The UK government has procured 150,000 doses of additional mpox vaccine in preparation for anticipated cases of a new potentially deadlier strain causing a growing outbreak in Africa and isolated cases in Europe and Asia detected in recent weeks.
The UK has yet to identify a case of the Clade 1b strain of mpox, and health officials say the risk to the UK remains “low”.
Despite precautions at UK borders, the long incubation time of mpox and likely global spread mean health officials are preparing for its arrival.
In addition to purchasing more doses of mpox vaccine, on Monday the UK Health Security Agency (UKHSA) published its risk assessment for Clade 1b, including scenarios for a UK outbreak.
“Alongside vaccination, we have been working rapidly to ensure that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission,” said Professor Susan Hopkins, chief medical adviser at the UKHSA.
The risk assessment is based largely on the ongoing outbreak of Clade 2 mpox that has led to more than 100,000 cases worldwide and nearly 4,000 in the UK.
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1:53
Last month: Mpox – what is the risk?
That strain of the virus has been confined largely to gay and bisexual men and a vaccine campaign centred around sexual health clinics that began in 2022 has been successful in reducing levels of transmission in the UK.
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The Clade 1b outbreak in Africa has different features that make the virus of concern. It has been spreading among heterosexual partners – largely among sex workers – but also causing outbreaks within families and among children.
Image: The Democratic Republic of Congo has seen a recent upsurge in cases. File pic: Reuters
Based on available data less than 1% of cases are fatal.
However with so few cases outside of Africa, there is little information to assess whether it is more infectious or more dangerous.
The first UK outbreak scenario assumes the Clade 1b strain is less infectious than the Clade 2 strain of mpox and results in “incursions and small clusters” of cases. In this case, any outbreak would be largely self-contained and contact tracing and isolation of infected cases would be sufficient to contain it.
Image: Mpox virus under a microscope. Pic: NIAID/Reuters
‘Controllable epidemic’ is possible
The second scenario assumes Clade 1b is as infectious as the Clade 2 strain and would result in a “controllable epidemic”. In these circumstances, it is assumed that by the time it is detected in the UK, there would already be “established chains of transmission” among sexual networks.
Targeted vaccination of “high-risk” individuals including men who have sex with men, sex workers and at risk clinical staff is expected to be sufficient to bring the outbreak under control. “Ring vaccination” of contacts of infected individuals would be used to limit “breakthrough” infections within families including young children.
The third scenario assumes Clade 1b is more infectious than Clade 2. While, according to the risk assessment this should not be discounted, there is “considerable uncertainty on whether it is possible for mpox to be more transmissible”.
Not enough jabs for whole of UK
In this case, the virus spreads via physical contact and would lead to multiple outbreaks in households and other “close-contact” settings such as nurseries, care homes hospitals and prisons.
Steps such as contact tracing or quarantine would not be effective in controlling an outbreak in this scenario – only a UK-wide vaccination programme. Currently, global stocks of the mpox vaccine would be insufficient to allow this.
Hopefully, it would never come to that. Officials estimate that the most likely outcome for Clade 1b mpox is somewhere between the first and second scenarios.
For the time being, the UK has ordered what it believes to be sufficient vaccine to tackle the expected outbreak. A calculation also based on the fact the best way of protecting ourselves is to ensure there is sufficient global supply to ensure it is available in Africa – the current epicentre.
“Across government, we are closely monitoring the spread of this virus overseas and are proud to be at the forefront of the international response, including through our early support to the Democratic Republic of Congo,” said Health Secretary Wes Streeting.
Ukraine’s President Volodymyr Zelenskyy has arrived in Saudi Arabia ahead of his team having talks with America’s top diplomat on Tuesday.
Mr Zelenskyy will not be at the meeting with US secretary of state Marco Rubio, but Mr Zelenskyy’s team will try to improve relations following his disastrous 28 February visit to Washington, which descended into an Oval Office argument with President Donald Trump and vice president JD Vance.
Image: Mr Zelenskyy with Prince Saud bin Mishaal, and Saudi commerce minister Majid bin Abdullah al Qasabi. Pic: AP
Mr Zelenskyy is due to meet Crown Prince Mohammed bin Salman later on Monday, after the end of the daily fast during the Muslim holy month of Ramadan.
US secretary of state Marco Rubio is also in Jeddah. He is not due to meet Mr Zelenskyy – but he held talks with Prince Mohammed to discuss Yemen and threats to ships from Houthis, Syria, and the reconstruction of Gaza.
During talks on Tuesday the Ukrainian team will try to convince the US to restore military aid and intelligence that had helped Kyiv since Russia‘s full-scale invasion of Ukraine in 2022.
Speaking to reporters while travelling to Jeddah, Mr Rubio said if Ukraine and the US reach an understanding acceptable to Mr Trump, that could accelerate his administration’s push to peace talks.
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“What we want to know is, are they interested [in] entering some sort of peace conversation and general outlines of the kinds of things they could consider, recognising that it has been a costly and bloody war for the Ukrainians,” Mr Rubio said.
“They have suffered greatly and their people have suffered greatly. And it’s hard in the aftermath of something like that to even talk about concessions, but that’s the only way this is going to end and prevent more suffering.”
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‘We want Ukraine to be serious’ about peace
He said: “I’m not going to set any conditions on what they have to or need to do. I think we want to listen to see how far they’re willing to go and then compare that to what the Russians want and see how far apart we truly are.”
He added: “The most important thing that we have to leave here with is a strong sense that Ukraine is prepared to do difficult things, like the Russians are going to have to do difficult things to end this conflict.”
Meanwhile, British prime minister Sir Keir Starmer spoke to Mr Trump on Monday ahead of the US-Ukraine meeting.
A Downing Street readout of the call said that Sir Keir told the president that “UK officials had been speaking to Ukraine officials over the weekend and they remain committed to a lasting peace”.
“The prime minister said he hoped there would be a positive outcome to the talks that would enable US aid and intelligence sharing to be restarted,” the statement said.
“The two leaders also spoke about the economic deal they had discussed at the White House and the prime minister welcomed the detailed conversations that had already happened to move this forward. Both leaders agreed to stay in touch.”
The European Union agreed last week to boost the continent’s defences and free up hundreds of billions of euros for security in response to the Trump administration’s shift in policy towards Ukraine.
A US intelligence official said a pause on sharing US intelligence that can be used for offensive purposes by Ukrainian forces remains in effect.
The official suggested that progress could be made towards reinstating intelligence sharing with Ukraine during the Saudi talks.
Syria’s interim government has signed a deal with the Kurdish-led authority that controls the country’s oil-rich northeast.
The agreement – which includes a ceasefire and the merging of Syrian Democratic Forces (SDF) there into the Syrian army – will bring most of the nation under the control of the government.
The government is currently led by Islamist group Hayat Tahrir al Sham, which helped to topple president Bashar al Assad in December.
Image: Syria’s interim president Ahmad al Sharaa (R) shakes hands with Mazloum Abdi, the commander of Kurdish-led Syrian Democratic Forces. Pic: AP
On Monday, the deal was signed by interim president Ahmad al Sharaa and Mazloum Abdi, the commander of the US-backed SDF.
The deal – to be implemented by the end of the year – would bring all border crossings with Iraq and Turkey, airports and oil fields in the northeast under the central government’s control.
Prisons, where about 9,000 suspected members of the Islamic State group are being held, are also expected to come under government control.
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Syria’s Kurds will gain their “constitutional rights” including using and teaching their language, which were banned for decades under Mr Assad.
Hundreds of thousands of Kurds who were displaced during Syria’s nearly 14-year civil war will return to their homes.
The deal will also allow all Syrians to be part of the political process, no matter their religion or ethnicity.
Image: Clashes between government supporters and those loyal to Bashar al Assad have seen more than 1,000 people killed. Pic: AP
Image: A coffin carrying the body of Nawaf Khalil Baytar, who was killed during the recent wave of violence. Pic: AP
Syria’s new rulers are struggling to exert their authority across the country and reach political settlements with other minority communities, notably the Druze in southern Syria.
Earlier in the day, the government announced the end of the military operation against insurgents loyal to Mr Assad and his family in the worst fighting since the end of the civil war.
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Surge of violence in Syria explained
The defence ministry’s announcement came after a surprise attack by gunmen from the Alawite community on a police patrol near the port city of Latakia on Thursday spiralled into widespread clashes across Syria’s coastal region.
Defence ministry spokesperson Colonel Abdel-Ghani said security forces will continue searching for sleeper cells and remnants of the insurgency of former government loyalists.
Though the government’s counter-offensive was able to mostly contain the insurgency, footage surfaced of what appeared to be retaliatory attacks targeting the broader minority Alawite community, an offshoot of Shia Islam whose adherents live mainly in the western coastal region.
The Syrian Observatory for Human Rights, a Britain-based war monitoring group, said 1,130 people were killed in the clashes, including 830 civilians.
Former Bank of England governor Mark Carney has been named Canadian prime minister after winning the Liberal Party leadership in a landslide victory.
Mr Carney, who also used to head up Canada’s central bank, had emerged as the frontrunner as his country was hit with tariffs imposed by President Trump.
He ended up winning 85.9% of the vote.
During his victory speech, he told the crowd: “Donald Trump, as we know, has put unjustified tariffs on what we build, on what we sell and how we make a living.
“He’s attacking Canadian families, workers and businesses and we cannot let him succeed and we won’t.”
Mr Carney said Canada would keep retaliatory tariffs until “the Americans show us respect”.
Mr Trump’s tariffs against Canada and his talk of making the country America’s 51st state have infuriated Canadians.
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The American national anthem has been repeatedly booed at NHL and NBA games.
“Think about it. If they succeeded, they would destroy our way of life… America is a melting pot. Canada is a mosaic,” Mr Carney added.
“America is not Canada. Canada will never ever be part of America in any way, shape or form.”
An easy pick for his party – but now he must win over Canada
Mark Carney had no problem convincing the Liberal Party he was the best man for the job. 85.9% of the vote speaks for itself. Now he must convince the country.
After unparalleled experience as central bank governor, both of Canada and of the UK, albeit at different times, he has the economic wherewithal to fortify the economy against the battering Donald Trump seems intent on dealing it.
He has made it very clear he is ready for the fight to come. “In trade, as in hockey, we will win!” he told his fellow liberals to wild applause. “We’re strongest when we are united,” he told the country on X.
His conservative rivals had what seemed like an unbeatable lead in the polls until just a few short weeks ago, but Trump’s trade tariffs have rallied Canadians behind the flag and their government.
That gives Mr Carney momentum ahead of a general election that will likely come sooner rather than later. Now he must exercise the political genius to capitalise on that.
The 59-year-old will replace Justin Trudeau, who has served as prime minister since 2015.