First monkeypox case in UK likely seen in March

Lab technician conducting tests
Lab technician conducting tests

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Yesterday the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) released a new report on the monkeypox outbreak in Europe, and noted that the first specimen identified through retrospective testing in the United Kingdom was on Mar 7, and the earliest date of symptom onset was reported on Apr 17.

The UK Health Security Agency, in contrast, confirmed the first UK case in the current global outbreak on May 7.

Four HCW cases tied to healthcare exposure

As of Sep 27, the WHO and ECDC have been informed of four cases of occupational exposure to monkeypox, according to the report. In three cases of occupational exposure, healthcare workers were wearing recommended personal protective equipment but were exposed to body fluid while collecting samples, the report said.

Since the spring, a total of 24,622 cases in Europe have been identified, with 98% of cases found in men. Of 10,610 patients with known sexual orientation, 96% identified as men who have sex with men (MSM), and among cases with known HIV status, 38% were HIV-positive.

Spain has the highest case count, with 7,149, followed by France (3,970), the United Kingdom (3,635), and Germany (3,607).

In an additional report that excluded UK data, the ECDC said monkeypox cases have declined since July, but the likelihood of the disease spreading further in networks of people with multiple sexual partners is high, especially among MSM.

US vaccine eligibility expands

Yesterday during a White House press briefing, officials from the Centers for Disease Control and Prevention (CDC) said Americans who were at risk for contracting monkeypox could now get the Jynneos vaccine prophylactically.

Previously, the CDC recommended that only those with known or likely exposure be vaccinated.

The CDC yesterday reported 168 more monkeypox cases, raising the national total to 25,509 infections. To date, the United States has administered 800,000 doses of Jynneos vaccine.

Early vaccine data promising but incomplete

Also at yesterday's briefing, CDC Director Rochelle Walensky, MD, MPH, shared preliminary data that showed unvaccinated people at risk for contracting monkeypox were 14 times more likely to become infected than those who received the monkeypox vaccine. She also said protection began as soon as 14 days after the first dose of vaccine.

She emphasized, however, that lab data show the highest level of protection 2 weeks after the second dose.

"These new data provide us with a level of cautious optimism that the vaccine is working as intended," Walensky said.

But Michael T. Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, said he believed it was too early to assume protection after one dose of vaccine, and there were too many unaccounted for variables in the CDC data.

"People who seek out vaccines may be behaving differently from people who don't," he explained. "Did they also take a pause on sexual behavior?"

Also missing he said, was information about how the vaccine was administered (intramuscularly or intradermally), and the sexual behaviors of each group, the vaccinated and unvaccinated.

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