Monkeypox has now been spotted in Portugal and Spain, in what could be the first global outbreak of the rare disease.
Spain is monitoring eight men who it believes are infected, with tests being carried out to confirm they have the virus.
All of the men are gay or bisexual, according to local media, and most were detected at STI clinics in Madrid.
Five men in Portugal have also tested positive and at least 15 more cases are being investigated, health officials there said today.
These cases are all male and mostly ‘young’ — but it is not yet clear how they caught the virus.
Until now, monkeypox cases were confined to travellers and their relatives returning from western and central Africa, where the virus is endemic.
But experts now fear it is spreading more widely for the first time, after seven Britons were diagnosed in the past fortnight.
Six of them appear to have been infected in the UK and the majority are not linked, which suggests more cases are going undetected. Health chiefs are scrambling to find the source of the cases.
Four of the British patients are gay or bisexual men, and officials say the pattern of transmission is ‘highly suggestive of spread in sexual networks’.
Dr Simon Clarke, a microbiologist at the University of Reading, told MailOnline he suspects UK case numbers are already ‘in the tens’.
But he insisted the disease will not spread like Covid, adding: ‘I would be surprised if we ever got to more than 100 cases [in Britain]’.
Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)
Seven Britons have been diagnosed with monkeypox and six of them appear to have contracted it in the UK — in a sign the virus is spreading in the community. The seventh UK patient had brought the virus back from Nigeria, where the disease is widespread. At least three patients are receiving care at specialist NHS units in London and Newcastle
US monitors six people who shared flight with UK monkeypox ‘patient zero’
Officials in the US are keeping tabs on six people who were in close contact with a UK monkeypox case.
The Americans were on the same flight as the patient who travelled from Nigeria to the Britain on May 4, and became the first case of the virus there.
The potential US cases sat within a three-row radius of his seat, according to Jennifer McQuiston, a senior CDC official.
She told STAT News the Americans will be monitored for 21 days.
McQuiston also warned that Britain’s current spate of cases could be the tip of the iceberg.
The lack of travel links and connections between UK cases suggest there are ‘unknown chains of transmission happening’, she said.
‘You have two clusters that have no link to travel or to other people who are known to be associated with a recognized outbreak.
‘It suggests that there are unknown chains of transmission happening.
‘If there appears to be unknown chains of transmission, it just puts us on alert to be thinking: Could this be spreading outside the UK?’
Regions across Spain have been put on alert following the announcement of eight suspected cases in Madrid.
Confirmation is still awaited from the National Centre for Microbiology but health chiefs say ‘great care must be taken.’
The country’s top public health doctor, Fernando Simón, said ‘it is not likely that monkeypox will generate a significant transmission but it cannot be ruled out’.
The Spanish health alert system has called on communities to notify public health services ‘urgently’ of patients with symptoms.
He said it was now necessary to take extreme surveillance measures and investigate all the hypotheses about the routes of contagion.
Mr Simon was talking to the media in Valencia during the I International Summit on Pandemic Management.
Spanish newspaper El Pais says it has had access to health papers and that the health leaders have confirmed the investigation.
It claims most of the cases were detected at the Sandoval Health Centre in the capital, an STI clinic.
The Spanish broadcaster RTVE said all eight of the patients were men who had homosexual relationships.
Meanwhile, the suspected cases in Portugal were all detected in the Lisbon and Tagus Valley region.
The men are said to be ‘stable’ and all suffering from ‘ulcerative lesions’, one of the tell-tale signs of the virus.
Portugal’s health ministry has issued a warning urging people with lesions and rashes to see a doctor.
When these symptoms appear, ‘direct physical contact’ should be avoided, officials added.
Until now monkeypox had only ever been detected in four countries outside of Africa — the UK, US, Israel and Singapore.
All of the cases had travel links back to Nigeria and Ghana.
Infections are more common in central and western Africa, where they can result from direct contact with infected animals.
Health experts investigating the new monkeypox outbreak in Britain believe the virus may be spreading sexually between people for the first time.
It was thought that monkeypox could only be passed on through close contact with the likes of body fluids, respiratory droplets and lesions.
Nurses and doctors are being advised to stay ‘alert’ to patients who present with a new rash or scabby lesions (like above)
But an expert from the UK Health Security Agency said the latest UK cases ‘appear to have acquired the infection via sexual contact’.
Dr Mateo Prochazka, who leads the UKHSA team which is investigating monkeypox, described this route of transmission as ‘novel’.
Seven people have been diagnosed with the virus in England over the past two weeks, five of which are in London.
STI clinics bring social distancing BACK ‘as patients with monkeypox rash mistake it for syphilis’
Sexual health clinics have reintroduced social distancing amid fears about a spate of monkeypox cases in the UK.
At least one practice in West London had already brought in stricter infection control measures yesterday, before the total number of British cases rose to seven.
Patients were told to keep a one-metre distance in the waiting room and were asked if they had any unusual bumps or rashes prior to each appointment.
Monkeypox can be mistaken for syphilis or other common rash illnesses, making it difficult to diagnose early.
A health source told MailOnline the stricter measures were not part of new national guidance but they could not rule out some NHS boards ‘putting in measures locally’.
UK Health Security Agency (UKHSA) bosses have now written to regional NHS teams telling them to stock up on PPE and be on alert for patients with a new rash.
Four are gay or bisexual men and only one has recent travel links to a country where the virus is endemic, which is ‘highly suggestive’ of spread in ‘sexual networks’, Dr Prochazka added.
Writing on Twitter, he said: ‘Transmission is not easy but can happen person to person from direct contact with lesions, or respiratory secretions.
‘The closer and longer the contact, the more likely it is to transmit.
‘Close contact between two people (such as during sex) could also facilitate transmission – but this has never been described before.
‘However, the high proportion of cases in the current outbreak in England that are gay or bisexual (4/7, 57%) is highly suggestive of spread in sexual networks.
‘This is further suggested by the fact that common contacts have been identified for only 2 of the 4 latest cases.’ Dr Prochazka continued: ‘Finding monkeypox cases that do not have travel links is rare, and suggestive of importation followed by some extent of community transmission.
‘This situation is being rapidly assessed.
‘What is even more bizarre is finding cases that appear to have acquired the infection via sexual contact – this is a novel route of transmission that will have implications for outbreak response and control.’
Sexual health services are now working to identify more cases, control its spread and tackle potential stigma.
Other experts said further research is necessary before it will be possible to conclude if the virus is sexually transmissible.
Other infections that are not technically STIs but can spread during sex include shigella.
Monkeypox can kill up to one in ten people who get it but the new cases have the West African variant, which is deadly for around one in 100.
Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.
A rash can develop, often beginning on the face, then spreading to other parts of the body including the genitals.
The rash changes and goes through different stages, and can look like chickenpox or syphilis, before finally forming a scab, which later falls off.
EVERYTHING you need to know about monkeypox: Strain spreading in UK ‘transmits through sex’ and is about as deadly as the Wuhan Covid variant — but UK doesn’t have a vaccine
What is monkeypox?
Monkeypox is a rare viral infection which people usually pick up in the tropical areas of west and central Africa.
It is usually spread through direct contact with animals such as squirrels, which are known to harbour the virus.
However, it can also be transmitted through very close contact with an infected person.
Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.
Only a handful of cases have been reported outside of Africa and they are normally confined to people with travel links to the continent.
How deadly is it?
Monkeypox is usually mild, with most patients recovering within a few weeks without treatment. Yet, the disease can prove fatal.
Monkeypox kills up to 10 per cent of people it infects.
However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.
The UK cases all had the West African strain of the virus, which is mild compared to the Central African strain.
Is there a cure?
There are no specific treatments available for monkeypox infection.
However, because monkeypox virus is closely related to the virus that causes smallpox, jabs for smallpox can also protect people from getting monkeypox.
One vaccine, Jynneos, also known as Imvamune or Imvanex, has been licensed in the US to prevent monkeypox, but it’s not approved in the UK.
The vaccine was shown to be around 85 per cent effective in preventing monkeypox.
Antivirals and pooled blood from individuals vaccinated against smallpox can be used to treat severe cases.
What is the situation with the current UK outbreak?
Seven cases of monkeypox have been confirmed in the UK between May 6 and 15.
Six of the infected Brits had not recently travelled abroad, suggesting there is transmission between people in the UK for the first time.
Some of the cases are believed to have caught the virus through sex — which health experts have described as ‘bizarre’.
Monkeypox was not thought to spread via sexual intercourse but through close contact with lesions or respiratory droplets. However, just because it can spread during sex does not mean it is the virus’ primary route of transmission, nor does it make it an STI.
The NHS is tracking down contacts of those infected to identify additional cases, as it is not clear how all of the infected people caught Monkeypox.
Health leaders are also working with international agencies to determine if similar outbreaks are occurring elsewhere.
What do we know about the British cases so far?
Five are based in London, one in the South East, and one in the North East.
The first case was confirmed on May 7 in an individual who had recently travelled to Nigeria.
They received care at the expert infectious disease unit at Guy’s and St Thomas’ NHS Foundation Trust in London.
Two more cases in London were announced on May 14. The infected pair live together in the same household but had not been in contact with the case announced one week earlier.
One of these individuals is receiving care at the expert infectious disease unit at St Mary’s Hospital in London. The other is isolating at home and does not need hospital treatment.
Four more cases were announced on May 16, bringing the UK total to seven.
Two of the cases were in London, with the other two in the North East and South East of England.
The most recent four cases have no known connections with the earlier three cases, but two of them were known to each other.
The four new cases were in gay and bisexual men.
Mateo Prochazka, an STI expert and head of UKHSA team probing the outbreak, claimed the pattern of spread is ‘highly suggestive of spread in…