Monkeypox

You may have heard about monkeypox in the news recently. But what is it, what are the symptoms and how can you access help and information?

Monkeypox is a rare infectious viral disease usually associated with travel to West Africa. It is generally a mild self-limiting illness, spread by very close contact with someone with monkeypox and most people recover within a few weeks.

Monkeypox can affect anyone. It can be passed on through close physical contact like kissing, skin-to-skin or sharing things like clothing, bedding and towels. Although more people have been diagnosed with it recently, only a small number of people in the UK have had monkeypox and the risk remains low. However we ask that people stay alert to any new rashes or lesions on any part of their body. Although this advice applies to everyone, the majority of monkeypox cases in the UK continue to be in gay, bisexual and other men who have sex with men (MSM), with the infection being passed on mainly through close contact between people in interconnected sexual networks. We therefore advise this group in particular to be aware of the symptoms, especially if they have recently had a new sexual partner.

If you have symptoms of monkeypox please phone a sexual health service or call NHS 111. You must call ahead before your visit.

How do you reduce your risk of getting monkeypox?
  • wash your hands with soap and water regularly or use an alcohol-based hand sanitiser
  • only eat meat that has been cooked thoroughly
  • do not go near wild or stray animals, including dead animals
  • do not go near any animals that appear unwell
  • do not eat or touch meat from wild animals (bush meat)
  • do not share bedding or towels with people who are unwell and may have monkeypox
  • do not have close contact with people who are unwell and may have monkeypox
What are the symptoms of monkeypox?

If you test positive for monkeypox, it usually takes between five and 21 days for the first symptoms to appear. These include:

  • unusual rashes or blisters on the body, including mouth, genitals and anus. Some get just one
    spot.
  • a high temperature
  • a headache
  • muscle aches
  • backache
  • swollen glands
  • shivering (chills)
  • exhaustion
  • proctitis (anal or rectal pain or bleeding)
When should I take action?

Please contact a sexual health clinic if you have a rash with blisters and you’ve been either:

  • in close contact, including sexual contact, with someone who has or might have monkeypox (even if they’ve not been tested yet) in the past 3 weeks
  • to West or Central Africa in the past 3 weeks

Make sure you contact the sexual health clinic before your visit. Tell the person you speak to if you’ve had close contact with someone who has or might have monkeypox, or if you’ve recently travelled to Central or West Africa.

Do not go to a sexual health clinic without contacting them first. Stay at home and avoid close contact with other people until you’ve been told what to do.

If you are not able to contact a sexual health clinic you should call NHS 111.

What should people do if they are concerned?

The risk of monkeypox is low to the UK public. Contact a sexual health clinic or NHS 111 if you need urgent advice.

How can the virus be passed on?

Spread of monkeypox may occur when a person comes into contact with an animal, human, or
materials contaminated with the virus. The virus enters the body through broken skin (even if not
visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth).

Person-to-person spread may occur through:

  • contact with clothing or linens (such as bedding or towels) used by someone with monkeypox
  • direct contact with monkeypox skin lesions or scabs
  • coughing or sneezing of an individual with a monkeypox rash
What do people who are identified as close contacts need to do?

Anyone identified as a close contact of an infected individual will be contacted by the relevant teams. If anyone is concerned they may have been in contact with someone displaying monkeypox symptoms, they should call NHS 111 if they need urgent advice.

Who will be carrying out the contact tracing?

The UK Health Security Agency is contacting any potential close contacts in the community. They are also working with the NHS to reach any healthcare contacts who have had close contact with the cases prior to confirmation of their infection, to assess them as necessary and provide advice.

What is the incubation period (the time period between exposure to an infection and the appearance of the first symptoms) of monkeypox?

The incubation period for monkeypox is between 5 and 21 days.

Is monkeypox treatable?

Treatment for monkeypox is mainly supportive, but newer antivirals may be used. The illness is usually mild and most of those infected will recover within a few weeks without treatment. High-quality medical and nursing supportive care will be provided to individuals to manage symptoms.

Do the UK Health Security Agency have a vaccination strategy for monkeypox?

A vaccine strategy has been launched to vaccinate and protect those who are more likely to get monkeypox.

At this time, a vaccine is being offered only to those who are at a higher risk of having very close or frequent contact with someone with monkeypox.

Although anyone can get monkeypox, the large majority of cases in the UK at the moment are in gay, bisexual and other men who have sex with men, with the infection being passed on through close contact between people in interconnected networks. By offering the vaccine to individuals who are more likely to get the infection, we will help prevent infection and limit transmission of the virus.

Monkeypox vaccination strategy.

 

Who will the vaccine be offered to?

The UK Health Security Agency currently recommends that the vaccine is offered to:

  • healthcare workers who are caring for and who are due to start caring for a patient with confirmed monkeypox. This includes some staff in sexual health clinics who are assessing any suspected cases.
  • Some GBMSM who are more likely to get the infection, using criteria similar to those used to assess eligibility for HIV pre-exposure prophylaxis (PrEP), even if someone is already living with HIV. These criteria would include a recent history of multiple partners, participating in group sex, attending sex on premises venues or a proxy marker such as recent bacterial STI (in the past year).
  • People who have already had close contact with a confirmed monkeypox case. Vaccination with a single dose of vaccine should be offered as soon as possible, ideally within 4 days of contact but may be offered up to 14 days in those at ongoing risk, or those who are at higher risk of the complications of monkeypox.
Why can’t everyone who wants a vaccine have one?

The NHS will follow UK Health Security Agency guidance on prioritising those at greatest risk.

How will people be able to get a vaccine?

The NHS is working with local partners to make sure current vaccine supply is in the right place for those who need to access it most.  Soon, local services will be contacting people who are eligible for a vaccination as well as offering protection to those at regular clinics and health appointments.

How concerned are the UK Health Security Agency about this? Is the risk to the public really low?

This is a rare and unusual situation. The UK Health Security Agency is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, passed on by close contact. Monkeypox remains rare in the UK and the risk to the general public remains low. The UK Health Security Agency 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.

Are children more at risk?

Monkeypox is usually a mild self-limiting illness and most people recover within a few weeks. However, severe illness can occur in some people. As with many infectious diseases, the young, pregnant women, the elderly and those who are immuno compromised can be at increased risk of more severe outcomes.

The World Health Organisation website provides more detail on this, based on reports from countries where monkeypox is endemic. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications.

Should children be going to school? What about if a confirmed case has been in an educational setting?

Monkeypox remains rare in the UK and the risk to the general public remains low.

Local health protection teams are working with individuals who have been identified as a confirmed monkeypox case to advise them on what they should do and are managing close contacts/contact tracing.

During the contact tracing process if any settings of interest are identified, such as education or childcare settings, they will also be contacted and provided with expert advice on any actions that are required.

Schools with concerns should contact their local Health Protection Team in the usual way. ​

 

What are the UK Health Security Agency doing to inform people of the risks of this disease now it appears to be spreading more widely?

We are urging anyone with unusual rashes or lesions on any part of their body, especially their genitalia, to immediately contact their local sexual health service. We are contacting any potential close contacts of the cases to provide health information and advice.

The UK Health Security Agency 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.

We continue to engage with partners across the sector to ensure people are aware of the signs and symptoms and what action to take, including working with partners across the sector at pace to deliver training webinars about monkeypox to clinicians to increase knowledge and awareness of this infection, which is unusual in clinical settings in the UK.

For more information please visit nhs.uk or gov.uk for regular updates posted by the UK Health Security Agency.