Two cases of monkeypox imported to the United Kingdom, September 2018

Aisling Vaughan, Emma Aarons, John Astbury, Sooria Balasegaram, Mike Beadsworth, Charles R Beck, Meera Chand, Catherine O'Connor, Jake Dunning, Sam Ghebrehewet, Nick Harper, Ruth Howlett-Shipley, Chikwe Ihekweazu, Michael Jacobs, Lukeki Kaindama, Parisha Katwa, Saye Khoo, Lucy Lamb, Sharon Mawdsley, Dilys Morgan, Ruth Palmer, Nick Phin, Katherine Russell, Bengü Said, Andrew Simpson, Roberto Vivancos, Michael Wade, Amanda Walsh, Jennifer Wilburn, Aisling Vaughan, Emma Aarons, John Astbury, Sooria Balasegaram, Mike Beadsworth, Charles R Beck, Meera Chand, Catherine O'Connor, Jake Dunning, Sam Ghebrehewet, Nick Harper, Ruth Howlett-Shipley, Chikwe Ihekweazu, Michael Jacobs, Lukeki Kaindama, Parisha Katwa, Saye Khoo, Lucy Lamb, Sharon Mawdsley, Dilys Morgan, Ruth Palmer, Nick Phin, Katherine Russell, Bengü Said, Andrew Simpson, Roberto Vivancos, Michael Wade, Amanda Walsh, Jennifer Wilburn

Abstract

In early September 2018, two cases of monkeypox were reported in the United Kingdom (UK), diagnosed on 7 September in Cornwall (South West England) and 11 September in Blackpool (North West England). The cases were epidemiologically unconnected and had recently travelled to the UK from Nigeria, where monkeypox is currently circulating. We describe the epidemiology and the public health response for the first diagnosed cases outside the African continent since 2003.

Keywords: England; Monkeypox; Nigeria; Poxvirus; United Kingdom.

Conflict of interest statement

Conflict of interest: None declared.

References

    1. Public Health England (PHE). Guidance monkeypox. The epidemiology, symptoms, diagnosis and management of monkeypox virus infections. London; PHE; 2018. Available from:
    1. Bavarian Nordic. Summary of product characteristics - Imvanex. Kvistgaard: Bavarian Nordic; 2018. Available from:
    1. Breman JG, Kalisa-Ruti, Steniowski MV, Zanotto E, Gromyko AI, Arita I. Human monkeypox, 1970-79. Bull World Health Organ. 1980;58(2):165-82.
    1. Jezek Z, Fenner F. Human monkeypox. In: Melnick J, ed. Monographs in virology. Vol. 17. New York: Karger, 1988.
    1. McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis. 2014;58(2):260-7. 10.1093/cid/cit703
    1. Reynolds MG, Yorita KL, Kuehnert MJ, Davidson WB, Huhn GD, Holman RC, et al. Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis. 2006;194(6):773-80. 10.1086/505880
    1. World Health Organization (WHO). Monkeypox. Fact sheet. Geneva: WHO; 2018. Available from:
    1. Damon IK. Status of human monkeypox: clinical disease, epidemiology and research. Vaccine. 2011;29(29) Suppl 4;D54-9. 10.1016/j.vaccine.2011.04.014
    1. Di Giulio DB, Eckburg PB. Human monkeypox: an emerging zoonosis. Lancet Infect Dis. 2004;4(1):15-25. 10.1016/S1473-3099(03)00856-9
    1. Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, et al. Introduction of monkeypox into a community and household: risk factors and zoonotic reservoirs in the Democratic Republic of the Congo. Am J Trop Med Hyg. 2015;93(2):410-5. 10.4269/ajtmh.15-0168
    1. Khodakevich L, Szczeniowski M, Manbu-ma-Disu, Jezek Z, Marennikova S, Nakano J, et al. The role of squirrels in sustaining monkeypox virus transmission. Trop Geogr Med. 1987;39(2):115-22.
    1. Khodakevich L, Jezek Z, Messinger D. Monkeypox virus: ecology and public health significance. Bull World Health Organ. 1988;66(6):747-52.
    1. Parker S, Buller RM. A review of experimental and natural infections of animals with monkeypox virus between 1958 and 2012. Future Virol. 2013;8(2):129-57. 10.2217/fvl.12.130
    1. Ladnyj ID, Ziegler P, Kima E. A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bull World Health Organ. 1972;46(5):593-7.
    1. Rimoin AW, Mulembakani PM, Johnston SC, Lloyd Smith JO, Kisalu NK, Kinkela TL, et al. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci USA. 2010;107(37):16262-7. 10.1073/pnas.1005769107
    1. Nigeria Centre for Disease Control (NCDC). Re: Monkeypox Cases in the United Kingdom. Abuja: NCDC; 2018. Available from:
    1. Likos AM, Sammons SA, Olson VA, Frace AM, Li Y, Olsen-Rasmussen M, et al. A tale of two clades: monkeypox viruses. J Gen Virol. 2005;86(Pt 10):2661-72. 10.1099/vir.0.81215-0
    1. Saijo M, Ami Y, Suzaki Y, Nagata N, Iwata N, Hasegawa H, et al. Virulence and pathophysiology of the Congo Basin and West African strains of monkeypox virus in non-human primates. J Gen Virol. 2009;90(Pt 9):2266-71. 10.1099/vir.0.010207-0
    1. Learned LA, Reynolds MG, Wassa DW, Li Y, Olson VA, Karem K, et al. Extended interhuman transmission of monkeypox in a hospital community in the Republic of the Congo, 2003. Am J Trop Med Hyg. 2005;73(2):428-34. 10.4269/ajtmh.2005.73.428
    1. Yinka-Ogunleye A, Aruna O, Ogoina D, Aworabhi N, Eteng W, Badaru S, et al. Reemergence of human monkeypox in Nigeria, 2017. Emerg Infect Dis. 2018;24(6):1149-51. 10.3201/eid2406.180017
    1. Reynolds MG, Davidson WB, Curns AT, Conover CS, Huhn G, Davis JP, et al. Spectrum of infection and risk factors for human monkeypox, United States, 2003. Emerg Infect Dis. 2007;13(9):1332-9. 10.3201/eid1309.070175
    1. Centers for Disease Control and Prevention (CDC) Update: multistate outbreak of monkeypox--Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, 2003. MMWR Morb Mortal Wkly Rep. 2003;52(27):642-6.
    1. Hatch GJ, Graham VA, Bewley KR, Tree JA, Dennis M, Taylor I, et al. Assessment of the protective effect of Imvamune and Acam2000 vaccines against aerosolized monkeypox virus in cynomolgus macaques. J Virol. 2013;87(14):7805-15. 10.1128/JVI.03481-12
    1. Bavarian Nordic. About Imvanex. Kvistgaard: Bavarian Nordic. [Accessed: 14 September 2018]. Available from:
    1. Vollmar J, Arndtz N, Eckl KM, Thomsen T, Petzold B, Mateo L, et al. Safety and immunogenicity of IMVAMUNE, a promising candidate as a third generation smallpox vaccine. Vaccine. 2006;24(12):2065-70. 10.1016/j.vaccine.2005.11.022
    1. European Medicines Agency (EMA). Imvanex: modified vaccinia Ankara virus. Summary of European public assessment report on Imvanex. London: EMA. [Accessed: 14 September 2018]. Available from:

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera