1. There's a new #monkeypox technical brief out from @UKHSA. Always an interesting read.
A 🧵
HSA's modeling suggests the outbreak isn't expanding, though they acknowledge cases are certainly being missed and that makes it hard to accurately gauge things.
2. If I'm reading this correctly (not a given), @UKHSA's nowcasting suggests the #monkeypox outbreak has plateaued and maybe is declining?
Full report is here: gov.uk/government/pub…
3. @UKHSA is monitoring the proportion of cases in women as a way of trying to determine if #monkeypox transmission is moving beyond networks of gay, bisexual & men who have sex with men. To date there is no evidence of growth outside the GBMSM sexual networks in the UK.
4. Something that is changing in the UK outbreak: The location of the #monkeypox cases. The number of cases in the SE and NW of England is growing.
5. The vast majority of the UK #monkeypox cases are from the outbreak strain known as B.1. But 2 viruses were from a different lineage, A.2, that was first detected by @CDCgov. @UKHSA suggests there may be more undetected spread of A.2. statnews.com/2022/06/03/gen…
6. How long has #monkeypox been spreading internationally? Within the UK? Neither question is answerable right now, but evidence points to potentially years for question 1. @UKHSA says so far the earliest case they've detected dates to early March.

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More from @HelenBranswell

Aug 8
1. @WHO has updated its very useful data collection on #monkeypox. A quick 🧵
There have now been 12 deaths reported in 2022: 4 in Nigeria, 2 apiece in Spain & the Central African Republic & 1 each in Brazil, Peru, Ghana & India.
2. @WHO said the accumulation of new cases slowed last week, with 6% fewer cases than the week before.
Of the nearly 27,000 cases reported globally, 10 countries account for 89% of those cases.
3. Of cases for which @WHO has gender info (n=17,048), 99% of #monkeypox cases are male.
Of cases for which sexual orientation is known (n=7742), 97.4% are MSM. Of cases where a transmission route was reported (n=5,314), 91.4% reported it was via a sexual encounter.
Read 4 tweets
Aug 5
1. A #MPX 🧵
The latest technical brief from @UKHSA suggests that the trajectory of the #monkeypox outbreak in the UK is slowing. HSA says there are signs the outbreak has plateaued.
2. But the plateauing that @UKHSA is reporting is not happening in all locations with #monkeypox outbreaks.
3. Fascinating (to me): @UKHSA says that while the majority of the #MPX viruses they've sequenced are from the outbreak strain, 2 are not. They cluster with the cases @CDCgov reported back in early June. Indian scientists have also detected these viruses. statnews.com/2022/06/03/gen…
Read 8 tweets
Jul 26
1. The UK's #monkeypox total has climbed to 2,432 cases, up 224 since Friday. @UKHSA has now started presenting cases as either "Confirmed" or "Highly Probable." gov.uk/government/pub…
2. The number of women infected with #monkeypox is slowly ticking up. Women make up a tiny fraction of all cases, but it's unlikely that will remain the case. There've now been 18 women among the UK's cases.
3. @WHO_Europe regional director @hans_kluge issued a statement on #monkeypox today. Kluge suggested the number of cases among women & children is increasing. While some are household contacts of confirmed cases, sometimes there's no discernible link to a previous case.
Read 5 tweets
Jul 25
1. #PediatricHepatitis: 2 groups of researchers in the UK have posted preprints that flesh out a new theory on what may be behind the apparent increase in cases of pediatric hepatitis of unknown etiology seen this spring in the UK & Europe & first reported in Alabama last fall.
2. The tl;dr version: It's complicated.
A combination of 3 factors, exacerbated by a 4th, is likely responsible for these cases of #PediatricHepatitis, the studies conclude. statnews.com/2022/07/25/new…
3. For a time, the leading theory was that these unusual cases of #PediatricHepatitis were caused by adenovirus 41, which was found in all the Alabama cases & a number in the UK. But the new theory suggests it's more complicated than that.
Read 5 tweets
Jul 23
1. A #monkeypox 🧵
The US has surpassed the UK in #MPX cases, trailing only Spain at this point, I believe. Friday's tally from @CDCgov is 2891 cases. A couple of weeks ago the tally grew by about 50 cases a day. Now it's hundreds — nearly 400 today.
2. At a White House briefing late today, Jennifer McQuiston from @CDCgov said 99% of the US #monkeypox cases are gay, bisexual & other men who have sex with men. CDC knows of 2 cases in children (household transmission), 8 cases in cisgendered women & 5 in transgendered men.
3. In the UK, the #monkeypox case total is 2208, the vast majority of which were detected in England. @UKHSA updates its case count on Tuesdays & Fridays; today's total was only up 71 cases from what HSA reported on Tuesday.
Read 10 tweets
Jul 22
1. A short #Marburg 🧵
@WHO issued an update on the cases of Marburg in Ghana today. It didn't declare the outbreak over, but it did say that all 108 known contacts of the 2 cases have gone through 21 days without becoming sick, so they are in the clear. Good news. Image
2. However, investigations into the two men — both of whom died — have not revealed how they contracted #Marburg. Hard to rule out the possibility there might be other, as yet undetected cases. This is the first time Marburg has been detected in Ghana. Image
3. Both men were from the Ashanti region of Ghana, the most heavily populated part of the country. One of the men — the first to seek care — had traveled to the western part of Ashanti before he became ill & he was buried in the Savannah region. It was not a safe burial. Image
Read 5 tweets

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