Twenty-six cases of monkeypox reported in Scotland 

As of 23 June 2022, Public Health Scotland (PHS) confirmed there have been 26 laboratory-confirmed cases of monkeypox reported since 23 May 2022 in Scotland. On the same date, the UK Health Security Agency (UKHSA) reported 873 confirmed cases in England, eight in Wales and three in Northern Ireland. 

PHS and UKHSA are advising people to be alert to any new rashes or lesions, which appear like spots, ulcers or blisters, on any part of their body. Although this advice applies to everyone, the majority of cases identified to date have been among men who are gay, bisexual and men who have sex with men (MSM), so people in these groups are advised to be aware of the symptoms, particularly if they have recently had a new sexual partner. Anyone with unusual rashes or lesions is advised to contact NHS 24 (Scotland), NHS 111 (England or Wales) or a sexual health service, contacting clinics ahead of visiting and avoiding close contact with others until seen by a clinician. 

Vaccinations are being offered to close contacts of those who have monkeypox, however, on 21 June 2022, the UK Health Security Agency (UKHSA) published a strategy, endorsed by the Joint Committee on Vaccination and Immunisation (JCVI), recommending that some gay and bisexual men at higher risk of exposure to monkeypox should be offered pre-exposure vaccinations to help control the recent outbreak of the virus. The Scottish Government has subsequently confirmed Scotland will also adopt this approach, with full details on how eligible people can get vaccinated provided in due course.

Monkeypox is a viral infection usually associated with travel to West Africa and has only rarely been reported outwith this region. Monkeypox can be transmitted through close contact with a person who already has the infection, including direct contact during sex, and can also be passed on by contact with clothing or linens used by a person who has the disease. Initial symptoms of monkeypox 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 before finally forming a scab, which later falls off. 

PHS and the UKHSA are working closely with the NHS and other stakeholders, in order to urgently investigate where and how recent confirmed monkeypox cases were acquired, including how they may be linked to each other. Clinicians should be alert to individuals presenting with rashes without a clear alternative diagnosis and should contact local specialist services for advice, if monkeypox infection is suspected. 

Sources: PHS, 24 June 2022 and UKHSA, 24 June  2022