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UK Health Security Agency

Monkeypox 2022

Transmission electron micrograph of monkeypox (NCPV 2206091v). Image provided by Microbial Imaging, Porton, UKHSA.

 

This virus can be bought from the NCPV catalogue. Further information about monkeypox can be found below.

Monkeypox was highlighted in the WHO R&D Blueprint: 2018 as one of the diseases that poses a significant risk to public health. Although monkeypox wasn’t included in the list it was agreed that rapid evaluation of available potential countermeasures, more comprehensive surveillance and diagnostics, and the establishment of accelerated R&D and public health action was required (5).

The initial symptom of monkeypox is febrile prodrome, consisting of a fever, chills, aches, swollen glands, and exhaustion. One to five days later this is followed by a rash that turns into blisters. These can be confused with chicken pox (which is part of the herpesvirus family). Monkeypox is generally self-limiting, and no treatment is required. However, more vulnerable individuals (e.g. young, old, or immunocompromised people) may be admitted to a Specialist Regional Infectious Disease Centre, and may benefit from treatment with antivirals such as tecovirimat.

The smallpox vaccination also offers protection against monkeypox. The re-emergence of monkeypox in humans is generally seen in younger people born after the smallpox vaccine programme was discontinued in 1971 in the UK (6). Unlike previous outbreaks, the current outbreak includes transmission of monkeypox within the community, and so a new programme of vaccination has been implemented (7).

Monkeypox is transmitted by close contact or sharing personal items (e.g. towels) with an infected person. Due to the current outbreak, the WHO convened experts in pox biology and reviewed the existing nomenclature and known phylogeny of monkeypox.

Historically, pathogens or diseases would be given names by a variety of methods including names of geographic locations (e.g. original isolation location, such as Ziika Forest or Ebola River), animals (e.g. disease reservoirs such as swine or birds carrying flu), or people (e.g. relevant scientists such as neurologists Hans Creutzfeldt and Alfons Jakob). The naming process also depended on what gained traction in debates among scientists.

To expedite the process and to follow current best practice in naming, the pox experts proposed that the naming system consist of Roman numerals. The former Congo Basin (Central African) clade is to be referred to as I, and the West African clade as II. This second clade is split into IIa and IIb, and the current outbreak mainly consists of isolates from clade IIb.

A paper by Happi et al. (8) also recognised the need for a new lineage system and used the PANGOLin (Phylogenetic Assignment of Named Global Outbreak Lineages) (9) alphanumeric nomenclature, where the current outbreak consists of isolates from B.1.

NextClade can be used to identify genomes based on the WHO and Happi et al. (8) definitions. Our variant NCPV 2206091v is clade IIb, lineage B.1. NCPV is pleased to be able to make this 2022 isolate of monkeypox available through our website.

Monkeypox is an ACDP hazard group 3 virus and is listed under Schedule 5 of counter-terrorism legislation. Hazard group 2 poxviruses available through NCPV are cowpox (NCPV 0310121v), camelpox (NCPV 0408151v), and vaccinia virus (NCPV 0110282v, vaccine strain).

 

Written by Jane Burton, NCPV

 

References


1. Petersen E, Kantele A, Koopmans M, Asogun D, Yinka-Ogunleye A, Ihekweazu C, Zumla A. 2019. Human Monkeypox: Epidemiologic and Clinical Characteristics, Diagnosis, and Prevention. Infectious Disease Clinics of North America 33:1027-1043.


2. Vaughan A, Aarons E, Astbury J, Balasegaram S, Beadsworth M, Beck CR, Chand M, O'Connor C, Dunning J, Ghebrehewet S, Harper N, Howlett-Shipley R, Ihekweazu C, Jacobs M, Kaindama L, Katwa P, Khoo S, Lamb L, Mawdsley S, Morgan D, Palmer R, Phin N, Russell K, Said B, Simpson A, Vivancos R, Wade M, Walsh A, Wilburn J. 2018. Two cases of monkeypox imported to the United Kingdom, September 2018. Euro Surveill 23.


3. Atkinson B, Burton C, Pottage T, Thompson KA, Ngabo D, Crook A, Pitman J, Summers S, Lewandowski K, Furneaux J, Davies K, Brooks T, Bennett AM, Richards KS. 2022. Infection-competent monkeypox virus contamination identified in domestic settings following an imported case of monkeypox into the UK. Environ Microbiol doi:10.1111/1462-2920.16129.


4. Hobson G, Adamson J, Adler H, Firth R, Gould S, Houlihan C, Johnson C, Porter D, Rampling T, Ratcliffe L, Russell K, Shankar AG, Wingfield T. 2021. Family cluster of three cases of monkeypox imported from Nigeria to the United Kingdom, May 2021. Euro Surveill 26.


5. Mehand MS, Al-Shorbaji F, Millett P, Murgue B. 2018. The WHO R&D Blueprint: 2018 review of emerging infectious diseases requiring urgent research and development efforts. Antiviral Res 159:63-67.


6. Millward G. 2019. Vaccinating Britain: Mass vaccination and the public since the Second World War [Internet]. Manchester (UK): Manchester University Press; .


7. Vivancos R, Anderson C, Blomquist P, Balasegaram S, Bell A, Bishop L, Brown CS, Chow Y, Edeghere O, Florence I, Logan S, Manley P, Crowe W, McAuley A, Shankar AG, Mora-Peris B, Paranthaman K, Prochazka M, Ryan C, Simons D, Vipond R, Byers C, Watkins NA, Welfare W, Whittaker E, Dewsnap C, Wilson A, Young Y, Chand M, Riley S, Hopkins S. 2022. Community transmission of monkeypox in the United Kingdom, April to May 2022. Euro Surveill 27.


8. Happi C, Adetifa I, Mbala P, Njouom R, Nakoune E, Happi A, Ndodo N, Ayansola O, Mboowa G, Bedford T, Neher RA, Roemer C, Hodcroft E, Tegally H, O'Toole Á, Rambaut A, Pybus O, Kraemer MUG, Wilkinson E, Isidro J, Borges V, Pinto M, Gomes JP, Freitas L, Resende PC, Lee RTC, Maurer-Stroh S, Baxter C, Lessells R, Ogwell AE, Kebede Y, Tessema SK, de Oliveira T. 2022. Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus. PLoS Biol 20:e3001769.


9. Rambaut A, Holmes EC, O'Toole Á, Hill V, McCrone JT, Ruis C, du Plessis L, Pybus OG. 2020. A dynamic nomenclature proposal for SARS-CoV-2 lineages to assist genomic epidemiology. Nat Microbiol 5:1403-1407.


Bibliography

Advisory Committee on Dangerous Pathogens. 2021. The Approved List of biological agents, version 4. Health and Safety Executive. https://www.hse.gov.uk/pubns/misc208.pdf Accessed 2022, September 02.


Anti-terrorism, Crime and Security Act 2001. Chapter 24, Schedule 5. https://www.legislation.gov.uk/ukpga/2001/24/schedule/5. Accessed 2022, September 02.


NHS England. 2022, July 6. Management of laboratory confirmed monkeypox infections, version 3. NHS England. https://www.england.nhs.uk/wp-content/uploads/2022/06/B1794-Management-of-laboratory-confirmed-monkeypox-infections-6-July-2022.pdf Accessed 2022, September 01.


UK Health Security Agency. 2022, May 20. Monkeypox: case definitions. UK Government. https://www.gov.uk/guidance/monkeypox-case-definitions Accessed 2022, September 01.


UK Health Security Agency. 2022, August 22. Guidance: Protecting you from monkeypox: information on the smallpox vaccination. UK Government. https://www.gov.uk/government/publications/monkeypox-vaccination-resources/protecting-you-from-monkeypox-information-on-the-smallpox-vaccination Accessed 2022, September 02.


WHO. 2022, May 19. Monkeypox fact sheet. The World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/monkeypox Accessed 2022, September 02.


WHO. 2022, August 12. Monkeypox: experts give virus variants new names. The World Health Organisation. https://www.who.int/news/item/12-08-2022-monkeypox--experts-give-virus-variants-new-names Accessed 2022, September 01.

 

December 2023