Monkeypox continues to spread across the UK, with current efforts insufficient to contain the outbreak, experts have warned, as a whistleblower said there were serious gaps in the support given to those who believe they have been at risk .
According to the UK Health Safety Agency (UKHSA), there were 1,552 confirmed cases of monkeypox in the UK linked to the outbreak as of 7 July.
Although anyone can catch the virus because it is spread through close or intimate contact, the majority of cases so far have been among gay and bisexual men and men who have sex with men (MSM). In England, the majority of cases are in London.
There is little sign of infections abating, with the latest UKHSA estimates suggesting the number of cases is doubling every 15 days.
“[There is] there is no evidence that current strategies are likely to end this any time soon,” said Paul Hunter, professor of medicine at the University of East Anglia, although he noted that while the total number of cases continued to rise, the rate of new infections may have reached plateau.
The concerns came as a whistleblower working on the UKHSA’s monkeypox inquiry line said there were numerous problems, including offering little support to people who were not confirmed contacts of cases – ie. someone whose name was provided to contact trackers by a person with monkeypox.
The Guardian has seen scripts which show that even if someone calls because they are concerned they may have had contact with a confirmed case, they are told their risk is very low if they are not officially identified as a contact. The informant said it doesn’t make sense when a caller says a sexual partner has monkeypox symptoms.
In addition, the whistleblower said callers are not allowed to suggest that callers contact a sexual health clinic unless sexual health was raised by the caller. They added that some clinics had turned off their phone lines.
The UKHSA rejected the claims, saying the helpline was an additional service to provide non-clinical advice to members of the public.
Dr William Welfare, the agency’s director of incidents, said specialist public health teams were fast-tracking all cases to limit transmission, with contacts assessed as high-risk being offered vaccination.
“Contact tracing often relies on people sharing contacts for a large number of sexual contacts, so it can inevitably be difficult when privacy is also a consideration. We quickly implemented a high-quality public health operation with sexual health services to investigate and control monkeypox and to support those affected,” Welfare said.
“Monkeypox is primarily spread through very close contact, mostly through relatively closed sexual networks, and is not routinely found in the wider population. The prevalence of infection in the UK as a whole, and therefore the risk to the general public, currently remains low.
Vaccination includes a smallpox shot, which also offers protection against monkeypox. The UKHSA recently announced that it will expand vaccination eligibility to include some gay and bisexual men at higher risk of exposure to the virus, even if they have not been a confirmed close contact with a case.
UKHSA confirmed it had a ready supply of vaccine with almost 30,000 doses secured, but said the NHS had not yet announced plans to roll out the vaccine.
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An NHS spokesman said: “The National Health Service is working with local partners to identify and invite those who are eligible to be vaccinated to attend and will be rapidly increasing the number of clinics over the coming weeks to make it as quick as possible and convenient to vaccinate.
“Following UKHSA’s advice, the NHS will continue to prioritize vaccination for those at higher risk, including healthcare workers in specialist roles and clinics where exposure to Monkeypox is highest.”
But Hunter said an even broader approach may be needed. “I think that more widespread vaccination of high-risk MSM — people who have frequent, repeated contact — and maybe sex workers is the way forward,” he said. “We may not have enough vaccine to do that, but I think there may be a case for offering a vaccine to everyone who attends the STD [sexually transmitted diseases] clinic.”
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