Monkeypox outbreak: epidemiological overview, 1 November 2022
Updated 7 November 2024
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Data as of 31 October 2022
Monkeypox is a zoonotic infection, caused by the monkeypox virus, that occurs mostly in West and Central Africa. Previous cases in the UK had been either imported from countries where monkeypox is endemic or contacts with documented epidemiological links to imported cases. Between 2018 and 2021, there had been 7 cases of monkeypox in the UK. Of these, 4 were imported, 2 were cases in household contacts, and one was a case in a health care worker involved in the care of an imported case. There was no documented community transmission in previous outbreaks.
Current epidemiological situation as of 31 October 2022
Cases of monkeypox infection were confirmed in England from 6 May 2022. The outbreak has mainly been in gay, bisexual, and men who have sex with men without documented history of travel to endemic countries. Further details on the epidemiology are available in the monkeypox technical briefing.
To expand the UK’s capability to detect monkeypox cases, some NHS laboratories are now testing suspected monkeypox samples with an orthopox polymerase chain reaction (PCR) test (orthopox is the group of viruses which includes monkeypox). Since 25 July 2022, the monkeypox case definition recognises those who are orthopox-positive as highly probable cases, and those who test positive on a monkeypox PCR test as confirmed cases. The counts below combine both of these categories.
Up to 31 October 2022 there were 3,552 confirmed and 149 highly probable monkeypox cases detected in the UK: 3,701 in total. Of these, 94 were in Scotland, 34 were in Northern Ireland, 46 were in Wales and 3,527 were in England.
Table 1: Number of confirmed and highly probable monkeypox cases by UK nation of residence, 6 May to 31 October 2022
| UK nation | Total* | Confirmed* | Highly Probable* |
|---|---|---|---|
| England | 3,527 (+3) | 3,378 (+4) | 149 (–1) |
| Northern Ireland | 34 | 34 | 0 |
| Scotland | 94 | 94 | 0 |
| Wales | 46 | 46 | 0 |
| Total | 3,701 (+3) | 3,552 (+4) | 149 (–1) |
*The numbers in brackets show change since last report (24 October 2022)
A high proportion of England cases were London residents (69%, 2,424 of 3,514 with location information). For confirmed and highly probable cases in the UK, where gender information was available, 3,628 (98.6%) were men and 51 were women. The median age of confirmed and highly probable cases in the UK was 37 years (interquartile range 30 to 44).
Table 2: Number of confirmed and highly probable monkeypox cases by region of residence, England, 6 May to 31 October 2022
| Region of residence | Total confirmed and highly probable cases | Change since last report |
|---|---|---|
| East of England | 122 | 0 |
| East Midlands | 66 | 0 |
| London | 2,424 | +1 |
| North East | 48 | 0 |
| North West | 227 | +1 |
| South East | 324 | 0 |
| South West | 92 | 0 |
| West Midlands | 127 | 0 |
| Yorkshire and Humber | 84 | +1 |
| Under investigation** | 13 | 0 |
| Total | 3,527 | +3 |
**Address not yet confirmed. Negative changes due to updates to location information.
Data sources
Monkeypox surveillance data in England is currently compiled daily, based on monkeypox and orthopox virus test results from the Rare and Imported Pathogens Laboratory (RIPL), which is the UK Health Security Agency (UKHSA) monkeypox reference laboratory, and other UK laboratories with monkeypox and orthopox testing. This is combined with case information recorded by local health protection teams in the UKHSA national case management system.
Counts of confirmed cases in Wales, Northern Ireland, and Scotland are submitted to UKHSA by Public Health Wales, Public Health Agency Northern Ireland, and Public Health Scotland respectively.
Information about this publication
This update is currently published on Tuesdays, using data extracted by 9.30am on Mondays.
These figures are used for official reporting of monkeypox confirmed case counts in the UK.
England counts may differ from those published in the Notifications of infectious diseases (NOIDs) causative agents weekly report. This is due to differences in timings of when the data is compiled, and differences in processing of duplicate data (for example, if a person has tested more than once but insufficient information is provided to identify them).
While data cleaning is carried out routinely, corrections can be applied between reports, such as updates to patient information and the removal of quality assurance samples from laboratory surveillance systems.