Monkeypox homosexual spread

MonkeypoxWHO Reconsiders considering calling a Public Health Emergencyhttps://www.medscape.co.uk/viewarticle/monkeypox-reaches-6000-globally-who-reconsiders-calling-2022a1001qnc?uac=127834AR&faf=1&sso=true&impID=4403342&src=mkm_ret_220707_mscpmrk_newsalertuk_intUKLevel 2Transmission within a defined sub-population with high number of close contacts.https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview/monkeypox-outbreak-epidemiological-overview-5-july-2022https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefingsMonkeypox is a zoonotic infectionMonkeypox virusEndemic in West and Central AfricaUK, between 2018 and 20217 casesEpidemiological links to imported cases4 were imported2 were cases in household contacts1 health care workerNo documented community transmission until 6th May 2022Outbreak mainly (96%) been in homosexual and bisexual men(without history of travel to endemic countries)Cases, history of a sexually transmitted infection (STI) in the last year (54.2%),and 10 or more sexual partners in the last 3 months (31.8%)Monkeypox is being transmitted in interconnected sexual networks that sustain STI transmissionUK, up to 4 July 20221,351 laboratory confirmed cases(Rare and Imported Pathogens Laboratory,RIPL) 40 in Scotland11 in Northern Ireland15 in Wales1,285 in England (77% in London)6 confirmed cases in womenMedian age, 36 years (interquartile range 31 to 43)Monkeypox outbreak: vaccination strategyhttps://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategySmallpox Modified Vaccinia Ankara – Bavarian NordicFor pre and post exposureThe committeeUsing markers of high-risk behaviour,Similar to those used to assess eligibility for HIV pre-exposure prophylaxis (PrEP)These risk criteria would includea recent history of multiple partners, participating in group sex, attending sex on premises venues,or a proxy marker such as recent bacterial STIEuropean Centre for Disease Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe (WHO/Europe)https://monkeypoxreport.ecdc.europa.eu5,949 cases of monkeypox, from 33 European countries99 cases where sequencing was available,confirmed to be of the West African cladeImplications for HIV-Positive Men40% of cases were also (364/917) HIV-positive99% of those with known sexual orientation stated they were MSM or bisexualECDC and WHO/EuropeReported cases presented with a rash (96.1%)Systemic symptoms (69%)fever, fatigue, muscle pain, vomiting, diarrhoea, chills, sore throat, or headacheHospitalised, 9.9%intensive care, 0.2%Fifteen European cases, health workersDr Tedros Adhanom GhebreyesusI continue to be concerned by the scale and spread of the virusTesting remains a challenge and it's highly probable that there are a significant number of cases not being picked up