Monkeypox

What is it?

The monkeypox virus, is an orthopoxvirus. It was first discovered in 1958 and occurs mainly in tropical rainforest areas of Central and West Africa thought to be spread by infected wild animals including rats, mice, monkeys and squirrels.

What are the symptoms?

The most common symptoms of monkeypox, include:

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

The rash starts on the face one to five days after the first symptoms, and spreads to other parts of the body before forming a scab which then falls off. 

The disease 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.

How does it spread?

The virus can spread if there is close contact between people through:

• touching clothing, bedding or towels used by someone with the monkeypox rash
• touching monkeypox skin blisters or scabs
• the coughs or sneezes of a person with the monkeypox rash

What do I do if I get it?

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

How is it treated?

Treatment for monkeypox is mainly supportive. The illness is usually mild and most of those infected will recover within a few weeks without treatment.

Smallpox vaccine, cidofovir, and tecovirimat can be used to control outbreaks of monkeypox.

Vaccination against smallpox can be used for both pre and post-exposure and is up to 85% effective in preventing monkeypox. People vaccinated against smallpox in childhood may experience a milder disease.

The NHS is contacting people at the highest risk of exposure to monkeypox to come forward for vaccination. Find out more information about the vaccination process.

What if I can’t get help?

Contact Customer Service at London Borough of Lewisham so we can find a way to best help you.

Does it impact one group more than another?

As recent cases have been predominantly in gay, bisexual or other men who have sex with men, local authorities are working with sexual health services to ensure a level of heightened awareness and to encourage them to look out for symptoms. This does not mean it only impacts this cohort of people. 

Where can I find out more information?

Anyone with concerns that they could be infected should see a health professional but make contact with the clinic or surgery ahead of a visit. NHS 111 can also give advice.

Frequently Asked Questions

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.

How concerned are you about this? Is the risk to the public really low?

This is a rare and unusual situation. 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.

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

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.

Gay, bisexual and other men who have sex with men (MSM)  

Why have they specified the sexuality of the cases?

The most recent cases are predominantly in gay, bisexual, and other men who have sex with men. They have no travel links to a country where monkeypox is endemic, so it is possible they acquired the infection through community transmission. As the virus spreads through close contact, we are asking these groups to be alert to any unusual rashes or lesions on any part of their body and to contact a sexual health service if they have concerns.

What is being done to inform people of the risks of this disease now it appears to be spreading more widely?

The UK Health Security Agency are urging men in gay, bisexual and other men who have sex with men to be aware of any unusual rashes or lesions and contact a sexual health service without delay. 

UKHSA 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.

Do condoms prevent you catching or passing on monkeypox?

We always encourage use of condoms to prevent STIs. Monkeypox is not a sexually transmitted infection by nature, though it can be passed on by direct contact during sex.

Contagious lesions, through which infections are most likely to be passed on, can appear on any part of the body so condoms will not necessarily prevent transmission of the virus between two people who are in direct contact. The infection can also be passed on through contact with clothing or linens used by an infected person.