Four more cases of monkeypox have been identified in England by the UK Health Security Agency (UKHSA), bringing the total number of cases reported this month to seven.

Monkeypox is a rare viral infection with symptoms similar to those seen in smallpox patients, such as fever, rash, and swollen lymph nodes. While typically most patients suffer from a mild illness and recover relatively quickly, the disease can be fatal, especially for younger people, and some people can develop more serious symptoms. 

These four new cases, three of which are in London, have no known connections with the previously confirmed cases announced on May 14 and the case announced on May 7. None of these new cases have recently traveled to West or Central Africa, where the disease is endemic and naturally found in rodents and primates.

Another unexpected link between the cases has been discovered: all four of these cases self-identify as gay, bisexual, or other men who have sex with men. 

Monkeypox is not considered to be a sexually transmitted disease, but it can be spread through close contact. It’s noteworthy that common contacts have been identified for two of the four latest cases. 

It’s currently unclear how the people caught the virus, but the risk to the UK population is currently considered to be low, says the UKSHA.

“This is rare and unusual. UKHSA is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact,” Dr Susan Hopkins, Chief Medical Adviser, UKHSA, said in a statement.

“We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay,” continued Dr Hopkins.

"We are contacting any potential close contacts of the cases to provide health information and advice."

Since being first scientifically identified in 1970, human cases of monkeypox have been reported from 11 African countries: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan.

There have been numerous incidents where a case of the disease has been exported outside of Africa. Just last year, two cases of monkeypox were reported in two members of the same household in England. Cases of the infection also popped up in the UK in September 2018 and December 2019.