Four more cases of monkeypox have been identified in the UK, bringing the total number of confirmed cases of the disease to seven, health bosses have said. Three of the cases were detected in London, and one in the north-east of England, the UK Health Security Agency (UKHSA) announced on Monday. It is working to find links between the latest four cases, which all appear to have been contracted in the capital. Common contacts have been established between two of the four people who have caught the virus. Those needing care are being treated in specialist infectious disease units at the Royal free hospital and Guy’s and St Thomas’ in London, and the Royal Victoria infirmary in Newcastle upon Tyne. The cases do not, however, seem to be connected to the previous confirmed cases of monkeypox in the UK announced on 14 May, nor the first UK case announced on 7 May, which has led to concerns that there has been community transmission of the virus. The first case was a person who had recently travelled to Nigeria, which is where they are believed to have contracted the infection before travelling to the UK. UKHSA added that all four of the most recent cases are men who identify as gay or bisexual. The health body is therefore asking these groups “to be alert” to possible symptoms, which include rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service if they have concerns. Due to the recent rise in case numbers and uncertainties about how the infections were transmitted, UKHSA has said it is working closely with NHS partners to establish whether there have been any more cases in recent weeks, and with international partners to examine whether other countries have seen a similar rise in monkeypox. The health agency emphasises that the virus does not spread easily between people and that the risk to the UK population is low. Dr Susan Hopkins, chief medical adviser at the UKHSA, said: “This is rare and unusual. UKHSA is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact. “We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay. We are contacting any potential close contacts of the cases to provide health information and advice.” The rash, which can develop as part of the virus, changes and goes through different stages before finally forming a scab, which later falls off. The health agency also said that initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.