it is endemic. But reports of a handful of cases in Britain in early May signalled that the outbreak had moved into Europe. So far, there have been more than 16,000 confirmed cases of monkeypox in more than 75 countries.

People infected with monkeypox can isolate at home if they remain well enough, whilst following measures to limit close contact with others, the UK's health security agency (UKHSA) said on Monday (May 30), part of guidance designed to curb the country's rise in cases of the viral illness. More than 300 suspected and confirmed cases of monkeypox have been reported in May, outside of Africa where the virus is endemic. The usually mild illness spreads through close contact and can cause flu-like symptoms and pus-filled skin lesions. An additional 71 cases of monkeypox have been identified in England, taking the total number of confirmed cases in the UK as a whole to 179 since early May. Scientists are looking into what might explain the unusual surge of cases, given most are not linked to travel. The UKHSA indicated community transmission was occurring in the UK and said infected people should avoid contact with others until their lesions have healed and the scabs have dried off.

The British scientists behind one of the major therapeutic Covid-19 trials have turned their focus to treatments for monkeypox, a viral disease that has been labelled a global health emergency by the World Health Organization. The team from Oxford University behind the so-called RECOVERY trial - which honed in on four effective Covid treatments - on Tuesday unveiled a new trial, dubbed PLATINUM, to confirm whether Siga Technologies' tecovirimat is an effective treatment for monkeypox. Although there are vaccines developed for the closely related smallpox that can reduce the risk of catching monkeypox, there are currently no treatments that have been proven to help hasten recovery in those who develop the disease. The UK has over 3,000 confirmed cases of monkeypox. The virus is transmitted chiefly through close contact with an infected person. It typically causes mild symptoms including fever, rash, swollen lymph nodes and pus-filled skin lesions. Severe cases can occur, though people tend to recover within two to four weeks. Siga's drug, branded Tpoxx, has been cleared to treat diseases caused by the family of orthopoxvirus that includes smallpox, monkeypox and cowpox by the European Union and United Kingdom, but due to limited trial data it is generally only used in severe cases in Britain.

The UK Health Security Agency (UKHSA) has advised self-isolation for people diagnosed with monkeypox to reduce the risk of spreading the infection. Household members are at the highest risk of becoming infected from a case within their house. The new guidance advises people with monkeypox infection to take steps to try and limit transmission within the household. "Monkeypox infection mainly spreads between people through direct, skin-to-skin contact, including sexual contact. Infection can also be spread via contaminated objects such as linen and soft furnishings," said UKHSA. The guidance advises that, where possible, cases are encouraged to sleep and eat in a separate room and use a separate bathroom to their household if possible. Good hygiene measures, to follow at all times, have also been set out. It suggests, "Where the use of a separate room isn't possible, cases should avoid physical contact and keep at least three steps (one metre) away from all household members. It is particularly important that they avoid close contact with young children, pregnant women and immunosuppressed people as they may be at higher risk of serious illness."

A total of 37 more cases of monkeypox have been detected in England and Scotland, public health officials said on Monday, taking the total to 57. Thirty-six confirmed cases were found in England, and one north of the border, the UK Health Security Agency and Public Health Scotland said. The UKHSA said it was now advising high-risk contact cases of confirmed cases who have not tested positive or developed symptoms to isolate for up to 21 days. It has also bought supplies of smallpox vaccine, which is being offered to close contacts to reduce the risk of symptomatic infection and severe illness. Chief medical adviser Susan Hopkins said contact tracing was helping to limit the close-contact spread of the virus, which causes a chickenpox-like rash. "Because the virus spreads through close contact, we are urging everyone to be aware of any unusual rashes or lesions and to contact a sexual health service if they have any symptoms," she added in a statement.

Professor Sir Jonathan Van-Tam has announced that he will step down as deputy chief medical officer (DCMO) for England at the end of March to take up a new role at the University of Nottingham. He joined Department of Health and Social Care (DHSC) on secondment from the university in 2017, and will soon return to be the pro-vice-chancellor for Faculty of Medicine and Health Sciences. Professor Van-Tam said: "My time as DCMO have been the most challenging of my professional career, especially the Covid response. We all wish Covid had never happened. Notwithstanding, it has been the greatest privilege of my professional career to have served the people of the UK during this time. "I want to pay tribute to Professor Chris Whitty, the CMO team, my fellow scientists, public health professionals and clinicians whose support, wisdom and energy has been inspiring. "I will continue to work until the end of March and look forward to the next challenge." As the DCMO for Health Protection, he has played key roles in various incidents, including domestic outbreaks of MERS and monkeypox, 2017 to 2018 influenza season and during the Covid-19 pandemic.