Monkeypox, multiple mutations confirmed

Monkeypox, upgraded to a notifiable disease Doctors required to notify health authorities of every case Labs must tell the UK Health Security Agency (UKHSA) https://reference.medscape.com/slideshow/monkeypox-6015388?src=mkm_ret_220616_mscpmrk_exclusiveuk_int&uac=127834AR&impID=4337730&faf=1#8 Same legal status as 33 other diseases https://www.gov.uk/guidance/notifiable-diseases-and-causative-organisms-how-to-report Acute encephalitis Acute infectious hepatitis Acute meningitis Acute poliomyelitis Anthrax Botulism Brucellosis Cholera COVID-19 Diphtheria Enteric fever (typhoid or paratyphoid fever) Food poisoning Haemolytic uraemic syndrome (HUS) Infectious bloody diarrhoea Invasive group A streptococcal disease Legionnaires’ disease Leprosy Malaria Measles Meningococcal septicaemia Monkeypox Mumps Plague Rabies Rubella Severe Acute Respiratory Syndrome (SARS) Scarlet fever Smallpox Tetanus Tuberculosis Typhus Viral haemorrhagic fever (VHF) Whooping cough Yellow fever 40 countries UK https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates Cases, 524 Anyone can get monkeypox, particularly if you have had close contact, including sexual contact, with an individual with symptoms. Contact followed by rash with blisters Sudden and unexpected number of cases, previous silent spread Currently most cases have been in men who are gay, bisexual or have sex with men. How common is lesbian, gay or bisexual (LGB) https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/sexualidentityuk/2019 UK population aged 16 years and 2.7% of the UK population aged 16 years and over identified as lesbian, gay or bisexual (LGB) in 2019 (2.2% in 2018) Between 2018 and 2019 Men identifying as GB increased from 2.5% to 2.9% Women identifying as LB increased from 2.0% to 2.5% Monkeypox is being transmitted in geographically diffuse sexual networks. https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings Nearly all (98%) of interviewed cases reported sex with other men during the incubation period (5 to 21 days) First technical briefing https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-1 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 with high number of close contacts. 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. Detailed case interviews, traditional contact tracing is currently challenging, identify transmission networks Serial interval, 9.8 days (95% credible interval, 5.9 to 21.4) (Interval between clinical onsets) The mutations specific to the current global outbreak clade are distributed across the genome. There is a small subset of mutations in proteins that are involved in virus transmission, virulence, or interaction with antiviral drugs. UKHSA has convened an expert group of public health, NHS and academic partners to steer a comprehensive investigation. Prof David Heymann, infectious disease UK decision, concern transmission is occurring outside most at-risk groups So far, gay, bisexual men Latest outbreak driven by sexual networks It suggests that they want to focus surveillance on the entire population – not only on the risk groups identified so far Prof Francois Balloux, University College London Genetics Institute More infections than cases This is particularly the case for a disease which can often be mild with fairly unspecific symptoms such as monkeypox. It is difficult to work out at the moment whether cases are going up, down or plateauing worldwid Learn more about your ad choices. Visit megaphone.fm/adchoices