Monkeypox

Monkeypox is a rare infectious disease, but there are a number of cases in the UK. That number is rising.

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

The virus can spread if there is close contact between people and the risk to the UK population is low. However, recent cases are predominantly in gay, bisexual and other men who have sex with men and as the virus spreads through close contact, we are advising these groups to be alert to any unusual rashes or lesions on any part of their body, especially their genitalia, and to contact a sexual health service if they have concerns.

Symptoms

• Unusual rashes or lesions on the body such as the face or genital area
• Fever
• Muscle aches
• Chills and exhaustion
• Headaches
• Swollen lymph nodes

A rash usually appears 1 to 5 days after the first symptoms. The rash often begins on the face, then spreads to other parts of the body.

The rash is sometimes confused with chickenpox. It starts as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs which later fall off.

The symptoms usually clear up in 2 to 4 weeks.

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 is the duration/time between contact with the infected person and the time that the first symptoms appear. The incubation period for monkeypox is between 5 and 21 days.

How is monkeypox spread?

Monkeypox can spread if there is close contact between people

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 is very uncommon, but may occur through:

• contact with clothing or linens (such as bedding or towels) used by an infected person
• direct contact with monkeypox skin lesions or scabs
• coughing or sneezing of an individual with a monkeypox rash

Is monkeypox spread by sex?

Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. It can also be passed on through other close contact with a person who has monkeypox or contact with clothing or linens used by a person who has monkeypox.

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.

What is the death rate for monkeypox?

The disease caused by monkeypox is usually mild and most of those infected will recover within a few weeks without treatment. However, severe illness can occur in some individuals and those with underlying conditions such as severe immunosuppression.

There are different strains of monkeypox virus in different parts of Africa. The cases confirmed recently in England have been a strain found in West Africa, which is known to be associated with less severe disease. No fatal cases occurred in an outbreak of monkeypox in the USA in 2003 which came from West Africa. 

Is there a vaccine available for monkeypox and will you be offering it to people?

There isn’t a specific vaccine for monkeypox, but vaccinia (smallpox) vaccine does offer some protection. Some individuals with higher level of exposures are being offered this smallpox vaccine. We have pro-actively procured further doses of these vaccines.

Could you have picked this up sooner?

As soon as the cases presented themselves to healthcare settings they were triaged and clinically assessed by trained healthcare staff. Due to the rare nature of the virus, monkeypox was not an immediate consideration in all cases. However, once monkeypox was suspected, each of the cases was immediately isolated and tested, and the results of those tests very quickly confirmed the diagnoses. As soon as these cases were confirmed, local Health Protection Teams were alerted and contact tracing and isolation of anyone suspected to be in recent close contact with the infected individuals quickly got underway.

Does this mean monkeypox is circulating undetected in the population?

Monkeypox remains very rare in the UK. In the majority of previous cases, there were links to countries where the disease is more common. There are currently no known links to recent travel for these recent cases and so we are rapidly investigating where and when transmission may have taken place. We closely monitor the prevalence of all infectious diseases and the risk of community transmission of monkeypox in the UK remains extremely low. 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.  Detailed contact tracing is ongoing for follow-up of individuals who have come into contact with these cases.

How many cases do you think could be going undetected - have you done any modelling?

UKHSA and academic partners will be developing an assessment of potential undiagnosed cases, or cases in the community and considering a range of scenarios. We have robust contact tracing procedures in place to ensure we follow up with anyone who has been in close contact with the infected individuals so we can pick up any additional cases as soon as possible. 

Can Monkeypox cases be asymptomatic and if this is possible, can they still spread the virus? ​​​​​​​

Previous asymptomatic infection has been in those with low-level exposure to infected animals in Africa. Person to person transmission of monkeypox is rare and there is no animal reservoir of infection in the UK for this to occur. 

What should people do if they are concerned?

The risk of monkeypox is very low to the UK public. Please speak to your local healthcare provider if you have concerns, or NHS 111 if you need urgent advice.

ahead of your visit and avoid close contact with others until you have been seen by a clinician. Your call or discussion will be treated sensitively and confidentially.

What should someone do if they suspect they have monkeypox?

You can help slow the spread of the outbreak. If you think you have Monkeypox symptoms – however mild:

• Contact NHS 111 or call a sexual health clinic immediately. Your call will be treated sensitively and confidentially.
• Avoid close personal or sexual contact with others until you know that this is not monkeypox.

Please contact clinics ahead of your visit and avoid close contact with others until you have been seen by a clinician. Your call or discussion will be treated sensitively and confidentially