UKHSA has advised that cases of monkeypox have increased recently but the risk to the UK population remains low.

Advice from UKHSA is that this is because the virus does not usually spread easily between people. It can be passed on through close person-to-person contact or contact with items used by a person who has monkeypox such as clothes, bedding or utensils. Monkeypox is usually a mild illness and most people recover within a few weeks.

The UK clinical and public health response to monkeypox was initially based on the High Consequence Infectious Disease management (HCID) system in line with guidance from the UKHSA. This was highly precautionary and designed for complete containment around single cases. It was also designed prior to the confirmed availability of vaccine and treatment. UKHSA has confirmed that community transmission is occurring in the UK with multiple generations of spread. Illness appears to be generally mild, consistent with other information about the West African clade. Therefore, UKHSA and the NHS will be adopting a more proportionate response as set out in this letter.

Anyone can get monkeypox. Currently most cases have been in men who are gay, bisexual or have sex with men, so it's particularly important for these people to be aware of the symptoms.

Patients should contact a sexual health clinic if they have a rash with blisters and either:

• have been in close contact, including sexual contact, with someone who has or might have monkeypox (even if they've not been tested yet) in the past 3 weeks
• have been to west or central Africa in the past 3 weeks

Patients who meet these criteria should be assessed and tested in line with UKHSA guidance.

If patients are not able to contact a sexual health clinic they should call 111.

Patients should contact the GUM or sexual health clinic by telephone to make an appointment for an assessment in order to ensure appropriate infection control processes are in place. The GUM or sexual health clinic will discuss the case with the patient and in circumstances where it is not appropriate to be seen at the clinic, such as children or pregnant women, alternative arrangements will be made.

Patients that may have an unexplained rash, but do not meet the above criteria should continue to access NHS services as usual. Further public information is available on nhs.uk