Monkeypox

Monkeypox is a rare infectious disease caused by the monkeypox virus. Other diseases in the same family include variola virus (which causes smallpox), vaccinia virus and cowpox virus.

Monkeypox occurs in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions. Whilst the natural reservoir of monkeypox virus remains unknown, it is mainly spread by African rodents, such as rats, mice, and squirrels. The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC). Since then, according to the World Health Organization, cases have been reported in Benin, Cameroon, Central African Republic, Cote d’Ivoire, Gabon, Liberia, Nigeria, Republic of the Congo, Sierra Leone and South Sudan. DRC and Nigeria are the countries currently reporting the largest number of monkeypox cases annually. The true burden of monkeypox is not known.

In 2003 the USA reported a monkeypox outbreak related to close contact with pet prairie dogs infected by imported African rodents. All cases made a fully recovery.

Travel-related monkeypox cases have been reported in the United Kingdom (UK) in previous years, including in 2021, when a case of monkeypox was identified in an individual who previously travelled from Nigeria. Two family members were subsequently identified as having monkeypox

In 2022, clusters of monkeypox have been identified in several countries where the disease is not regularly found, including the UK. A notable portion of cases in this international outbreak have been detected in gay, bisexual and other men who have sex with men (GBMSM), though not exclusively.

Monkeypox can be transmitted when a person comes into close contact with an infected animal (rodents are believed to be the primary animal reservoir for human transmission), human or with contaminated material. The virus enters the body through broken skin (even if not visible), the respiratory tract or the mucous membranes (eyes, nose, or mouth). The virus does not usually spread easily between people, but 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, towels or utensils. Person-to-person contact can also occur through direct contact with monkeypox skin lesions or scabs or coughing/sneezing of an individual with a monkeypox rash.

The incubation period for monkeypox is between five and 21 days. Symptoms usually begin with fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. Within one to five days after the appearance of fever, a rash develops, often on the face and spreading to other parts of the body. The rash goes through different stages and ends with a scab that later falls off. An individual is contagious until all the scabs fall off and the skin underneath is intact. Scabs may also be infectious.

Monkeypox is usually a self-limiting illness with mild symptoms; most people recover, within several weeks, without treatment. However, severe illness, which can be fatal, can occur in some individuals. Treatment for monkeypox is mainly supportive.

Check our Country Information pages for destination specific news and outbreaks.

Prevention

All travellers to areas where monkeypox is known or presumed to occur should:

  • avoid contact with respiratory secretions or skin lesions of an infected person
  • avoid contact with personal items belonging to individuals that have symptoms (clothes, bedding, or medical equipment)
  • avoid contact with animals, especially rodents
  • do not eat, cook or prepare any type of raw or wild meat (bushmeat) or any meat from unknown sources

Aid workers and health professionals planning to undertake humanitarian work in areas where outbreaks or isolated monkeypox cases are reported should seek advice and training from their employer/organisation, prior to travel.  A licensed vaccine is available in some countries for the prevention of monkeypox and may be considered in some circumstances as a potential post-exposure option.

Most travellers are at very low risk of infection and the risk to the UK population remains low.

Travel to a monkeypox affected area may affect travel health insurance options. Travellers should discuss their plans with their travel insurance provider before they go. UK travellers experiencing symptoms abroad should seek local medical advice as soon as possible.

Travellers who become unwell after returning to the UK should contact their GP for advice or call NHS111. It is important that returning travellers provide full details of any recent travel, so that appropriate measures and testing can be carried out.

More detailed information is available from the UKHSA Monkeypox webpages.