THE UK has started stockpiling mpox vaccines as it prepares for a worst-case scenario, where the bug could spread through touch.
The UK Health Security Agency (UKHSA) is ramping up its preparedness after a case of the new clade 1b variant was detected in Europe.
3
3
Mpox, previously called monkeypox, is a viral infection that causes flu-like symptoms and pus-filled lesions.
The new clade 1b variant started spreading rapidly in the Democratic Republic of Congo (DCR) last year.
As this new bug began to sweep across international borders – as far afield as Sweden and Thailand – the World Health Organization (WHO) last month declared a global health crisis.
The clade 1b strain driving the current outbreak has a higher mortality rate than clade 2 which triggered the first emergency in 2022.
Experts also fear the new variant might also be more contagious.
While no cases of clade I mpox have been detected in the UK, the UKHSA – and the risk to the population is considered low – the Goverment has begun preparing for a possible outbreak.
The UKHSA has created a series of Covid-style scenarios to forecast outcomes based on whether the new bug is more or less transmissible than its predecessor.
Under scenario c, which examines the bug in its most contagious form – the virus could cause “widespread population transmission across multiple groups”.
As it stands, mpox mostly spreads among men who sleep with men through sexual contact.
However, under scenario c, the virus could also be transmitted via touch and breathing.
This could result in the bug reaching a broader range of groups, including children and the elderly, who may have little to no immunity if they haven’t been vaccinated.
However, experts believe the trajectory of the new bug is more likely to align with scenario a or b, both of which pose a much smaller risk to the population.
Scenario a, which involves a version of the bug less contagious than clade 2, would lead to a small cluster of cases emerging in the UK.
Scenario b, considers a version of the bug similar to clade 2, which would spark a “controllable epidemic”, like what we saw in 2022.
If this were the case, the virus would be transmissible through sex but would not spread easily through other means limiting its overall transmission.
VACCINE ROLLOUT
As part of preparations for potential cases of clade I mpox in the UK, the Government has also ordered more than 150,000 doses of mpox vaccine from biotechnology firm Bavarian Nordic to ensure high-risk groups are protected.
It is the same jab that was used to tackle the outbreak in 2022.
3
Under the plans, the Government has agreed that gay, bisexual or men who have sex with men should be offered the vaccine, along with close contacts of confirmed cases.
Certain healthcare workers in infectious diseases inpatient units and sexual health services, and certain health and humanitarian workers who go to affected countries will also get the jab.
It is understood the jab will be offered to patients in stages, as it becomes available and based on clinical need, with separate rollouts across the four nations.
Professor Susan Hopkins, chief medical adviser at the UK Health Security Agency, said: “There are no cases of clade I mpox confirmed in the UK and the risk to the general UK population of being exposed to mpox clade I is currently considered low.
“However, we are preparing for any cases that we might see in the UK and vaccination plays a vital part in our defences.
“Alongside vaccination, we have been working rapidly to ensure that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission.”
‘THE NHS REMAINS FULLY PREPARED’
Clade 2 has been present in the UK for more than two years after a large outbreak was identified in the spring of 2022.
A vaccination programme was launched that summer and closed the following July.
It is understood more than 49,000 people have had two doses of the jab, which is 80 per cent effective at preventing mpox cases, while more than 83,000 have had one dose.
Steve Russell, national director for vaccinations and screening at NHS England, added: “The NHS remains fully prepared to roll out mpox vaccination at pace once again to priority groups.
“While the risk of catching mpox in the UK is low, vaccination offers a vital level of protection for those most likely to be exposed. We encourage those eligible to come forward when invited by local health services, to ensure they have the best defence.”
Should we be worried?
Dr Jonas Albarnaz, a research fellow specialising in pox viruses at The Pirbright Institute, said:
“This news of a case of clade 1 mpox in Sweden is concerning for two main reasons.
“First, this is the first clade 1 mpox virus case outside Africa. This indicates that the extent of the international spread of clade 1 outbreak in DRC might be larger than we knew yesterday.
“And second, clade 1 mpox virus is associated with a more severe disease and higher mortality rates than the clade 2 virus responsible for the international mpox outbreak in 2022.
“This is hard to predict whether we will see further cases of clade 1 mpox outside of Africa, but this case in Sweden is a warning call for public health authorities to be vigilant and implement robust surveillance and contact-tracing strategies to detect possible new cases early on.
“It’s also critical to determine what is the link between this clade 1 mpox virus detected in Sweden and the ongoing outbreak in DCR.”
