PUBLIC health experts are aiming to vaccinate around 6,500 people in Scotland against monkeypox as supplies of the jag increase.

A total of 69 cases of the disease - which can occasionally be fatal - have been identified in Scotland since the end of May, including in one woman, but there is currently no evidence of community transmission.

Public Health Scotland said "most if not all" infections so far identified in Scotland have been found in gay, bisexual and men who have sex with men (MSM) who had recently returned from abroad or travelled to London.

Cases have been concentrated mostly in Glasgow, Edinburgh and other urban centres, but every health board in Scotland has reported at least one case.

Dr Nick Phin, director of health protection at Public Health Scotland, said 3000 doses of vaccine had been distributed to health boards across Scotland, but stressed that shortages of supply globally mean that those at highest risk of exposure are being prioritised.

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Since July 14, 700-800 people in Scotland have been vaccinated, said Dr Phin, with PHS currently projecting that around 6000-6,500 people in Scotland will be targeted for inoculation once the UK receives its next supply of 100,000 doses in September - enabling the rollout to accelerate.

It comes after Euan McLeod, executive director of the LGBT Co-op, said some Scots were travelling to London to get the vaccine, and criticised a "lack of information" on monkeypox.

Dr Phin said: "There's a case of thinking you're at high risk, and being at high risk.

"The health boards are each taking a slightly different approach but by and large they are identifying people at high risk when they present [at GUM sexual health clinics] or by looking back through the records and then asking these individuals to come in.

"My advice would be, to wait until such time as you are invited or attend clinics for some other reason and are then offered.

"We are targeting the highest risk first because there is limited global supply and we are trying to be most effective."

Healthcare workers who may be caring for individuals with monkeypox are also being prioritised. 

Dr Phin said there had been a "mixed response" in terms of vaccine uptake among those offered it to date, but added that cases "seem to have plateaued". 

He said: "They seem to be slowing down. It's too early to say whether that's a consequence of vaccination, or of greater awareness."

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In July, the World Health Organisation escalated monkeypox to a public health emergency of international concern, with over 21,000 cases detected globally including around 5000 in the US and 4,600 in Spain.

The UK and Germany have similar number of known cases, at just under 3000. 

The high level alarm has previously been used for Covid-19, as well as outbreaks of polio, Ebola, Zika virus and H1N1 swine flu. 

Although most people will recover from the infection without treatment, the WHO estimates that the case fatality rate for the disease is aroud 3-6%.

However, the vaccine - known as Imvanex in Europe, and originally developed for smallpox - is highly protective.

Dr Phin said it should prevent around 98-99% of monkeypox infections. 

Its sole manufacturer, Danish pharmaceutical firm Bavarian Nordic, has had to ramp up production to respond to a sudden spike in demand worldwide. 

Previously, the UK had only a small stockpile reserved to respond to potential smallpox outbreaks or sporadic cases of monkeypox, typically associated with travel to Africa.

Monkeypox symptoms usually start within three weeks of exposure to the virus.

Some people will experience flu-like symptoms such as fever, chills, sore throat or exhaustion first, before developing a rash around their genitals, bottom, hands, feet, chest or mouth, which is initially characterised by painful or itchy blisters. 

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Infected individuals are contagious from the time of symptom onset until the blisters have scabbed over, fallen off and the skin healed. 

It can be spread by skin-to-skin contact, and by sharing towels and bed linen. 

Public health teams are advising people worried about their risk to reduce their sexual partners, take the vaccine when offered, and engage with contact tracing if found to be infected.

They also caution that using condoms does not provide any protection against monkeypox. 

The first known human case of the disease was discovered in 1970 in the Democratic Republic of Congo.

Since then, outbreaks have been contained and limited to around a dozen African countries.

Dr Phin said the disease had probably been spreading for weeks in Europe before a link was made with monkeypox.

He said: "The only thing that's changed is that it was missed. People were presenting with symptoms that now we'd recognise as monkeypox, but at the time were not being recognised as such.

"The UK was one of the first countries in the world to identify it, but there was a query from Portugal saying 'we're seeing this unusual syndrome, can anyone make suggestions as to what it might be?'.

"To which the immediate response from the UK was 'have you tested for monkeypox?' - and it was found out that it was monkeypox.

"So this has been circulating in Europe probably for several weeks, maybe months, undetected - what we're now seeing is that we've become aware of it, we're picking up, and hopefully it's like tendrils of a jellyfish where we're cutting them off one by one and minimising further spread, but it will take time.

"The virus has had a bit of a head start, because it's been circulating unnoticed, but now that we're aware of it we have the opportunity to try and stop it."