Monkeypox contacts to be told to isolate
Latest guidance advises high-risk contacts to avoid children under 12 as authorities detect more cases ‘on a daily basis’
High-risk contacts of people with monkeypox will be asked to self-isolate and avoid contact with children under the age of 12 for three weeks. The number of confirmed cases in the UK – currently 20 – is expected to rise today, with the release of updated figures from the weekend. Dr Susan Hopkins, a chief medical adviser for the UK Health Security Agency, said yesterday that authorities were detecting more cases of monkeypox “on a daily basis”.
HIGH-RISK contacts of people with monkeypox will be asked to self-isolate and avoid contact with children under the age of 12 for three weeks.
The number of confirmed cases in the UK – currently 20 – is expected to rise today, with the release of updated figures for the weekend.
Dr Susan Hopkins, a chief medical adviser for the UK Health Security Agency (UKHSA), said yesterday that authorities were detecting more cases “on a daily basis”.
People who have had direct unprotected contact with an infected person will be advised to self-isolate for 21 days, including from the workplace, according to UKHSA guidance for contact tracing monkeypox.
The guidance also states contacts should “avoid contact with immunosuppressed people, pregnant women, and children aged under 12 where possible”. Contacts will also receive daily communication from authorities.
Individuals considered “high-risk contacts” will be offered the MVA-BN smallpox vaccine, which has historically been shown to be protective against monkeypox.
Examples of high-risk contacts include household contacts, sexual contacts, and those changing a patient’s bedding without appropriate PPE.
Medium-risk contacts will also be offered the vaccine, encouraged to avoid contact with the above groups and receive daily communication from authorities, but they will not be asked to self-isolate, the guidance says.
Passengers seated directly next to an individual with monkeypox on a flight, those who shared a car or taxi with a monkeypox sufferer, and anyone treated in a consultation room after a confirmed case prior to room cleaning, are considered to be medium risk.
These individuals are also asked to stay away from work for 21 days if their employment involves contact with immunosuppressed people, pregnant women and children aged under 12. They are also encouraged to discuss any travel plans on a case-by-case basis if asymptomatic.
Keith Neal, professor in the epidemiology of infectious diseases at the University of Nottingham, said quarantine
‘Community transmission is largely in urban areas ... we are seeing it mainly in gay or bisexual men’
of infected people and those who have come into contact with them cannot be enforced in the same way as cases of Covid-19, as monkeypox is not a “notifiable disease”.
Notifiable diseases are a specific legal category of diseases that must be flagged to public health authorities, which include Covid-19, cholera and malaria.
It is understood that isolation advice is being given on a case-by-case basis.
Any contacts with symptoms will be tested. Testing is being carried out at the UKHSA’S specialist Rare and Imported Pathogens Laboratory.
The UK advice comes after Belgium announced that confirmed monkeypox cases must self-isolate for 21 days. Joe Biden, the US president, said over the weekend that the recent cases of monkeypox identified in Europe and the United States are something “to be concerned about”.
In his first public comments on the disease, Mr Biden said: “It is a concern in a sense that if it were to spread, it’s consequential.”
Dr Hopkins yesterday told BBC One’s current affairs programme Sunday Morning that reports suggest there are “certain individuals who are much more at risk of severe disease, particularly the immunosuppressed or young children”.
She added: “In adults we think it is relatively mild, but again, we will learn more.”
A young child has tested positive for the virus and is being treated in intensive care, according to reports.
The World Health Organisation also reports that children are at higher risk and that contracting the virus during pregnancy may lead to complications.
Asked if there is community transmission in the UK, Dr Hopkins said: “Absolutely. We are finding cases that have no identified contact with an individual from West Africa [where the virus primarily occurs], which is what we’ve seen previously in this country.
“The community transmission is largely centred in urban areas and we are predominantly seeing it in individuals who self-identify as gay or bisexual, or other men who have sex with men.”
Concerns have been raised about healthcare staffing after some workers from sexual health services have already been forced to isolate.
Dr Claire Dewsnap, a consultant in genitourinary medicine and president of the British Association for Sexual Health and HIV, told the BBC that staff in clinics were already “under significant pressure”.
“It is already stretching the workforce and will have a massive impact if staff have to isolate if they are in close contact with someone who is infected,” she said.