Last Updated 24/06/2022
Monkeypox is a rare infection that’s mainly found in parts of west or central Africa. There have been some recent cases in the UK, but the risk of catching it is low.
How you get monkeypox
Monkeypox can be caught from infected rodents (such as rats, mice and squirrels) in parts of west and central Africa.
You can catch monkeypox from an infected animal if you’re bitten or you touch its blood, body fluids, spots, blisters or scabs.
It may also be possible to catch monkeypox by eating meat from an infected animal from central or west Africa that has not been cooked thoroughly, or by touching other products from infected animals (such as animal skin or fur).
Monkeypox can also spread from person to person through:
- touching clothing, bedding or towels used by someone with the monkeypox rash
- touching monkeypox skin blisters or scabs (including during sex)
- the coughs or sneezes of a person with the monkeypox rash
Monkeypox in the UK
UKHSA has advised that cases of monkeypox have increased recently but the risk to the UK population remains low.
This is because the virus does not usually spread easily between people. It can be passed on through close person-to-person contact or contact with items used by a person who has monkeypox such as clothes, bedding or utensils. Monkeypox is usually a mild illness and most people recover within a few weeks.
The UK clinical and public health response to monkeypox was initially based on the High Consequence Infectious Disease management (HCID) system in line with guidance from the UKHSA. This was highly precautionary and designed for complete containment around single cases. It was also designed prior to the confirmed availability of vaccine and treatment. UKHSA has confirmed that community transmission is occurring in the UK with multiple generations of spread. Illness appears to be generally mild, consistent with other information about the West African clade. Therefore, UKHSA and the NHS will be adopting a more proportionate response as set out in this letter.
Anyone can get monkeypox. Currently most cases have been in men who are gay, bisexual or have sex with men, so it’s particularly important to be aware of the symptoms if you’re in these groups.
Non-urgent advice: Contact a sexual health clinic if:
You have a rash with blisters and either:
– you’ve been 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
– you’ve been to west or central Africa in the past 3 weeks
Make contact with any medical centre before visiting.
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.
Stay at home and avoid close contact with other people until you’ve been told what to do.
If you have a rash but have not been in close contact with someone who has or might have monkeypox, and you have not been to west or central Africa recently – get advice about your symptoms from 111 online.
Symptoms of monkeypox
If you get infected with monkeypox, it usually takes between 5 and 21 days for the first symptoms to appear.
The first symptoms of monkeypox include:
- a high temperature
- a headache
- muscle aches
- swollen glands
- shivering (chills)
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. This can include the genitals.
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 a few weeks.
Treatment for monkeypox
Monkeypox is usually mild and most people recover within a few weeks without treatment.
But as the infection can spread through close contact, it’s important to isolate if you’re diagnosed with it.
You may be asked to isolate at home if your symptoms are mild.
If your symptoms are severe or you’re at higher risk of getting seriously ill (for example, if you have a weakened immune system), you may need to stay in a specialist hospital until you recover.
You may be offered a vaccination to reduce the risk of getting seriously ill.
Things you can do to avoid getting monkeypox while travelling
Although monkeypox is rare, there are things you can do to reduce your risk of getting it while travelling in west and central Africa.
- wash your hands with soap and water regularly or use an alcohol-based sanitiser
- only eat meat that has been cooked thoroughly
- go near wild or stray animals, including dead animals
- go near any animals that appear unwell
- eat or touch meat from wild animals (bush meat)
- share bedding or towels with people who are unwell and may have monkeypox
- have close contact with people who are unwell and may have monkeypox
Where can I find the latest information about monkeypox?
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?
Imvanex, a smallpox vaccine, is the recommended vaccine for pre- and post-exposure treatment against monkeypox in the UK. Imvanex is approved by the MHRA and the European Medical Agency for the prevention of smallpox and is approved by the FDA for prevention of monkeypox and smallpox in the US. It is a two-dose course.
Who can get a vaccination?
The NHS will follow UKHSA guidance on prioritising those at greatest risk. The UKHSA estimate that the number of those eligible for pre-exposure prophylaxis vaccination is around 100,000 people.
The decision to offer a vaccination will be done on a case by case basis following a discussion between a medical professional and an individual, based on individual circumstances.
Local services will soon be contacting people who are eligible for a vaccination. Please do not contact any health service to request a vaccination against monkeypox.
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.
Why is the sexuality of the cases specified?
Whilst anyone can contract monkeypox, a notable proportion of recent cases are 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, these groups should 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. Close contacts of cases will be contacted to provide health information and advice.
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 the 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.
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’s the testing process? Does it get sent to labs like the COVID tests?
Monkeypox testing is carried out at the UKHSA specialist Rare and Imported Pathogens Laboratory (RIPL).
How long do close contacts need to isolate for?
Contacts are categorised by tracing teams following verbal assessment based on their level of contact with the infected individual and the likelihood that they may have contracted the infection. The maximum isolation period for the highest category of contact is 21 days from the point they interacted with the infected individual. However, isolation advice is given on a case-by-case basis depending on the specific exposure circumstances of that individual so will differ among different contacts.