A report entitled ‘Two cases of monkeypox imported to the United Kingdom, September 2018’ has been published in Eurosurveillance.The report presents a summary of the presentation and management of both cases, travellers arriving from Nigeria, as well as detail on the public health response managed by Public Health England (PHE).
With respect to any relationship between the cases the report notes that there is no evidence that the cases are epidemiologically linked other than both cases recently travel to southern Nigeria, the location of a recent monkeypox outbreak. Preliminary analysis indicates the monkeypox for both of these cases belongs to the less severe West African clade; one of two clades of monkeypox the other being the more severe Central African clade.
PHE have made efforts to identify contacts and to ensure that they have been risk assessed and followed up appropriately. Of 243 contacts identified 229 are currently under surveillance having been given appropriate information on monkeypox. In addition, 103 of the 229 contacts were offered post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP) with vaccinia vaccine.
The presentation of two unrelated cases of monkeypox in the UK is unusual but highlights the importance of clinical awareness, obtaining a full travel history for all patients, early recognition and isolation as well as infectious disease surveillance.
Further information on monkeypox and related guidance is available on the PHE website
Information and advice for travellers is available from the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.