RESUMO
The mpox epidemic in the UK began in May 2022, with rates of new cases unexpectedly and rapidly declining during August 2022. Interpreting trends in infection requires disentangling the underlying growth rate of cases from the delay from symptom onset to presenting to healthcare. We developed a nowcasting Bayesian method which incorporates time-varying delays (EpiLine) to quantify the changes in the delay from symptom onset to healthcare presentation and the underlying mpox growth rate over the period May-August 2022 in the UK. We show that the mean delay between symptom onset and healthcare presentation for mpox in the UK decreased from 22 days in early May 2022 to 10 days by early June and 8 days in August 2022. When we account for these dynamic delays, the time-varying growth rate declined gradually and continuously in the UK during the May-August 2022 period. Not accounting for varying time delays would have incorrectly characterised the growth rate by a sharp increase followed by a rapid decline in mpox cases. Our results highlight the importance of correctly quantifying the delay between symptom onset to healthcare presentation when characterising the epidemic growth of mpox in the UK. The gradual reduction in the rate of epidemic spread, which pre-dated the vaccine roll-out, is consistent with gradual risk reduction or acquired immunity amongst the highest risk individuals. Our study highlights the need for public health agencies to record the delays from symptom onset to healthcare presentation early in an outbreak.
Assuntos
Teorema de Bayes , Epidemias , Humanos , Reino Unido/epidemiologia , Fatores de TempoRESUMO
Mathematical modelling has played an important role in offering informed advice during the COVID-19 pandemic. In England, a cross government and academia collaboration generated medium-term projections (MTPs) of possible epidemic trajectories over the future 4-6 weeks from a collection of epidemiological models. In this article, we outline this collaborative modelling approach and evaluate the accuracy of the combined and individual model projections against the data over the period November 2021-December 2022 when various Omicron subvariants were spreading across England. Using a number of statistical methods, we quantify the predictive performance of the model projections for both the combined and individual MTPs, by evaluating the point and probabilistic accuracy. Our results illustrate that the combined MTPs, produced from an ensemble of heterogeneous epidemiological models, were a closer fit to the data than the individual models during the periods of epidemic growth or decline, with the 90% confidence intervals widest around the epidemic peaks. We also show that the combined MTPs increase the robustness and reduce the biases associated with a single model projection. Learning from our experience of ensemble modelling during the COVID-19 epidemic, our findings highlight the importance of developing cross-institutional multi-model infectious disease hubs for future outbreak control.
RESUMO
We first review the way in which Hasselmann's paradigm, introduced in 1976 and recently honored with the Nobel Prize, can, like many key innovations in complexity science, be understood on several different levels. It can be seen as a way to add variability into the pioneering energy balance models (EBMs) of Budyko and Sellers. On a more abstract level, however, it used the original stochastic mathematical model of Brownian motion to provide a conceptual superstructure to link slow climate variability to fast weather fluctuations, in a context broader than EBMs, and led Hasselmann to posit a need for negative feedback in climate modeling. Hasselmann's paradigm has still much to offer us, but naturally, since the 1970s, a number of newer developments have built on his pioneering ideas. One important one has been the development of a rigorous mathematical hierarchy that embeds Hasselmann-type models in the more comprehensive Mori-Zwanzig generalized Langevin equation (GLE) framework. Another has been the interest in stochastic EBMs with a memory that has slower decay and, thus, longer range than the exponential form seen in his EBMs. In this paper, we argue that the Mori-Kubo overdamped GLE, as widely used in statistical mechanics, suggests the form of a relatively simple stochastic EBM with memory for the global temperature anomaly. We also explore how this EBM relates to Lovejoy et al.'s fractional energy balance equation.
RESUMO
BACKGROUND: Variant classification in the setting of germline genetic testing is necessary for patients and their families to receive proper care. Variants are classified as pathogenic (P), likely pathogenic (LP), uncertain significance (VUS), likely benign (LB) and benign (B) using the standards and guidelines recommended by the American College of Medical Genetics and the Association for Molecular Pathology, with modifications for specific genes. As the literature continues to rapidly expand, and evidence continues to accumulate, prior classifications can be updated accordingly. In this study, we aim to characterise variant reclassifications in Ontario. METHODS: DNA samples from patients seen at hereditary cancer clinics in Ontario from January 2012 to April 2022 were submitted for testing. Patients met provincial eligibility criteria for testing for hereditary cancer syndromes or polycystic kidney disease. Reclassification events were determined to be within their broader category of significance (B to LB or vice versa, or P to LP or vice versa) or outside of their broader category as significance (ie, significant reclassifications from B/LB or VUS or P/LP, from P/LP to VUS or B/LB, or from VUS to any other category). RESULTS: Of the 8075 unique variants included in this study, 23.7% (1912) of variants were reassessed, and 7.2% (578) of variants were reclassified. Of these, 351 (60.7%) variants were reclassified outside of their broader category of significance. Overall, the final classification was significantly different for 336 (58.1%) variants. Importantly, most reclassified variants were downgraded to a more benign classification (n=245; 72.9%). Of note, most reclassified VUS was downgraded to B/LB (n=233; 84.7%). CONCLUSIONS: The likelihood for reclassification of variants on reassessment is high. Most reclassified variants were downgraded to a more benign classification. Our findings highlight the importance of periodic variant reassessment to ensure timely and appropriate care for patients and their families.
Assuntos
Testes Genéticos , Variação Genética , Humanos , Testes Genéticos/métodos , Ontário/epidemiologia , Mutação em Linhagem Germinativa/genética , Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/diagnóstico , Síndromes Neoplásicas Hereditárias/classificação , Feminino , Laboratórios Clínicos , Técnicas de Diagnóstico Molecular/métodosRESUMO
Management of the electrode surface temperature is an understudied aspect of (photo)electrode reactor design for complex reactions, such as CO2 reduction. In this work, we study the impact of local electrode heating on electrochemical reduction of CO2 reduction. Using the ferri/ferrocyanide open circuit voltage as a reporter of the effective reaction temperature, we reveal how the interplay of surface heating and convective cooling presents an opportunity for cooptimizing mass transport and thermal assistance of electrochemical reactions, where we focus on reduction of CO2 to carbon-coupled (C2+) products. The introduction of an organic coating on the electrode surface facilitates well-behaved electrode kinetics with near-ambient bulk electrolyte temperature. This approach helps to probe the fundamentals of thermal effects in electrochemical reactions, as demonstrated through Bayesian inference of Tafel kinetic parameters from a suite of high throughput experiments, which reveal a decrease in overpotential for C2+ products by 0.1 V on polycrystalline copper via 60 °C surface heating.
RESUMO
OBJECTIVE: Chromosomal microarray (CMA), while considered the gold standard for detecting copy number variants (CNVs) in prenatal diagnostics, has its limitations, including the necessity to replace aging microarray equipment, low throughput, a static design, and an inefficient multi-day workflow. This study evaluates the feasibility of low-pass genome sequencing (LP-GS) as a potential replacement for CMA in prenatal diagnostics. METHODS: We comprehensively compared LP-GS at 10x and 5x average depths with CMA in a prenatal laboratory. We examined parameters, including concordance, sensitivity, specificity, workflow efficiency, and cost-effectiveness. RESULTS: We found a high degree of agreement between LP-GS and CMA for detecting CNVs and absence of heterozygosity. Furthermore, compared to CMA, LP-GS increased workflow efficiency and proved to be cost-neutral at 10x and cost-effective at 5x. CONCLUSION: Our study suggests that LP-GS is a promising alternative to CMA in prenatal diagnostics, offering advantages, including a more efficient workflow and scalability for larger testing volumes. Importantly, for clinical laboratories that have adopted next-generation sequencing in a separate capacity, LP-GS facilitates a unified NGS-centric approach, enabling workflow consolidation. By offering a single, streamlined platform for detecting a broad range of genetic variants, LP-GS may represent a critical step toward enhancing the diagnostic capabilities of prenatal laboratories.
Assuntos
Variações do Número de Cópias de DNA , Diagnóstico Pré-Natal , Gravidez , Feminino , Humanos , Mapeamento Cromossômico , Análise em MicrossériesRESUMO
Photoelectrochemical CO2 reduction (CO2R) is an appealing solution for converting carbon dioxide into higher-value products. However, CO2R in aqueous electrolytes suffers from poor selectivity due to the competitive hydrogen evolution reaction that is dominant on semiconductor surfaces in aqueous electrolytes. We demonstrate that functionalizing gold/p-type gallium nitride devices with a film derived from diphenyliodonium triflate suppresses hydrogen generation from 90% to 18%. As a result, we observe increases in the Faradaic efficiency and partial current density for carbon monoxide of 50% and 3-fold, respectively. Furthermore, we demonstrate through optical absorption measurements that the molecular film employed herein, regardless of thickness, does not affect the photocathode's light absorption. Altogether, this study provides a rigorous platform for elucidating the catalytic structure-property relationships to enable engineering of active, stable, and selective materials for photoelectrochemical CO2R.
RESUMO
PURPOSE: Genetic variants at the low end of the penetrance spectrum have historically been challenging to interpret because their high population frequencies exceed the disease prevalence of the associated condition, leading to a lack of clear segregation between the variant and disease. There is currently substantial variation in the classification of these variants, and no formal classification framework has been widely adopted. The Clinical Genome Resource Low Penetrance/Risk Allele Working Group was formed to address these challenges and promote harmonization within the clinical community. METHODS: The work presented here is the product of internal and community Likert-scaled surveys in combination with expert consensus within the Working Group. RESULTS: We formally recognize risk alleles and low-penetrance variants as distinct variant classes from those causing highly penetrant disease that require special considerations regarding their clinical classification and reporting. First, we provide a preferred terminology for these variants. Second, we focus on risk alleles and detail considerations for reviewing relevant studies and present a framework for the classification these variants. Finally, we discuss considerations for clinical reporting of risk alleles. CONCLUSION: These recommendations support harmonized interpretation, classification, and reporting of variants at the low end of the penetrance spectrum.
Assuntos
Variação Genética , Humanos , Alelos , Variação Genética/genética , Penetrância , Frequência do GeneRESUMO
In near-collisionless plasmas, which are ubiquitous in astrophysics, entropy production relies on fully-nonlinear processes such as turbulence and reconnection, which lead to particle acceleration. Mechanisms for turbulent reconnection include multiple magnetic flux ropes interacting to generate thin current sheets which undergo reconnection, leading to mixing and magnetic merging and growth of coherent structures, unstable reconnection current layers that fragment and turbulent reconnection outflows. All of these processes act across, and encompass, multiple reconnection sites. We use Magnetospheric Multi Scale four-point satellite observations to characterize the magnetic field line topology within a single reconnection current layer. We examine magnetopause reconnection where the spacecraft encounter the Electron Diffusion Region (EDR). We find fluctuating magnetic field with topology identical to that found for dynamically evolving vortices in hydrodynamic turbulence. The turbulence is supported by an electron-magnetohydrodynamic (EMHD) flow in which the magnetic field is effectively frozen into the electron fluid. Accelerated electrons are found in the EDR edge where we identify a departure from this turbulent topology, towards two-dimensional sheet-like structures. This is consistent with a scenario in which sub-ion scale turbulence can suppress electron acceleration within the EDR which would otherwise be possible in the electric field at the X-line.
RESUMO
BACKGROUND: Comparisons of transfusion practice between organisations are time-consuming using manual methods for data collection. We performed a feasibility study to determine whether large-scale transfusion data from three English hospitals could be combined to allow comparisons of transfusion practice. METHODS: Clinical, laboratory and transfusion data from patients discharged between 1 April 2016 and 31 March 2017 were extracted from Patient Administration Systems (PAS), Laboratory Information Management Systems (LIMS), and electronic transfusion systems at three NHS hospitals, which are academic medical centres based in large cities outside London. A centralised database and business intelligence software were used to compare the data. RESULTS: The dataset contained 748 982 episodes of patient care with 91 410 blood components transfused. The study confirms the results of previous studies finding peaks in the ages of transfusion in the 0-4 years age range, in women of childbearing ages, and in males over 60 years. The number of components transfused per 1000 bed days was used as a standardised comparator. Red cell utilisation was 42.4, 40.4 and 49.5 units/1000 bed days and platelet utilisation 11.69, 7.76, and 11.66 units/1000 bed days. 60.5% (6848/11 310) of Group O D negative red cell units were transfused to non-group O D negative recipients. An analysis of component usage highlighted variations in practice, for example platelet usage for cardiac surgery varied from 2.4% to 7.3% across the three hospitals. CONCLUSION: This feasibility study demonstrates that large electronic datasets from hospitals can be combined to identify areas for targeted interventions to improve transfusion practice.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Transfusão de Eritrócitos , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Transfusão de Sangue , Hospitais , Transfusão de Componentes SanguíneosRESUMO
Ribosome biogenesis is one of the biggest consumers of cellular energy. More than 20 genetic diseases (ribosomopathies) and multiple cancers arise from defects in the production of the 40S (SSU) and 60S (LSU) ribosomal subunits. Defects in the production of either the SSU or LSU result in p53 induction through the accumulation of the 5S RNP, an LSU assembly intermediate. While the mechanism is understood for the LSU, it is still unclear how SSU production defects induce p53 through the 5S RNP since the production of the two subunits is believed to be uncoupled. Here, we examined the response to SSU production defects to understand how this leads to the activation of p53 via the 5S RNP. We found that p53 activation occurs rapidly after SSU production is blocked, prior to changes in mature ribosomal RNA (rRNA) levels but correlated with early, middle and late SSU pre-rRNA processing defects. Furthermore, both nucleolar/nuclear LSU maturation, in particular late stages in 5.8S rRNA processing, and pre-LSU export were affected by SSU production defects. We have therefore uncovered a novel connection between the SSU and LSU production pathways in human cells, which explains how p53 is induced in response to SSU production defects.
Assuntos
Subunidades Ribossômicas Maiores , Subunidades Ribossômicas Menores , Proteína Supressora de Tumor p53 , Humanos , Proteínas Ribossômicas/genética , Proteínas Ribossômicas/metabolismo , Subunidades Ribossômicas Maiores/metabolismo , Subunidades Ribossômicas Menores/metabolismo , Ribossomos/genética , Ribossomos/metabolismo , RNA Ribossômico/genética , RNA Ribossômico/metabolismo , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismoRESUMO
Blood cells contain functionally important intracellular structures, such as granules, critical to immunity and thrombosis. Quantitative variation in these structures has not been subjected previously to large-scale genetic analysis. We perform genome-wide association studies of 63 flow-cytometry derived cellular phenotypes-including cell-type specific measures of granularity, nucleic acid content and reactivity-in 41,515 participants in the INTERVAL study. We identify 2172 distinct variant-trait associations, including associations near genes coding for proteins in organelles implicated in inflammatory and thrombotic diseases. By integrating with epigenetic data we show that many intracellular structures are likely to be determined in immature precursor cells. By integrating with proteomic data we identify the transcription factor FOG2 as an early regulator of platelet formation and α-granularity. Finally, we show that colocalisation of our associations with disease risk signals can suggest aetiological cell-types-variants in IL2RA and ITGA4 respectively mirror the known effects of daclizumab in multiple sclerosis and vedolizumab in inflammatory bowel disease.
Assuntos
Estudo de Associação Genômica Ampla , Proteômica , Microscopia , Fatores de Transcrição , CausalidadeRESUMO
BACKGROUND: Vasovagal reactions (VVRs) are the most common acute complications of blood donation. Responsible for substantial morbidity, they also reduce the likelihood of repeated donations and are disruptive and costly for blood services. Although blood establishments worldwide have adopted different strategies to prevent VVRs (including water loading and applied muscle tension [AMT]), robust evidence is limited. The Strategies to Improve Donor Experiences (STRIDES) trial aims to reliably assess the impact of four different interventions to prevent VVRs among blood donors. METHODS: STRIDES is a cluster-randomised cross-over/stepped-wedge factorial trial of four interventions to reduce VVRs involving about 1.4 million whole blood donors enrolled from all 73 blood donation sites (mobile teams and donor centres) of National Health Service Blood and Transplant (NHSBT) in England. Each site ("cluster") has been randomly allocated to receive one or more interventions during a 36-month period, using principles of cross-over, stepped-wedge and factorial trial design to assign the sequence of interventions. Each of the four interventions is compared to NHSBT's current practices: (i) 500-ml isotonic drink before donation (vs current 500-ml plain water); (ii) 3-min rest on donation chair after donation (vs current 2 min); (iii) new modified AMT (vs current practice of AMT); and (iv) psychosocial intervention using preparatory materials (vs current practice of nothing). The primary outcome is the number of in-session VVRs with loss of consciousness (i.e. episodes involving loss of consciousness of any duration, with or without additional complications). Secondary outcomes include all in-session VVRs (i.e. with and without loss of consciousness), all delayed VVRs (i.e. those occurring after leaving the venue) and any in-session non-VVR adverse events or reactions. DISCUSSION: The STRIDES trial should yield novel information about interventions, singly and in combination, for the prevention of VVRs, with the aim of generating policy-shaping evidence to help inform blood services to improve donor health, donor experience, and service efficiency. TRIAL REGISTRATION: ISRCTN: 10412338. Registration date: October 24, 2019.
Assuntos
Doadores de Sangue , Síncope Vasovagal , Humanos , Medicina Estatal , Síncope Vasovagal/diagnóstico , Síncope Vasovagal/etiologia , Síncope Vasovagal/prevenção & controle , Água , Doação de SangueAssuntos
Epidemias , Mpox , Humanos , Epidemias/prevenção & controle , Governo , Organizações , Inglaterra/epidemiologiaRESUMO
Two of the four human ubiquitin-encoding genes express ubiquitin as an N-terminal fusion precursor polypeptide, with either ribosomal protein (RP) RPS27a or RPL40 at the C-terminus. RPS27a and RPL40 have been proposed to be important for the induction of the tumour suppressor p53 in response to defects in ribosome biogenesis, suggesting that they may play a role in the coordination of ribosome production, ubiquitin levels and p53 signalling. Here, we report that RPS27a is cleaved from the ubiquitin-RP precursor in a process that appears independent of ribosome biogenesis. In contrast to other RPs, the knockdown of either RPS27a or RPL40 did not stabilise the tumour suppressor p53 in U2OS cells. Knockdown of neither protein blocked p53 stabilisation following inhibition of ribosome biogenesis by actinomycin D, indicating that they are not needed for p53 signalling in these cells. However, the knockdown of both RPS27a and RPL40 in MCF7 and LNCaP cells robustly induced p53, consistent with observations made with the majority of other RPs. Importantly, RPS27a and RPL40 are needed for rRNA production in all cell lines tested. Our data suggest that the role of RPS27a and RPL40 in p53 signalling, but not their importance in ribosome biogenesis, differs between cell types.
Assuntos
Neoplasias , Ribossomos , Proteína Supressora de Tumor p53 , Humanos , Neoplasias/genética , Neoplasias/metabolismo , Proteínas Ribossômicas/genética , Proteínas Ribossômicas/metabolismo , Ribossomos/genética , Ribossomos/metabolismo , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Ubiquitina/metabolismo , Ubiquitinas/metabolismoRESUMO
Electrochemical CO2 reduction (CO2 R) at low pH is desired for high CO2 utilization; the competing hydrogen evolution reaction (HER) remains a challenge. High alkali cation concentration at a high operating current density has recently been used to promote electrochemical CO2 R at low pH. Herein we report an alternative approach to selective CO2 R (>70 % Faradaic efficiency for C2+ products, FEC2+ ) at low pH (pHâ 2; H3 PO4 /KH2 PO4 ) and low potassium concentration ([K+ ]=0.1â M) using organic film-modified polycrystalline copper (Modified-Cu). Such an electrode effectively mitigates HER due to attenuated proton transport. Modified-Cu still achieves high FEC2+ (45 % with Cu foil /55 % with Cu GDE) under 1.0â M H3 PO4 (pH≈1) at low [K+ ] (0.1â M), even at low operating current, conditions where HER can otherwise dominate.
RESUMO
The nucleolar surveillance pathway monitors nucleolar integrity and responds to nucleolar stress by mediating binding of ribosomal proteins to MDM2, resulting in p53 accumulation. Inappropriate pathway activation is implicated in the pathogenesis of ribosomopathies, while drugs selectively activating the pathway are in trials for cancer. Despite this, the molecular mechanism(s) regulating this process are poorly understood. Using genome-wide loss-of-function screens, we demonstrate the ribosome biogenesis axis as the most potent class of genes whose disruption stabilizes p53. Mechanistically, we identify genes critical for regulation of this pathway, including HEATR3. By selectively disabling the nucleolar surveillance pathway, we demonstrate that it is essential for the ability of all nuclear-acting stresses, including DNA damage, to induce p53 accumulation. Our data support a paradigm whereby the nucleolar surveillance pathway is the central integrator of stresses that regulate nuclear p53 abundance, ensuring that ribosome biogenesis is hardwired to cellular proliferative capacity.
Assuntos
Proteínas Proto-Oncogênicas c-mdm2 , Proteína Supressora de Tumor p53 , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/genética , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Transdução de Sinais/genética , Nucléolo Celular/metabolismo , Proteínas Ribossômicas/genética , Proteínas Ribossômicas/metabolismoRESUMO
Garrod's concept of 'chemical individuality' has contributed to comprehension of the molecular origins of human diseases. Untargeted high-throughput metabolomic technologies provide an in-depth snapshot of human metabolism at scale. We studied the genetic architecture of the human plasma metabolome using 913 metabolites assayed in 19,994 individuals and identified 2,599 variant-metabolite associations (P < 1.25 × 10-11) within 330 genomic regions, with rare variants (minor allele frequency ≤ 1%) explaining 9.4% of associations. Jointly modeling metabolites in each region, we identified 423 regional, co-regulated, variant-metabolite clusters called genetically influenced metabotypes. We assigned causal genes for 62.4% of these genetically influenced metabotypes, providing new insights into fundamental metabolite physiology and clinical relevance, including metabolite-guided discovery of potential adverse drug effects (DPYD and SRD5A2). We show strong enrichment of inborn errors of metabolism-causing genes, with examples of metabolite associations and clinical phenotypes of non-pathogenic variant carriers matching characteristics of the inborn errors of metabolism. Systematic, phenotypic follow-up of metabolite-specific genetic scores revealed multiple potential etiological relationships.
Assuntos
Erros Inatos do Metabolismo , Metaboloma , Humanos , Metaboloma/genética , Metabolômica , Plasma/metabolismo , Fenótipo , Erros Inatos do Metabolismo/genética , Proteínas de Membrana/metabolismo , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/genética , 3-Oxo-5-alfa-Esteroide 4-Desidrogenase/metabolismoRESUMO
Stroke is the second leading cause of death with substantial unmet therapeutic needs. To identify potential stroke therapeutic targets, we estimate the causal effects of 308 plasma proteins on stroke outcomes in a two-sample Mendelian randomization framework and assess mediation effects by stroke risk factors. We find associations between genetically predicted plasma levels of six proteins and stroke (P ≤ 1.62 × 10-4). The genetic associations with stroke colocalize (Posterior Probability >0.7) with the genetic associations of four proteins (TFPI, TMPRSS5, CD6, CD40). Mendelian randomization supports atrial fibrillation, body mass index, smoking, blood pressure, white matter hyperintensities and type 2 diabetes as stroke risk factors (P ≤ 0.0071). Body mass index, white matter hyperintensity and atrial fibrillation appear to mediate the TFPI, IL6RA, TMPRSS5 associations with stroke. Furthermore, thirty-six proteins are associated with one or more of these risk factors using Mendelian randomization. Our results highlight causal pathways and potential therapeutic targets for stroke.
Assuntos
Fibrilação Atrial , Diabetes Mellitus Tipo 2 , Acidente Vascular Cerebral , Fibrilação Atrial/genética , Proteínas Sanguíneas/genética , Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Análise da Randomização Mendeliana , Polimorfismo de Nucleotídeo Único , Proteoma/genética , Fatores de Risco , Acidente Vascular Cerebral/genéticaRESUMO
Between 7 and 25 May, 86 monkeypox cases were confirmed in the United Kingdom (UK). Only one case is known to have travelled to a monkeypox virus (MPXV) endemic country. Seventy-nine cases with information were male and 66 reported being gay, bisexual, or other men who have sex with men. This is the first reported sustained MPXV transmission in the UK, with human-to-human transmission through close contacts, including in sexual networks. Improving case ascertainment and onward-transmission preventive measures are ongoing.