Four cases of monkeypox have now been confirmed in England, the UK Health Security Agency (UKHSA) has said.

However, it said there is a ‘very low risk of transmission’ to the general public.

UKHSA announced on yesterday that four further individuals have been diagnosed with monkeypox in London and north-east England, after a two case was confirmed earlier this month.

‘Where and how’ the two new cases acquired their infection ‘remains under investigation’, although they live together in the same household and ‘are not linked to the previous confirmed case’, it said.

One of the new cases is receiving care at the expert infectious disease unit at St Mary’s Hospital, Imperial College Healthcare NHS Trust in London, while the other is isolating and ‘does not currently require hospital treatment’, it added.

UKHSA said: ‘Monkeypox is a rare viral infection that does not spread easily between people. It is usually a mild self-limiting illness and most people recover within a few weeks. However, severe illness can occur in some people.

‘The infection can be spread when someone is in close contact with an infected person, however, there is a very low risk of transmission to the general population.’

It added that UKHSA is ‘working closely’ with the infected individuals and the NHS and will contact people who might have been in close contact to provide ‘information and health advice’ as a ‘precautionary measure’.

It said: ‘People without symptoms are not considered infectious but, as a precaution, those who have been in close proximity to the individuals are being contacted to ensure that, if they do become unwell, they can be treated quickly.’

UKHSA director of clinical and emerging infections Dr Colin Brown added: ‘While investigations remain ongoing to determine the source of infection, it is important to emphasise it does not spread easily between people and requires close personal contact with an infected symptomatic person. The overall risk to the general public remains very low.

‘UKHSA and the NHS have well established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed.’

UKHSA announced on 7 May that it had confirmed a case of monkeypox in England, with the patient believed to have contracted the infection in Nigeria where they had recently travelled from to the UK.

It comes as UKHSA is also investigating an unexplained rise in child hepatitis, where the evidence ‘increasingly’ suggests that adenoviruses are behind the recent increase.