A Case of Monkeypox Emerges in England

Credit: CDC

According to UKHSA, the individual infected with monkeypox is currently under isolation at St Thomas’ Hospital in London, England.

Since the first case in 1970, monkeypox has caused multiple outbreaks in African countries such as Cameroon, the Democratic Republic of the Congo, Liberia, Nigeria, Sierra Leone, and South Sudan. In 2017, Nigeria reported the largest documented outbreak that affected more than 100 people and caused 7 deaths. Monkeypox cases have also occurred in people outside of Africa either due to international travel or imported animals infected with the virus. The most recent monkeypox case emerged in England.

Recently, the UK Health Security Agency (UKHSA) released a statement confirming a case of monkeypox in England. The individual had recently travelled back from Nigeria and most likely contracted the infection there. According to health officials, the patient is currently under isolation at St Thomas’ Hospital in London.

The patient is being treated in our specialist isolation unit at St Thomas’ Hospital by expert clinical staff with strict infection prevention procedures.

Dr. Nicholas Price, Director NHSE 

This is not the first time England has reported cases of Monkeypox. Last year, Public Health Wales (PHW) reported two cases in the region. The first patient had returned from Nigeria after having lived and worked there for a period. Two days later, he developed a rash. After completion of his mandatory post-travel quarantine, the person presented to the hospital where PCR of skin samples confirmed the presence of the monkeypox virus.

The second patient, a family member of the first one, also developed similar lesions and was soon shifted to a hospital. According to health authorities, both patients were kept in isolation and showed signs of recovery. Moreover, PHW conducted contact tracing for both patients and implemented healthcare measures. Fortunately, no more cases of the disease came forward.

Risk to Public Remains Low

Other than England, the United States has also reported cases of the rare disease. The most recent case occurred in Maryland in a patient who developed symptoms soon after returning from Nigeria.

According to Dr. Colin Brown at UKHSA, the risk of a potential spread in England is very low. However, NHS England and UKHSA have implemented strict infection control protocols to prevent the spread of disease. Moreover, NHS England and NHS Improvement (NHSEI) are currently working on tracing all close contacts of the patient to provide them with information and health advice. This includes all people the person may have come in close contact with prior to confirmation of their infection.

It is important to emphasise that monkeypox does not spread easily between people and the overall risk to the general public is very low.

Dr. Colin Brown, Director of Clinical and Emerging Infections, UKHSA

Typically, the disease spreads from direct contact with blood, bodily fluids, or skin lesions of infected animals. Humans can also contract the disease from close contact with an infected person; through respiratory secretions, contact with skin lesions, or touching contaminated surfaces. Moreover, eating inadequately cooked meat and other products of infected animals is also a risk factor in causing infections. However, the risk of human-to-human transmission is minimal. Only symptomatic people can spread infections; people without symptoms are generally not infectious.

According to researchers, the monkeypox virus circulates among rodents in Africa. Macaque monkeys, African squirrels, and other species of monkeys in the region have also demonstrated the virus. In the past, several outbreaks have been linked to animals imported from African countries.

The History of Monkeypox

The monkeypox virus belongs to the same family of viruses that caused smallpox and cowpox disease. In 1958, two pox-like outbreaks among laboratory monkeys first introduced scientists to the virus. However, the first human case did not occur until 1970, during smallpox eradication efforts. The case occurred in a 9-year-old boy in the Democratic Republic of the Congo (DRC) who was initially suspected of having smallpox due to similar clinical characteristics. Although symptoms of monkeypox are similar to cowpox, they are milder.

Typical symptoms include:

  • fever
  • headache
  • muscle ache
  • exhaustion
  • swelling of lymph nodes
  • backache

Within 1-3days of fever, the patient develops a rash that often begins on the face and then spreads all over the body. Initially, the rash appears as a small flat spot that turns into a bump, then fills with clear fluid and later pus, until it eventually dries, and falls off.

The disease is mostly self-limiting with most people suffering from a mild infection. However, some can develop a severe infection, especially in children. Complications include corneal infections leading to loss of vision, secondary infections, pneumonia, and encephalitis.

There is currently no specific treatment for the disease. However, the smallpox vaccine, antivirals and vaccinia immune globulin (VIG) are often used for decreasing the spread of the disease. According to health officials, the smallpox vaccine is 85% effective at preventing monkeypox.

The US Centers for Disease Control and Prevention (CDC) recommends that healthcare workers taking care of infected individuals or animals and people investigating outbreaks should all receive a smallpox vaccination. Even those suspected of contact with an infected individual or animal should receive the vaccine.

To further prevent the spread of infection, many countries have placed restrictions on the import of rodents and monkeys from Africa.


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