The Health and Social Care Minister has outlined how Welsh agencies are preparing for a potential future mpox outbreak.

Mpox was declared as an international emergency by the World Health Organisation (WHO) last month. 

In the statement, Jeremy Miles MS, Cabinet Secretary for Health and Social Care said: "To date, no clade I mpox cases have been reported in the UK.

"However, given the growth in cases across Africa we need to be prepared for the potential for UK cases."

There are two known clades (types) of mpox – clade I and clade II – each of which includes a subclade a and b.

Historically, cases of clade I mpox have been reported only in Cameroon, Central African Republic, the Democratic Republic of the Congo (DRC), Gabon and Republic of the Congo.

Why is he worried about a potential outbreak?

In the past month, more than 100 laboratory-confirmed cases of clade Ib mpox have been reported in four countries.

These are countries that neighbour the DRC and have not previously reported cases – Burundi, Kenya, Rwanda and Uganda. 

Reports have suggested clade I is more severe than the established clade II, which has been in circulation around the world in recent years. 

In August 2024, clade Ib mpox cases were reported outside Africa for the first time, in Sweden and Thailand.  

Both cases had a travel link to African countries experiencing clade I mpox outbreaks. 

In response to the upsurge in clade I mpox cases, the World Health Organisation declared it a Public Health Emergency of International Concern (PHEIC). 

How prepared are we for an outbreak?

The NHS and UK public health agencies have well-tested systems in place to detect, contain and treat novel infectious diseases, including mpox.

These led to the successful detection, containment and treatment of the first clade II mpox cases in the UK in 2018 and the control of the 2022 outbreak via vaccination. 

The Welsh Government is working in partnership with Public Health Wales (PHW), the UK Health Security Agency (UKHSA), and the other UK governments and the NHS to prepare for cases of mpox clade I in the UK. 

What measures are being put in place?

The following steps being taken were outlined in the statement:

  • An NHS-wide alert to raise awareness among clinicians and highlight guidance and support has been issued by the Chief Medical Officer for Wales. 

  • PHW briefing to alert NHS professionals of the mpox clade I case definition to ensure potential cases can be identified and treated promptly.

  • Details of a rapid testing process, isolation and PPE guidance and links to further advice and support have been provided.

  • A desktop exercise, led by PHW, to test preparedness arrangements was held on 5 September.

  • Development of testing capability to quickly identify different mpox strains.

  • NHS system preparedness for safe clinical care.

  • Public health messaging is being considered at a UK level, to ensure clear public communications which will be updated in response to developments.

How mpox (monkeypox) is transmitted

  • Any close physical contact with monkeypox blisters or scabs (including during sexual contact, kissing, cuddling, or holding hands).

  • Touching clothing, bedding or towels used by someone with mpox.

  • The coughs or sneezes of a person with monkeypox when they're close to you.

Mpox (monkeypox) signs and symptoms

According to the NHS, it can take between five and 21 days for symptoms to appear after you first get infected with mpox.

Symptoms include:

  • a high temperature

  • a headache

  • muscle aches

  • backache

  • swollen glands

  • shivering (chills)

  • exhaustion

  • joint pain

A rash, which is sometimes confused with chickenpox, usually appears one to five days after the first symptoms, often beginning on the face before spreading to other parts of the body. This can include the mouth, genitals, and anus.