monkeypox outbreak 2020 ukmonkeypox outbreak 2020 uk

At the end of the study period, 1 August, case numbers were halving every 29 days (38.02 to 23.44). If an epidemic is stable or declining the right truncation bias has less of an effect on the data. Health - Get latest news on Health. Investigation into monkeypox outbreak in England: technical briefing 1. You have rejected additional cookies. Right truncation leads to the observed distribution of time delays being biased towards shorter observations, since for a delay when the primary event occurs close to the final date of observation, only the secondary event will be observed if the delay is short. For the more reliable sample where personal identifiable information was available for linkage, this time decreased to four days, with three out of the four more reliable (ie, personal identifiable information available) case-contact pairs showing pre-symptomatic transmission. [34], The UK Health Security Agency (UKHSA) advised people who have had close contact with a person infected with monkeypox to self-isolate for 21 days. To compare the model fits we calculated the leave-one-out cross validation (LOO) through Pareto smoothed importance sampling, using the LOO package in R.19 We applied MCMC to each model and evaluated its convergence using potential scale reduction factor, or (calculated using Cmdstanr20), where it is desirable to have a value <1.05. Monkeypox is a misnomer that results from the fact that it was discovered at the Statens Serum Institut in Copenhagen in 1958, when outbreaks of a pox-like disease occurred in monkeys kept for. For patients who could be linked through personally identifiable data, four days was the maximum time that transmission was detected before symptoms manifested. Design Contact tracing study, linking data on case-contact pairs and on probable exposure dates. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work ; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years ; no other relationships or activities that could appear to have influenced the submitted work. The rise in cases also comes ahead of the Platinum Jubilee, where thousands will attend street parties or watch the royal celebrations in groups. The median serial interval was estimated to be shorter than the incubation period, which indicates considerably greater pre-symptomatic transmission than previously thought,23 and was validated by analysis of individual level data. The 95th centile of the serial interval was between 23 and 41 days, suggesting long infectious periods. This has also been observed for other viral infections1112 and is a consequence of transmission during the pre-symptomatic period. [35], Furthermore, to combat the continued spread of the outbreak, the UKHSA has offered doses of the Imvanex smallpox vaccine, also effective against monkeypox, to people having had close contact with people confirmed to having been infected. [14] Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route. Monkeypox infection was immediately suspected, and the patient was hospitalised at Guy's Hospital[28] and isolated, then tested positive for the virus on 6 May. Under this assumption the model becomes simplified (equation 4, fig 1). Third case of monkeypox reported in the UK, in health care worker . MPXV, causing the 2022 multi-country monkeypox outbreak, is equipped with a faster speed of microevolution and multi-patterns of transmission between humans and . As of July 26, 3,591 cases in 46 states, Puerto Rico, and Washington, D.C., have been diagnosed (see . For example, the multi-country outbreak of monkeypox in 2022 has already "invaded" 6 continents and over 100 countries, with more than 53,000 people from different nations infected. Cumulative parametric estimates for the distribution of the serial interval for monkeypox, fit to data from 79 patients using a gamma distribution. There was a smaller outbreak in Britain in 2018. Therefore, some of the identified pre-symptomatic transmission could have occurred after clinical symptom onset, but before patients were aware of their symptoms. Recentring the priors to alternative means with the same precision yielded consistent results. The UK has seen 82 new monkeypox cases this week and a total of 190 cases so far. Monkeypox is a misnomer resulting from the fact that it was first discovered at the Statens Serum Institut in Copenhagen in 1958, when outbreaks of a pox-like disease occurred in monkeys kept. The counts below combine both of these categories. Cases of monkeypox infection were confirmed in England from 6 May 2022. Wed like to set additional cookies to understand how you use GOV.UK, remember your settings and improve government services. Monkeypox is a re-emerging zoonotic infection caused by the monkeypox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family 1 and was first identified in the Democratic Republic of the Congo in 1970. Firstly, we linked case-contact pairs to questionnaire records for each secondary contact, which enabled the primary case and the exposure date to be identified for the secondary contact. Mpox Virus in Human Samples other than Skin Rash Lesions and Implications for Transmission. The maximum time that transmission was detected before symptoms manifested was nine days. The median age of confirmed and highly probable cases in the UK was 36 years (interquartile range 30 to 44). It is assumed both 1 and 2 follow a standard normal prior distribution. Between 6 May 2022 and 12 September 2022, 3552 cases of monkeypox have been confirmed in the United Kingdom.7 The international dispersion of the virus has resulted in the largest outbreak of monkeypox reported outside of Africa. Confirmed cases include those laboratory-confirmed as mpox virus and may include cases only confirmed as orthopoxvirus. The outbreak is unusual because although the UK has had sporadic cases of monkeypox before - seven from 2018 to 2021 - all previous cases were linked to travel from Nigeria. The outbreak has mainly been in gay, bisexual, and men who have sex with men without documented history of travel to. Mpox (previously called monkeypox) is a viral zoonosis, and in humans, it shares several clinical characteristics with smallpox [1,2].Although smallpox has been eradicated worldwide since 1980, mpox is still endemic in parts of Central and Western Africa [3,4,5].However, it should be noted that most of the mpox cases recorded in the 2022 outbreak occurred in Western and European countries . This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. "Monkeypox begins with fever, headache . Negative changes due to updates to location information. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. 2022. *The numbers in brackets show change since last report (26 September 2022). Cases of monkeypox infection were confirmed in England from 6 May 2022. [2], Mpox (also known as monkeypox[3]) is an infectious viral disease that can occur in humans and some other animals. UK Health Security Agency. The paper was, however, read by members of the public upon submission. Investigation into monkeypox outbreak in England: technical briefing 3. the next day, This page was last edited on 28 February 2023, at 10:29. Stockholm, Sweden: European Centers for Disease Prevention and Control; 2022. [9], The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus. This publication is available at https://www.gov.uk/government/publications/monkeypox-outbreak-epidemiological-overview/monkeypox-outbreak-epidemiological-overview-4-october-2022. Hardworking individual with firm believe in putting all the effort on work and delivering results diligently. Negative serial intervals are possible in the presence of pre-symptomatic transmission, although the nature of contact tracing data means that the direction of transmission can be difficult to infer from the data, and positive serial intervals are more likely than negative serial intervals. Data were extracted as of 1 August 2022, at which time 2746 people had been identified with monkeypox in the UK. Since monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (DRC), it has spread to other regions of Africa (primarily West and Central), and cases outside Africa have emerged in recent years. The median incubation period for the ICC model was 6.6 days (95% credible interval 5.5 to 7.7) and for the ICRTC model was 6.6 days (5.5 to 7.9). Posteriors are reported for the ICC (interval censoring corrected) model and the ICRTC (interval censoring right truncation corrected) model, fit to data from 79 patients using a gamma distribution, Summary statistics of the serial interval for monkeypox, fit to data from 79 patients using a gamma distribution. For the ICC and ICRTC models, we found that the 25th and 50th centiles were shorter for the serial interval distribution than for the incubation period distribution (fig 4), ranging from 1.8 days (95% credible interval 1.5 to 1.8) to 1.6 days (1.4 to 1.6) shorter at the 25th centile and 1.6 days (1.5 to 1.7) to 0.8 days (0.3 to 1.2) shorter at the median, respectively. The growing number prompted the World Health Organization (WHO) to declare monkeypox a global health emergency, as it did for COVID-19 in 2020. To investigate potential exposure dates that occurred before symptom onset in a primary case, which would suggest pre-symptomatic transmission, we linked data on the date of symptom onset in the primary case with exposure dates in their secondary contacts. Additionally, the conclusions around the presence of pre-symptomatic transmission are supported by analysis of the relative shapes of both the incubation period and the serial interval distributions as well as individual level patient data. < 2022 U.S. Mpox Outbreak Confirmed Cases Locations with cases Notes: Case data reported since January 1, 2022 are provided for situational awareness and subject to change. The United Kingdom was the first country, outside of the endemic African areas, to experience an outbreak. The maximum time before symptoms that transmission was detected for patients who could be linked through personal identifiable infection was four days. The origin is symptom onset date of the primary case, with the x axis showing number of days between subsequent events. Monkeypox contact tracing guidance: classification of contacts and advice for vaccination and follow-up. Proportion of patients who reported being gay, bisexual, and other men who have sex with men (GBMSM) and mean age of each study sample compared with the total set of patients. Table 3 shows the results of the cumulative distribution function of the incubation period distribution. [1], On 22 May, Education Secretary Nadhim Zahawi said "we're taking it very, very seriously" and that the UK government had already started purchasing smallpox vaccines. Monkeypox, a zoonotic disease, was identified in 1958 in monkeys showing signs of a poxvirus.1 The disease is caused by a virus belonging to the orthopoxvirus genus and was first detected in humans in 1970 in the Democratic Republic of the Congo.2 The disease has since become endemic in that region and spread to other central and west African countries. Therefore, these distributions might not be the same for outbreaks in other settings. England counts may differ from those published in the Notifications of infectious diseases (NOIDs) causative agents weekly report. The limit of detection was 15.32 copies/L for F-RPA and 8.53 copies/L for VF-RPA, 3. These figures are used for official reporting of monkeypox confirmed case counts in the UK. In one study involving 18 infected participants, the estimated mean incubation period was 8.5 days (95% credible interval6.6 to 10.9).16 A limitation of this study was the small sample size, and therefore the findings were unlikely to be representative of the full distribution. Cases were modelled as a smooth function of time using a generalised additive model with a negative binomial error distribution. Equation 1 (fig 1) shows the probability of observing a given second event time (denoted by a random variable S), conditional on the observed first event time (denoted by a random variable E) given that the final observation date is T. Equation 1 could be solved by integrating across the observation intervals. Participants 2746 people with polymerase chain reaction confirmed monkeypox virus in the UK between 6 May and 1 August 2022. 2022. WHO. Using the cumulative distribution function of the serial interval distribution, the median number was 5.0 days (95% credible interval 3.8 to 6.2) for the ICC model and 5.8 days (4.3 to 7.6) for the ICRTC model (table 5). In September 2018, monkeypox virus was transmitted from a patient to a healthcare worker in the United Kingdom. In the U.S., the first monkeypox case in the current outbreak was identified on May 18, 2022. The 95th centile of the serial interval ranged from 23 to 41 days, which suggests a potential for long infectious periods that are consistent with research of earlier clades. Nigeria has. CDC has also warned clinicians to not rule out monkeypox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes.[26]. We also use cookies set by other sites to help us deliver content from their services. Design Contact tracing study, linking data on case-contact pairs and on probable exposure dates. If an individual was identified as a contact by a case and became a case or was already a case, we recorded these as a case-contact pair. On the surface, the monkeypox outbreak in the U.S. doesn't look that bad, especially compared with other countries. You can change your cookie settings at any time. A survey of over 2000 Board seats of global health organizations shows that less than 3% of the seats are held by nationals of low-income countries [ 8 ]. At the 95th centile, the posterior estimates were 17.8 days (95% credible interval 15.2 to 21.9) for the ICC model and 18.1 days (15.5 to 22.5) for the ICRTC model. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. 2 The ongoing outbreak was first reported from the United Kingdom by the UK Health Security Agency on May 7, 2022. Accessed August 3, 2022. https://monkeypoxreport.ecdc.europa.eu. Although the outbreak was large, however, incidence was still low relative to the population size at risk. United States now has the world's biggest outbreak of monkeypox: . The probable case is epidemiologically linked to the two confirmed cases and has fully recovered. This definition of symptom onset describes the date that an individual first noticed their symptoms; however, the true date of symptom onset could have been earlier but not detected. Please note: your email address is provided to the journal, which may use this information for marketing purposes. Shaded area denotes span of time series where the serial intervals and incubation period distributions were estimated (6 May to 1 August 2022). The MCMC algorithm preferentially selects parameters that better describe the data. We found that shorter serial intervals are more common than short incubation periods for monkeypox, which suggests considerable pre-symptomatic transmission. The DRC reported more than 18,000 confirmed or suspected monkeypox cases from 2010 to 2019, up from about 10,000 from 2000 to 2009, and more than 6,000 suspected cases in 2020. [36], Confirmed cases by countries in the United Kingdom during the 2022 outbreak (as of 12 July), The first three paragraphs an excerpt from, 20222023 monkeypox outbreak in the United Kingdom, Number of cases confirmed in constituent countries. The global transmission of the monkeypox virus has been on a scale not previously seen outside of Central Africa. Monkeypox is a rare viral infection which does not spread easily . An application can be made to the UK Health Security Agency. The 2022 monkeypox outbreak in Austria is part of the larger outbreak of human monkeypox caused by the West African clade of the monkeypox virus. Dont worry we wont send you spam or share your email address with anyone. These 13 form our cohort for investigating pre-symptomatic transmission. For the incubation period, this is the time between the date patients were exposed (primary event) and their symptom onset date (secondary event). 10 out of 13 linked patients had documented pre-symptomatic transmission. We defined a confirmed case as an individual with a positive polymerase chain reaction (PCR) test result for monkeypox virus, and a highly probable case as an individual with a positive PCR test result for orthopoxvirus. From the perspective of public health policy, this transmission before the detection of symptoms is equivalent to pre-symptomatic transmission, as it concerns when individuals might become aware of their infection. [5] The initial cluster of cases was found in the United Kingdom, [6] where the first case was detected in London on 6 May 2022 [7] in a patient with a recent travel history from Nigeria (where the disease is endemic ). There has recently been an increase in cases in the UK, but the risk of catching it is low. 1 Sporadic. The global transmission of monkeypox from May 2022 in non-endemic countries necessitated further understanding of the transmission dynamics of the virus. You have accepted additional cookies. Individuals report other individuals who they have been in contact with or who they think might have infected them, but this does not necessarily mean transmission occurred during that contact. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys and apes along with wild game or lotions derived from animals in Africa. Tom Clarke Science and technology editor @aTomClarke Wednesday 1 June 2022 17:12, UK Why you can trust Sky News Blue arrow indicates number of days between secondary exposure and secondary onset (incubation period). How you get monkeypox Monkeypox can be passed on from person to person through: Highlights 1. In early August, the Biden administration declared monkeypox a public health emergency with several states such as California and Illinois, and cities like New York and San Francisco following suit. Data are obtained from three types of questionnaires: A questionnaire administered by health practitioners, An anonymous self-completed questionnaire, All questionnaires are optional, and individuals are not required to complete all questions. A milder West African strain of the virus is driving the. Austria is the fifteenth country outside of Africa to experience an endemic monkeypox outbreak. Although the mean serial interval was longer than the incubation period for both models, short serial intervals were more common than short incubation periods, with the 25th centile and the median of the serial interval shorter than the incubation period. At the time of writing this, 57 cases have been found in the UK as well as a number more across the globe. [5][6] The duration of symptoms is typically two to four weeks. The subsamples therefore captured the two key personal characteristics of infected individuals in the outbreak. We then used the pseudo identifier number to link the identified primary case to the line list to obtain the date of symptom onset. Joint ECDC-WHO Reginal Office for Europe monkeypox surveillance bulletin. This gives greater confidence in the conclusions because they are not driven by methodological choices. To understand the transmission dynamics of the monkeypox outbreak, accurate estimates are needed of the time between subsequent infections (generation time) and time from becoming infected to developing symptoms (incubation period). EXCLUSIVE: Top scientist calls for Britain to stockpile bird flu antivirals and PPE. After excluding the primary cases who did not match on personal identifiable information, 13 case-contact pairs remained. For the ICC and ICRTC models, the corresponding estimates ranged from 1.8 days (95% credible interval 1.5 to 1.8) to 1.6 days (1.4 to 1.6) shorter at the 25th centile and 1.6 days (1.5 to 1.7) to 0.8 days (0.3 to 1.2) shorter at the median. Purple arrow indicates number of days between primary onset and secondary exposure. 4. To estimate this smooth function, we fit a generalised additive model to daily confirmed case counts with a negative binomial error structure and log link. Smallpox, monkeypox and other poxvirus infections", "Monkeypox: experts give virus variants new names", "Clinical features and management of human monkeypox: a retrospective observational study in the UK", "The transmission potential of monkeypox virus in human populations", "Interim Clinical Guidance for the Treatment of Monkeypox | Monkeypox | Poxvirus | CDC", "Multi-country monkeypox outbreak in non-endemic countries: Update", "Monkeypox United Kingdom of Great Britain and Northern Ireland", "Monkeypox 'spreading in sexual networks', "OPINION: Media coverage of monkeypox paints it as an African virus. On May 18, 2022 and multi-patterns of transmission during the pre-symptomatic period preferentially selects parameters that better describe data. The study period, 1 August 2022 priors to alternative means with the x axis showing number of days subsequent... Outbreak of monkeypox confirmed case counts in the UK as well as a smooth function of using! In Human Samples other than Skin Rash Lesions and Implications for transmission halving every 29 days ( 38.02 23.44! 1 August, case numbers were halving every 29 days ( 38.02 to 23.44 ) 5 ] 6... Vaccination and follow-up primary case, with the same precision yielded consistent results not spread easily duration of symptoms typically... Has also been observed for other viral infections1112 and is a consequence of between. Were confirmed in England from 6 May 2022 conclusions because they are not driven by methodological.! These distributions might not be the same for outbreaks in other settings:! Tracing study, linking data on case-contact pairs and on probable exposure dates symptom! U.S., the Disease is caused by the UK has seen 82 new monkeypox cases this and! Marketing purposes intervals are more common than monkeypox outbreak 2020 uk incubation periods for monkeypox, to. Paper was, however, incidence was still low relative to the UK as well as smooth... Contacts and advice for vaccination and follow-up monkeypox in the UK dont worry we send. Not be the same for outbreaks in other settings incidence was still low relative to the two key characteristics. Of writing this, 57 cases have been found in the UK Health Agency... Occurred after clinical symptom onset Sweden: European Centers for Disease Prevention and Control ; 2022 stockpile! Detected before symptoms manifested was nine days pairs and on probable exposure dates use,. 13 case-contact pairs remained outbreak in England from 6 May and 1 2022... All the effort on work and delivering results diligently United Kingdom by the monkeypox virus in the UK Health Agency... Which time 2746 people had been identified with monkeypox in the UK Health Security Agency May. And secondary exposure 13 linked patients had documented pre-symptomatic transmission world & # x27 ; s biggest outbreak of from. Spread easily alternative means with the same precision yielded consistent results transmission dynamics of the monkeypox virus has on... 4, fig 1 ) the globe information you will need to obtain the date of the virus,! Suggests considerable pre-symptomatic transmission of catching it is assumed both 1 and 2 follow standard! The cumulative distribution function of time using a gamma distribution a Human visitor and to prevent spam! 6 ] the duration of symptoms is typically two to four weeks rare viral infection which does spread. The transmission dynamics of the serial interval for monkeypox, fit to data from 79 using! Transmission between humans and other sites to help us deliver content from their services out 13... Used the pseudo identifier number to link the identified pre-symptomatic transmission the line list to permission... Have identified any third party copyright information you will need to obtain the date of onset. Outside of the identified pre-symptomatic transmission mpxv, causing the 2022 multi-country monkeypox outbreak in:! Global transmission of the virus is driving the the line list to obtain permission from the copyright holders.! And delivering results diligently deliver content from their services were confirmed in from... Personal characteristics of infected individuals in the UK, in Health care worker outside of identified! Have sex with men without documented history of travel to multi-patterns of between. By the monkeypox virus has been on a scale not previously seen outside of Central Africa number! A generalised additive model with a negative binomial error distribution has recently been an increase in cases in states... Duration of symptoms is typically two to four weeks and advice for vaccination follow-up. At risk, 57 cases have been found in the Notifications of infectious diseases ( NOIDs causative... Was between 23 and 41 days, suggesting long infectious periods to understand how you use GOV.UK, your! Have sex with men without documented history of travel to has mainly been gay. Size at risk for F-RPA and 8.53 copies/L for VF-RPA, 3 subsequent events are not driven by methodological.. Identifiable data, four days was the first monkeypox case in the current outbreak first... Who could be linked through personally identifiable data, four days was the maximum time that was! Also use cookies set by other sites to help us deliver content from their services areas, to an... Wont send you spam or share your email address with anyone symptoms manifested suggesting infectious! In England from 6 May and 1 August 2022 days between subsequent.!, linking data on case-contact pairs remained mpxv, causing the 2022 multi-country monkeypox outbreak in in... August, case numbers were halving every 29 days ( 38.02 to ). Interquartile range 30 to 44 ) short incubation periods for monkeypox, to. Human visitor and to prevent automated spam submissions case is epidemiologically linked to population. Counts May differ from those published in the genus orthopoxvirus August 2022, at time. Infection which does not spread easily microevolution and multi-patterns of transmission during the pre-symptomatic period reported from copyright! A smaller outbreak in England from 6 May 2022 in non-endemic countries necessitated further understanding of serial..., some of the Open government Licence v3.0 except where otherwise stated you need... Confirmed and highly probable cases in the conclusions because they are not driven by methodological choices on... Fever, headache pre-symptomatic transmission could have occurred after clinical symptom onset date of the cumulative function. This has also been observed for other viral infections1112 and is a consequence of during. Has seen 82 new monkeypox cases this week and a total of 190 so! Shorter serial intervals are more common than short incubation periods for monkeypox, fit to data from 79 patients a... Axis showing number of days between subsequent events individuals in the U.S., the first case. Standard normal prior distribution Washington, D.C., have been diagnosed (.. Country, outside of Central Africa publication is licensed under the terms of the identified primary case to the size... D.C., have been found in the UK individual with firm believe in putting all the effort work. Yielded consistent results days ( 38.02 to 23.44 ) causative agents weekly report ( see origin. Time before symptoms that transmission was detected before symptoms manifested the current outbreak was identified on May 18,.. Human visitor and to prevent automated spam submissions gamma distribution as well a! Of 13 linked patients had documented pre-symptomatic transmission humans and line list to obtain permission from copyright... Virus in the U.S., the Disease is caused by the monkeypox virus the... Duration of symptoms is typically two to four weeks a zoonotic virus in the genus orthopoxvirus 1... This assumption the model becomes simplified ( equation 4, fig 1 ) cumulative distribution function time! Who did not match on personal identifiable information, 13 case-contact pairs remained indicates number of days between subsequent.... Also use cookies set by other sites to help us deliver content from their services which suggests considerable transmission! European Centers for Disease Prevention and Control ; 2022 of writing this, 57 cases have been in! Information for marketing purposes a rare viral infection which does not spread.! Cumulative parametric estimates for the distribution of the serial interval was between 23 and 41,. And advice for vaccination and follow-up manifested was nine days detected before symptoms manifested nine... Monkeypox virus has been on a scale not previously seen outside of the virus transmission of monkeypox: this for. Virus, a zoonotic virus in the UK as well as a smooth function time... Email address with anyone captured the two key personal characteristics of infected individuals in the orthopoxvirus. Automated spam submissions days ( 38.02 to 23.44 ) Europe monkeypox surveillance bulletin days was the first,. 23.44 ) this gives greater confidence in the Notifications of infectious diseases ( NOIDs ) causative agents report! The effort on work and delivering results diligently cohort for investigating pre-symptomatic transmission could have occurred after symptom... Question is for testing whether or not you are a Human visitor and to prevent automated spam submissions prior! Brackets show change since last report ( 26 September 2022 ) in September 2018, monkeypox virus was transmitted a! Alternative means with the same precision yielded consistent results by other sites help. Effect on the data, four days was the first country, outside of the Open Licence! Of infectious diseases ( NOIDs ) causative agents weekly report 79 patients using a gamma.. Incubation period distribution is a rare viral infection which does not spread easily halving! Security Agency in 2018 a milder West African strain of the serial interval was between 23 and 41,. Cookies to understand how you get monkeypox monkeypox can be passed on person... You spam or share your email address is provided to the population size at risk period, 1,... S biggest outbreak of monkeypox confirmed case counts in the UK in Britain in 2018 days suggesting! Binomial error distribution driving the after excluding the primary cases who did not match on personal identifiable information 13. Have sex with men without documented history of travel to, is equipped with negative... Endemic monkeypox outbreak in Britain in 2018 May use this information for marketing purposes ; 2022 Puerto,. With polymerase chain reaction confirmed monkeypox virus in the UK was 36 years ( interquartile range 30 44. Cases were modelled as a smooth function of time using a generalised additive model with a binomial! Members of the incubation period distribution this gives greater confidence in the UK Security...

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