First UK case of new clade 1b mpox variant detected in London

The UK Health Security Agency (UKHSA) announced on October 30, 2024 that it has detected the first case of infection with a new variant of the mpox virus, Clade 1b, in London. The person had recently traveled to African countries and had encountered community cases of Clade 1b mpox.

The patient flew back to Britain on an overnight flight on October 21 and started feeling unwell more than 24 hours after returning home. Flu-like symptoms developed on October 22, followed by a rash on October 24, which worsened over the following days. The rash started as raised spots that turned into ulcers or fluid-filled blisters, which eventually scabbed and fell off. On October 27, the person went to the emergency department in London, where they were tested for the virus and sent home to isolate while awaiting results. Laboratory testing confirmed that the infection was Clade 1b mpox.

The patient is currently being treated in a high dependency infectious disease unit at the Royal Free Hospital in London. Authorities trace fewer than ten household contacts with whom the person may have had contact. The UK Health Security Agency explained: “All contacts of this person will be offered testing and a vaccine if necessary and will be informed of additional care to be provided if they show symptoms or if the test is positive.”

Professor Susan Hopkins, the UKHSA’s chief medical adviser, said: “The risk to the UK population remains low, and we are working quickly to trace close contacts and reduce the risk of potential spread. In accordance with established protocols, investigations are ongoing to learn how the individual acquired the infection and to assess whether there are additional associated cases.”

Health and Social Care Minister Wes Streeting said: “We are working with UKHSA and the NHS to protect the public and prevent transmission. The overall risk to the UK population currently remains low.”

Clade 1b mpox is thought to be more dangerous than Clade II because it appears to spread more easily between people and causes more serious illness. This variant is circulating widely in the Democratic Republic of Congo (DRC) and has spread to neighboring countries including Burundi, Rwanda, Uganda and Kenya. Cases have also been discovered in Germany, Sweden, India and several Asian countries, some linked to travel to affected regions.

Mpox, formerly known as monkeypox, is a viral infection related to smallpox that typically causes flu-like symptoms including fever, muscle aches and skin lesions. The disease can last two to four weeks. Symptoms include high temperature, headache, muscle aches, back pain, swollen glands, exhaustion, joint pain and a characteristic lumpy rash with pus-filled lesions. A rash usually appears one to five days after flu-like symptoms begin.

The virus spreads through close physical contact, including sexual contact, kissing, hugging, holding hands, and direct contact with skin rashes or body fluids. It can also be transmitted by coughing and sneezing in the immediate environment. Mpox has been linked to dangerous complications for pregnant women, including miscarriage.

The UKHSA noted that this is the first detection of this type of mpox in the UK. “It is different from mpox Clade 2, which has been circulating at low levels in the UK since 2022, mainly among homosexuals and bisexuals,” the agency said. Clade II mpox led to the global outbreak of the disease in 2022, mainly affecting gays, bisexuals and other men who have sex with men in Europe and the United States.

The UKHSA is working with the NHS and academic partners to determine the characteristics of the Clade 1b virus and further assess the risk to human health. The agency is treating Clade 1b as a high-consequence infectious disease (HCID) and will adjust its response as more data becomes available. Extensive planning is underway to ensure that healthcare professionals are equipped and prepared to respond to any confirmed cases of mpox Clade 1b.

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Vaccination and awareness campaigns in many countries, including Britain, have helped reduce the number of global MPox cases. The UKHSA stated that the country has an existing stock of MPox vaccines. Last month, the agency announced further vaccine purchases to support a routine immunization programme, with more than 150,000 doses ordered to boost preparedness. The decision to purchase further vaccines is in line with more recent independent advice from the Joint Committee on Vaccination and Immunization (JCVI).

Globally, the World Health Organization (WHO) declared the outbreaks in Africa a global health emergency in July 2022 due to the rapid spread of mpox, especially after an outbreak in the DRC spread to neighboring countries. The WHO revoked the emergency declaration in May 2023 after reporting 140 deaths out of approximately 87,400 cases.

Clade 1b mpox has also been reported in Germany, with a case discovered on October 22, 2024. Additional cases have appeared in Sweden and several Asian countries. Cases of Clade 1b have been recorded in countries that had not previously detected mpox, highlighting the variant’s potential for wider spread.

Mpox has two main subtypes: Clade I and Clade II. Clade 1b, a subtype of Clade I, appears to be more dangerous because it spreads more easily between people and can cause more serious illness. Clade I mainly affects children, while Clade II has been present in Britain since 2022, with infections still occurring at low levels.

Anna Popova, head of Rospotrebnadzor, said about the global situation: “We decided that we had already survived all the terrible things in the COVID era. Unfortunately this is not the case.”

The UKHSA stressed the importance of vigilance and public health measures to prevent the spread of the virus. Close contacts of the individual will be offered MPox testing, vaccination and healthcare advice if they are found to have the virus.

In recent months, a new outbreak of mpox has hit Africa, with the highest infection rates reported in the DRC, Burundi and Nigeria. By early September 2024, more than 600 deaths from the mpox virus had been reported.

Vaccination and awareness campaigns have been crucial in reducing the number of cases worldwide. The UKHSA, NHS and partner organizations have well-tested capabilities to detect, contain and treat emerging infectious diseases, contributing to the low risk of contracting MPox in Britain.

Sources: Liverpool Echo, expressandstar.com, LaRepublica.pe, Izvestia.ru, Return to homepage, Yahoo News, France 24, www.elcolombiano.com, Nilepost News, Home, AL24 News

This article was written in collaboration with generative AI company Alchemiq