Info

Monkeypox

If you find a new unexplained rash or lesion you should contact your GP, sexual health clinic or call 111 and advise they are concerned about monkeypox. If you have come into close contact with people with a new rash or lesion you should do the same. Check the NHS website for further information Monkeypox - NHS (www.nhs.uk)

You should not attend a walk-in service if you have a rash or lesion unless asked to attend an appointment [please note: some clinics have closed these facilities already and introducing the measures we saw during COVID].

If you have HIV, BHIVA provide information: https://www.bhiva.org/BHIVA-rapid-statement-on-monkeypox-virus and our colleagues at the Brotherton Wing HIV clinic (Leeds Teaching Hospital Trust & Leeds Sexual Health) provide information on their website too: https://www.leedsth.nhs.uk/a-z-of-services/hiv-outpatient-service/

This Twitter thread may be helpful to you too: https://twitter.com/teozka/status/1526505294083276800?s=20&t=Or-pocblec8mMwZdC3CHgQ

For more information on HIV prevention, click here:

What is Monkeypox?

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

Monkeypox can be caught from infected wild animals in parts of west and central Africa. It's thought to be spread by rodents, such as rats, mice and squirrels.

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 that has not been cooked thoroughly, or by touching other products from infected animals (such as animal skin or fur).

Monkeypox 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 lesions or scabs, particularly if your own skin has sores or cuts
the coughs or sneezes of a person with the monkeypox rash

What are the 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
backache
swollen glands
shivering (chills)
exhaustion

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 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?

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.

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.

If someone was to die of monkeypox – would that be the first death of monkeypox in the UK?

Yes.