British scientists warned monkeypox would fill the void left by smallpox three years ago - as it emerges a child is in hospital among the 20 cases already in the UK

Top scientists in UK discussed how monkeypox could replace smallpox in 2019Experts warned monkeypox could evolve to take advantage of the smallpox voidEstimated 70% of world's population are no longer protected against pox viruses

Some of the country’s top disease experts warned that monkeypox would fill the void left by smallpox three years ago, it has emerged.

Scientists from leading institutions including the University of Cambridge and the London School of Tropical Hygiene and Medicine argued the viral disease would evolve to fill the ‘niche’ left behind after smallpox was eradicated.

It comes as it has emerged a child is in hospital among the 20 confirmed cases of monkeypox in the UK.

The rare viral infection which people  usually pick up in the tropical areas of west and central Africa can be transmitted by very close contact with an infected person.

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment.

Yet, the disease can prove fatal with the strain causing the current outbreak killing one in 100 infected.

The country's top disease experts warned that monkeypox would fill the void left by smallpox three years ago, it has emerged. Pictured: London School of Hygiene & Tropical Medicine

The country’s top disease experts warned that monkeypox would fill the void left by smallpox three years ago, it has emerged. Pictured: London School of Hygiene & Tropical Medicine

According to the Sunday Telegraph, the experts attended a seminar in London back in 2019 and discussed how there was a need to develop ‘a new generation vaccines and treatments’.

The seminar heard that as smallpox was eradicated in 1980, there has been a cessation of smallpox vaccinations and, as a result, up to 70 per cent of the world’s population are no longer protected against smallpox.

This means they are also no longer protected against other viruses in the same family such as monkeypox.

The scientists pointed to recent outbreaks of monkeypox in 2003 and more recently in 2018 and 2019 as evidence that monkeypox was re-emerging.

Their discussion was published in the Vaccine journal in 2020 and concluded that ‘these facts invite speculation that emergent or re-emergent human monkeypox might fill the epidemiological niche vacated by smallpox’.

Britain’s monkeypox outbreak has continued to rise with cases doubling overnight on Friday while the World Health Organization said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

Monkeypox is a rare viral infection which causes unusual rashes or lesions (shown in a handout provided by the Centers for Disease Control and Prevention (CDC) in the US
Nurses and doctors are being advised to stay 'alert' to patients who present with a new rash or scabby lesions (like above)

Medics are being advised to stay ‘alert’ to patients who present with a rash or scabby lesions

Sajid Javid yesterday revealed another 11 Britons had tested positive for the virus, taking the total to 20.

The Health Secretary said: ‘UKHSA have confirmed 11 new cases of monkeypox in the UK. This morning I updated G7 health ministers on what we know so far.

‘Most cases are mild, and I can confirm we have procured further doses of vaccines that are effective against monkeypox.’

No details about the new eleven patients have been released yet.

But six of the previous nine confirmed cases were in men who have sex with men — which officials say is ‘highly suggestive of spread in sexual networks’.

According to the Sunday Telegraph, a young child is among the 20 patients currently being treated in the UK.

The newspaper reports that the child is currently being treated in intensive care in a London hospital.

Yesterday, a top British doctor has predicted a ‘significant rise’ in monkeypox cases in the UK in the next few weeks, as the country recorded 20 cases — and more than 100 found in Europe.

The disease, which was first found in monkeys, can be transmitted from person to person through close physical contact – as well as sexual intercourse – and is caused by the monkeypox virus.

Dr Claire Dewsnap, president of the British Association for Sexual Health and HIV, is worried about the rate the virus is spreading.

She told Sky News that she expects a ‘significant’ rise in infections next week.

‘What worries me the most is there are infections across Europe, so this has already spread,’ she said. ‘It’s already circulating in the general population… It could be really significant numbers over the next two or three weeks.’

She also warned that the virus could have a ‘massive impact’ on access to sexual health services in Britain.

The UK Health Security Agency has said a notable proportion of recent cases in Britain and Europe have been found in gay and bisexual men.

The virus is more common to west and central Africa but the number of cases confirmed in Britain has hit 20, with nine other countries including Spain, Portugal and Canada also reporting outbreaks.

Meanwhile, Professor Sir Peter Horby, director of the Pandemic Sciences Institute at Oxford University, described the current monkeypox outbreak as ‘an unusual situation’, because the virus is being transmitted within communities outside of Central and West Africa.

Sir Peter told BBC Radio 4 on Saturday: ‘It’s transmitted by close person-to-person contact and, in the past, we have not seen it being very infectious.

‘What’s unusual about what we’re seeing now is that we’re seeing transmission occurring in the community in Europe and now in other countries, so it’s an unusual situation where we seem to have had the virus introduced but now have ongoing transmission within certain communities.’

He added: ‘It would appear that there is some element of sexual transmission perhaps with just the very close contact between people and the skin lesions, because a large proportion of the current cases are being detected in gay and bisexual men.

‘So it’s very important that we get the message across that if people have unusual skin lesions that they do seek attention quickly so that we can control this.

‘The important thing is that we interrupt transmission and this doesn’t become established in the human population in Europe.’

Monkeypox is a usually mild infection, with symptoms including fever, headaches and a distinctive bumpy rash.

In Britain, authorities are offering a smallpox vaccine to healthcare workers and others who may have been exposed.

Spain is assessing different therapeutic options, such as antivirals and vaccines, but so far all cases have mild symptoms and therefore no specific ad hoc treatment has been necessary, Spanish Health minister Carolina Darias told reporters on Friday.

The Portuguese cases remain under clinical follow-up but none have been hospitalized as they are all stable, the health authority said.

Portugal has 14 confirmed cases and 20 suspected infections. And across the Atlantic, there are two confirmed cases in Canada, with 20 suspected cases.

There are also cases in Italy, Sweden, Belgium, Germany, The Netherlands, France, Israel and Australia.

The World Health Organization said it expects to identify more cases of monkeypox as it expands surveillance in countries where the disease is not typically found.

As of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox have been reported from 12 member states that are not endemic for the virus, the U.N. agency said, adding it will provide further guidance and recommendations in coming days for countries on how to mitigate the spread of monkeypox.

‘Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic’, the agency added.

‘What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world,’ WHO official David Heymann, an infectious disease specialist, told Reuters.

He said close contact was the key transmission route, as lesions typical of the disease are very infectious. For example, parents caring for sick children are at risk, as are health workers, which is why some countries have started inoculating teams treating monkeypox patients using vaccines for smallpox, a related virus.

Many of the current cases have been identified at sexual health clinics.

Early genomic sequencing of a handful of the cases in Europe has suggested a similarity with the strain that spread in a limited fashion in Britain, Israel and Singapore in 2018.

Heymann said it was ‘biologically plausible’ the virus had been circulating outside of the countries where it is endemic, but had not led to major outbreaks as a result of COVID-19 lockdowns, social distancing and travel restrictions.

He stressed that the monkeypox outbreak did not resemble the early days of the COVID-19 pandemic because it does not transmit as easily.

Those who suspect they may have been exposed or who show symptoms including bumpy rash and fever, should avoid close contact with others, he said.

‘There are vaccines available, but the most important message is, you can protect yourself,’ he added. (Reporting by Jennifer Rigby and Akanksha Khushi; Editing by Pravin Char and David Gregorio)

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