Monkeypox may be spreading in communities as two new cases identified

Monkeypox could be spreading in communities, public health officials fear, with two more people diagnosed with the virus who had no links to previous cases.

The UK Health Security Agency (UKHSA) said it had detected two additional cases of monkeypox - one in London and one in the south-east of England.

The latest cases brings the total number of monkeypox diagnoses in England to nine, with recent cases predominantly in groups including gay and bisexual men.

The two latest cases have no travel links to a country where monkeypox is endemic, so it is possible they acquired the infection through community transmission, the UKHSA said.

Doctors have been asked to look out for individuals with rashes that do not have a clear, alternative diagnosis.

Canada reported 13 suspected cases of monkeypox on Wednesday night, all in Montreal, while the US confirmed its first infection - a man from Massachusetts who had recently travelled to Canada.

Spain and Portugal have more than 40 suspected cases between them, with 20 in Lisbon and 23 in Madrid.

Elena Andradas, head of public health in Madrid, told Cadena Ser radio: "All of the cases are young adult males and most of them have sexual relations with other men, but not all of them."

Dr Susan Hopkins, chief medical adviser at the UKHSA, said: “These latest cases, together with reports of cases in countries across Europe, confirm our initial concerns that there could be spread of monkeypox within our communities.

“UKHSA has quickly identified cases so far and we continue to rapidly investigate the source of these infections and raise awareness among healthcare professionals.

“We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay if they have concerns. Please contact clinics ahead of your visit.

“We are contacting any identified close contacts of the cases to provide health information and advice.”

The UKHSA said it is working closely with the NHS to urgently investigate how the virus was acquired. The Mail reported that contacts of cases are being offered vaccination.

Monkeypox does not usually spread easily between people and experts said the risk to the UK population remains low. It is usually a mild self-limiting illness and most people recover within a few weeks.

Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. A rash can develop, often beginning on the face, then spreading to other parts of the body, including the genitals.

The rash changes and goes through different stages. It can look like chickenpox or syphilis before finally forming a scab, which later falls off.

Monkeypox - a viral infection usually associated with travel to West Africa - has not previously been described as a sexually transmitted infection, although it can be passed on by direct contact during sex.

It can also be passed on through other close contact with a person who has monkeypox, or contact with clothing or linens used by a person who has monkeypox.

Anyone with concerns that they could be infected with monkeypox is advised to contact NHS 111 or a sexual health clinic. People are assured their call or discussion will be treated sensitively and confidentially.

Dr Michael Head, senior research fellow in global health at the University of Southampton, said: “We do see occasional imported cases of monkeypox into the UK, and have previously seen human-to-human transmission.

“There’s currently gaps in our knowledge, and the contact tracing and public health investigation being carried out by UKHSA will no doubt reveal more in due course.

“However, it would be very unusual to see anything more than a handful of cases in any outbreak, and we won’t be seeing Covid-style levels of transmission.”

Prof Kevin Fenton, London's public health regional director, said plans are in place to stockpile monkeypox treatments if infections rise further.

Speaking to BBC Radio London before the latest cases were revealed, Prof Fenton said attempts are being made to raise awareness in the capital. He urged people who could be at risk to "get checked out".

Speaking about those who have been diagnosed, he explained: "One is a person who returned from West Africa and may well have contracted the infection while they were there.

"There's a cluster in a family, a heterosexual family ... we haven't found any travel links as of yet, which could suggest that they may have picked up the infection in some contact here.

"And there's another cluster of gay, bisexual or other men who have sex with men and they have all reported no history of travel."