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Health bosses have issued a fresh warning against mpox, urging those eligible to get vaccinated against the 'unpleasant and painful' infection. The UK Health Security Agency (UKHSA) says it is aware of a small numbers of cases of 'clade Ib' mpox , formerly known as monkeypox, in Spain, Italy, Portugal and the Netherlands, as well as the US. It warned the locally-acquired cases "have no connection to countries with known clade Ib mpox transmission." Mpox is usually a mild infection but it can be severe. The UKHSA has said getting vaccinated is the best protection . Dr Katy Sinka, Head of Sexually Transmitted Infections at UKHSA: "The ways in which we are seeing mpox continue to spread globally is a reminder to come forward for the vaccine, if you are eligible. "Although mpox infection is mild for many, it can be severe. "Getting vaccinated is a proven effective way to protect yourself against severe disease, so please make sure to get the jab if you are eligible. "It is important to remain alert to the risks from this unpleasant illness. Anyone who thinks they may have mpox should contact NHS 111 for advice on what to do." The UK has a routine mpox vaccination programme in place for eligible groups, including those who: The infection is most commonly found in parts of central and east Africa, but a global outbreak in 2022 caused cases to spike across the globe. The UKHSA warns that most of the new mpox cases identified in Europe and the USA have been in gay, bisexual and other men who have sex with men - a population in which 'clade Ib' mpox transmission has not previously been seen. Richard Angell OBE, Chief Executive, Terrence Higgins Trust said: "The last outbreak of mpox hit the gay, bi and other men who have sex with men community disproportionately hard. "While it is described as ‘mild’, those who have the mpox rash around their face and body, including in intimate and sensitive areas, will tell you how unpleasant and painful it is. "In 2022, we were not prepared for the MPOX outbreak and the tools available were hard to mobilise – this time we have a government-funded vaccine programme available to gay and bi men and it is strongly encouraged for those who have multiple partners, take part in sex parties or visit sex on premises venues. "With Winter Pride season soon upon us across Europe, those travelling to these events would be wise to get vaccinated, at least once, if not twice. Those who have had 2 mpox jabs should have protection. Anyone experiencing a rash after sex should seek out a sexual health clinic or call THT Direct on 0808 802 1221." Common symptoms of mpox include a skin rash or pus-filled lesions which can last 2 to 4 weeks. It can also cause fever, headaches, muscle aches, back pain, low energy and swollen lymph nodes. Prof Matt Phillips, President of the British Association for Sexual Health and HIV said: "We encourage anyone who is eligible for the vaccine against mpox to talk to their local sexual health clinic and arrange to be vaccinated. "These cases are a reminder both that mpox has not gone away, and of the importance of vaccine programmes in reducing the impact of mpox infection."