Earlier this year, Dr Jake Dunning, who has studied infectious diseases all his working life, was catching up with a colleague about monkeypox in the Central African Republic. Then, a phone call caught him by surprise: a cluster of cases had been identified in the UK.
“We had often talked about transmission during sex, but I had never considered we would have an outbreak in the UK, let alone internationally, affecting people with a shared characteristic — men who have sex with men, where most transmission occurs during sex,” he recalls. “I never heard anyone else propose it as a likely scenario, either.”
As the outbreak developed, many patients were admitted to his communicable diseases unit at London’s Royal Free Hospital, says Dunning, who is also a senior researcher at Oxford university. “We all realised we had to prepare.”