Gay men could be offered monkeypox vaccines in a focused rollout, MailOnline has learned.
Experts said the strategy could be deployed if cases continue to disproportionally be in homosexual and bisexual males.
Six of Britain’s nine confirmed cases are men who have sex with men, which officials say is ‘highly suggestive of spread in sexual networks’.
Britain’s cases are expected to double today, with health chiefs expected to confirm nine more, it was claimed today.
MailOnline yesterday revealed that health chiefs were stockpiling jabs amid growing fears about the tropical virus’s spread. Ministers were already sitting on 5,000 doses but have now ordered an extra 20,000.
Close contacts of the UK’s known cases are already being offered the jab, which was originally designed for smallpox. The two rash-causing viruses are very similar.
Professor Paul Hunter, an infectious disease expert at the University of East Anglia, said he ‘could see a role’ for a targeted jab rollout ‘if this isn’t brought under control quickly’.
A health source told MailOnline ‘there would be a number of strategies we’d look at’ if cases continued to rise.
Nine Britons have been diagnosed with monkeypox and all but one of them appear to have contracted it in the UK. The original 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
Ten countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind
MONKEYPOX: Strain ‘spreads sexually’ and is as deadly as the original Wuhan Covid variant – but a jab exists
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 until now and they were 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.
However it can kill up to 10 per cent of people it infects.
The milder strain causing the current outbreak kills one in 100 — similar to when Covid first hit.
Monkeypox shuts down some aspects of your body’s ability to fight infections.
Because of the presence of other viruses and bacteria which your body can’t fight off, in the worst cases patients can succumb to a lethal shock throughout the body and blood poisoning.
Death is more likely to occur in younger patients. The skin lesions are painful and disfiguring, and can be the source of further infections.
Is there a cure?
Because monkeypox is closely related to the virus that causes smallpox, jabs for smallpox can also protect people from getting monkeypox.
One vaccine, Imvanex, was shown to be around 85 per cent effective in preventing monkeypox infection.
Antivirals and pooled blood from individuals vaccinated against smallpox can be used to treat severe cases.
How does it spread?
Monkeypox is not a sexually transmitted infection by nature, though it can be passed on by direct contact during sex.
Contagious lesions, through which infections are most likely to be passed on, can appear on any part of the body.
The infection can also be passed on through contact with clothing or linens used by an infected person.
Until now, monkeypox had only ever been detected in four countries outside of Africa – the UK, US, Israel and Singapore.
And all of those cases had travel links to Nigeria and Ghana.
Are gay men at greater risk?
Most of the British and Spanish cases are gay or bisexual men, which officials say is ‘highly suggestive of spread in sexual networks’.
The sexuality of patients in other countries has not been disclosed.
Health chiefs in the UK have issued a direct plea to men who have sex with men, telling them to come forward if they develop a rash on their face or genitals.
What are the symptoms?
Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.
But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the genitals, hands or feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
What do I do if I have symptoms?
Anyone worried that they could be infected with monkeypox is advised to make contact with clinics ahead of their visit.
Health chiefs say their call or discussion will be treated sensitively and confidentially.
Ten countries — including the US, Spain and Italy — have now detected monkeypox, in the first global outbreak of its kind.
Spain this morning reported 14 new confirmed cases, bringing the nation’s total to 21.
Australia last night confirmed two cases, including one man in his thirties who had travelled from Britain to Melbourne with symptoms earlier this week.
The outbreak has been described as ‘unusual’ by experts because person-to-person transmission of monkeypox was thought to be extremely rare.
Before May, the UK had only ever seen seven cases of the virus, which is endemic in West Africa.
It is usually spread through handling infected animals, either through their lesions, blood, bodily fluids or eating poorly cooked meat.
But it was known that it could be passed on between humans through close contact with the likes of body fluids, respiratory droplets and lesions.
This is why experts think the virus is passing through skin-to-skin contact sex, even though this has never been seen until now.
A similar pattern is emerging in Europe. Seven gay or bisexual men tested positive in Spain.
Authorities are now probing gay bars, clubs and spas visited by British cases as they scramble to contain the outbreak.
The UKHSA has also issued a direct plea to gay and bisexual men to be vigilant for new rashes on their face or genitals.
MailOnline this week revealed close contacts of monkeypox cases, including NHS workers, are already being offered the Imvanex smallpox vaccine.
The strategy is known as ring vaccination, involves jabbing and monitoring those around an infected person to form a buffer of immune people to limit the spread of a disease.
A spokesman for the UKHSA did not disclose how many have been vaccinated, but said: ‘Those who have required the vaccine have been offered it.’
Professor Geoffrey Smith, from the University of Cambridge, who advises the World Health Organization on virus research, said: ‘It is sensible for doctors and nurses who may be treating patients with monkeypox, to be vaccinated against smallpox.
‘This outbreak of monkeypox is highly unusual, but it is very likely the precautions being taken will mean it comes to an end quickly.’
Although designed for smallpox, Imvanex can protect against monkeypox because the viruses causing the illnesses are related.
Data shows it prevents around 85 per cent of cases, and has been used ‘off-label’ in the UK since 2018.
The jab, thought to cost £20 per dose, contains a modified vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people.
Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.
The US is already stockpiling the jabs for future, ordering 13million for a reported $299million (£240million).
Smallpox has been eradicated worldwide through vaccination and British children have not routinely been offered the jab since 1971.
But experts believe young people are most at risk of catching or falling ill with the disease because they are less likely to have been vaccinated against smallpox.
Professor Ian Jones, a virologist at Reading University, told MailOnline the current vaccination policy would be enough.
‘You would need much more evidence of community spread before it [targeted rollout] could be considered,’ he said.
He added: ‘Monkeypox doesn’t spread easily and is generally a mild infection so my view would be that the current policy is enough.
‘Very few people have been infected overall and a general vaccine rollout needs the community to agree to take it up and a willingness to fight off any negative anti-vax nonsense.
‘I doubt numbers will climb much more and think the current outbreak is controllable.’
But others have suggested that a targeted roll-out could be on the cards, unless the outbreak is thwarted soon.
Professor Hunter told MailOnline: ‘I presume if the UKHSA come to the conclusion that [targeted jab rollout] is what needs to be done then it’ll be done quite quickly.’
A public health source said if the outbreak spirals, ‘there would be a number of strategies we’d look at, but at the moment there are no plans in place for that’.
Another told MailOnline: ‘I don’t think it’s something we’re looking at just yet.’
There are also a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat, which was approved for monkeypox in the EU in January.
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)
Nurses and doctors are being advised to stay ‘alert’ to patients who present with a new rash or scabby lesions (like above)
Initial monkeypox 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.
Monkeypox has an incubation period of up to 21 days, meaning it can take three weeks after an infection for symptoms to appear.
Professor Kevin Fenton, London’s public health regional director, said if the outbreak in the capital continues to grow then the rollout of vaccines and treatments could be broadened to more groups.
He told BBC Radio 4’s Today programme yesterday: ‘If we see more cases and it continues to spread then there are plans in place to ensure we have more antiviral agents in place to deal with that.
‘We’re watching closely to see how this spreads over the next week or two and then we’ll get a better sense of how to project and plan for the month ahead.’
The UKHSA is ‘actively investigating’ venues visited by homosexual and bisexual men who tested positive in the past week.
They include bars, clubs and saunas, according to an update by the World Health Organization (WHO).
The UKHSA has said it is ‘particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay if they have concerns’.
It comes as the UKHSA is set to confirm today that eleven more monkeypox cases have been detected, which would bring the UK total to 20, according to The Times.
Ministers accept that there will be dozens more infections across the UK that have not been found and have ordered more Imvanex doses in response.
Timeline of monkeypox in the UK
1958: Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research.
1970: 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.
2003: A Monkeypox outbreak occurred in the US after rodents were imported from Africa. Cases were reported in both humans and pet prairie dogs. All the human infections followed contact with an infected pet and all patients recovered.
SEPTEMBER 8, 2018: Monkeypox appeared in the UK for the first time in a Nigerian naval officer who was visiting Cornwall for training. They were treated at the Royal Free Hospital in London.
SEPTEMBER 11, 2018: A second UK monkeypox case is confirmed in Blackpool. There is no link with the first case in Cornwall. Instead, the patient is though to have picked up the infection when travelling in Nigeria. They were treated at Blackpool Victoria Hospital and Royal Liverpool University Hospital.
SEPTEMBER 26, 2018: A third person is diagnosed with monkeypox. The individual worked at Blackpool Victoria Hospital and treated the second Monkeypox case. They received treatment at the Royal Victoria Infirmary in Newcastle.
DECEMBER 3, 2019: A patient was diagnosed with monkeypox in England, marking the fourth ever case.
May 25, 2021: Two cases of monkeypox were identified in north Wales. Both patients had travel links to Nigeria.
A third person living with one of the cases was diagnosed and admitted to hospital, bringing the total number ever to seven.
MAY 7, 2022: A person was diagnosed with Monkeypox in England after recently travelling to Nigeria. The person received care at the expert infectious disease unit at Guy’s and St Thomas’ NHS Foundation Trust in London.
MAY 14, 2022: Two more cases were confirmed in London. The infected pair lived in the same household but had not been in contact with the case announced one week earlier.
One of these individuals received care at the expert infectious disease unit at St Mary’s Hospital in London. The other isolated at home and did not need hospital treatment.
MAY 16, 2022: Four more cases were announced, bringing the UK total to seven. Three of these cases are in London, while one of their contacts is infected in the north east of England.
The spate of cases was described as ‘unusual’ and ‘surprising’ as experts warn gay and bisexual men to look out for new rashes.
MAY 19, 2022: Two more cases were revealed, with no travel links or connections to other cases. The cases were based in the South East and London. Fears began to grow that infections are going undetected.
MAY 20, 2022: Eleven more cases set to be announced, meaning Britain’s monkeypox outbreak have doubled. Minsters discuss the possibility of a public health campaign to warn gay men the disease may be more prevalent for them.