British scientists warned monkeypox would fill the void left by smallpox three years ago

A group of leading British scientists warned three years ago that Monkeypox would fill the void left behind by smallpox, The Telegraph can reveal.

Two dozen experts met at the Chatham House think tank’s headquarters in London in June 2019, including academics from the University of Cambridge, UCL and the London School of Tropical Hygiene and Medicine, as well as experts from the Ministry of Defence and Public Health England (now the UK Health Security Agency, or UKHSA).

At the impromptu seminar they discussed how monkeypox may “fill the ecological niche” left behind by smallpox — which was eradicated in 1980 — and that there is a need to develop “new generation vaccines and treatments”.

Alongside the elite British minds, which featured distinguished professors and SAGE advisers, were industry figures and international experts from four other nations, and the illustrious guestlist made up an “ad hoc and unofficial group of interested experts”.

The academics wrote their conclusions in a paper, published in 2020 in the journal Vaccine, and warned that fewer than one in three people are now protected against smallpox, and by association, monkeypox, as Britain's vaccination programmes were stopped in 1971. As a result, the population immunity against all pox viruses has dwindled to a diminutive level.

The smallpox vaccine was a live virus that often had side-effects. Now, a new vaccine is available that contains a non-replicating virus and is much better tolerated and offers around 85 per cent protection against monkeypox.

Since May 6, 20 cases of monkeypox have been identified in the UK, predominantly among gay and bisexual men. One of the 20 cases is reportedly a young child who is in intensive care in a London hospital.

In a prescient foreshadowing of what is unfolding currently, the 2019 paper said: “With the cessation of widespread smallpox vaccination, increased study of the monkeypox virus, the human disease it causes, and its epidemiology are important.

“Monkeypox has been viewed as ‘just another neglected disease’,” they said. “Global travel and easy access to remote and potentially monkeypox-endemic regions are a cause for increasing global vigilance.”

They added that “monkeypox might fill the epidemiological niche vacated by smallpox”.

This niche is one humanity would prefer to remain empty as smallpox claimed more than 300 million lives in the 20th century alone, killed up to 50 per cent of those infected, and was called “one of the most devastating diseases known to humanity” by the World Health Organization (WHO).

Four of the paper’s authors work for a German company called Bavarian Nordic, which manufactured the modern smallpox vaccine. It is known as Jynneos in the US and Imvanex is its UK moniker.

Britain has its own stockpile of the vaccine and it is being offered to the close contacts of confirmed cases, as it can reduce symptoms if administered within four days of exposure.

Prof David Heymann, a co-author of the paper and professor of infectious disease epidemiology at LSHTM, as well as a former chair of the Health Protection Agency at PHE and ex-WHO chief, told The Telegraph: “Three years ago, there was a meeting at Chatham House, which we convened to look at monkeypox.

“The vaccine Bavaria Nordic has is the only vaccine that has been licensed for use in people to prevent monkeypox. So there is a vaccine. And there are also antiviral drugs.

“If the vaccine is not available in sufficient quantities, then what might happen is that there would be prophylaxis of contacts with an antiviral drug in order to try to stop this virus from just continuing to spread.”