This written statement provides a further update about how the Welsh Government is responding to the mpox clade I outbreak in Africa and the preparations being put in place in Wales, should any cases be detected here. It provides a further update to the letter to all Senedd Members from the Cabinet Secretary for Health and Social Care on 23 August.
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.
But in the past month, more than 100 laboratory-confirmed cases of clade Ib mpox have been reported in four countries neighbouring the DRC that 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).
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. 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.
We are working closely 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.
Together with PHW, we have been working with other UK governments to develop the mechanisms to identify passengers who have been on a flight where a communicable disease, such as mpox is suspected. Guidance and advice have been provided to all passengers arriving in the UK on direct flights from affected countries.
Following the principles of the Communicable Disease Outbreak Control Plan for Wales, we have established policy oversight arrangements and PHW is establishing Wales-wide national co-ordination activities to monitor and respond should a case be identified in the UK.
Preparedness activities include:
- 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.
- The Chief Medical Officer for Wales has issued an NHS-wide alert to raise general awareness among clinicians and highlight key guidance and support.
- 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.
Vaccines developed for smallpox are licensed for mpox and alongside the other UK nations, we are developing a co-ordinated and proportionate vaccination response.
The UK Government has purchased more than 150,000 doses of mpox vaccine from Bavarian Nordic to ensure the UK is well prepared for any cases of clade I mpox that may enter the country. It will enable the NHS to vaccinate those who may be at high risk from mpox. The UK Government will make further decisions on vaccine procurement in the coming weeks as the situation evolves.
We quickly set up a successful Welsh vaccination programme to ensure those most at risk during the 2022 outbreak of mpox clade II in the UK could be protected. This programme is still operational in Wales and work has been ongoing to consider implementation of the 2023 Joint Committee on Vaccination and Immunisation advice to make this a routine part of our vaccination programme.
Our work in 2022 provides us with a basis on which to take further action, should the clinical and scientific advice suggest this is necessary.
Collaborative working between governments and public health authorities across the UK will be key in ensuring that any potential cases of mpox clade I are quickly identified and treated and that contacts are identified and supported. This will minimise the risk of onward spread and keep people safe.
I will continue to keep Members updated.
