09 Aug 2022

Monkeypox: clusters reported internationally

Multiple countries report cases of monkeypox Monkeypox: clusters reported internationally
  • This updates the news item of 29 July 2022

On 23 July 2022, WHO declared the multi-country monkeypox outbreak a Public Health Emergency of International Concern (PHEIC). WHO advise that individuals with confirmed, probable or suspected monkeypox or signs and symptoms of infection, and all contacts of monkeypox cases, should avoid undertaking any international travel, until they no longer constitute a public health risk [1].  UK advice on international travel for contacts of monkeypox cases can be found on GOV.UK. 

Travellers developing symptoms overseas, or who are considered a close contact of someone with monkeypox, may be required to self-isolate, be hospitalised or put into government quarantine (see ‘advice for travellers’ below).  

As the current international outbreak continues to be reported in an increasing number of countries, the Outbreak Surveillance page will no longer be updated to include first cases of monkeypox in a country. The World Health Organization (WHO) Emergency Dashboard provides the latest daily data on total cases and deaths of monkeypox globally, as well as details of other global health events and emergencies. Regular updates on the current monkeypox outbreak in the UK are available from the UK Health Security Agency (UKHSA) [2].

Monkeypox is a rare infectious disease caused by the monkeypox virus. Other diseases in the same family include variola virus (causing smallpox), vaccinia virus and cowpox virus. Monkeypox can be transmitted when a person comes into close contact with an infected animal, human or contaminated material. The virus does not usually spread easily between people, but it can be passed on through:

  • direct contact with monkeypox skin lesions or scabs  
  • the respiratory tract or mucous membranes (eyes, nose or mouth) from coughing/sneezing of an individual with a monkeypox rash
  • contact with items used by a person who has monkeypox, such as clothes and bedding [3]. 

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 [2]. Monkeypox cases continue to rise, with the virus being passed on predominantly in interconnected sexual networks. Most travellers are at very low risk of infection and the risk to the UK population remains low [2].

Advice for travellers

Although the risk of monkeypox is very low for most travellers, you can reduce your risk while travelling by taking the following steps: 

  • Avoid contact (including sexual contact) with anyone who is unwell or has an unusual rash and practise good hygiene before and after sex. Talk to sexual partners about their sexual health and any symptoms they may have.
  • Before you have sex, go to a party or event, check yourself for monkeypox symptoms, including rashes and blisters. If you have monkeypox symptoms, take a break from attending events or sex until you’ve been assessed by a clinician.
  • It can take up to 3 weeks for symptoms to appear after being in contact with someone with monkeypox, so stay alert for symptoms after you have skin to skin or sexual contact with someone new.
  • Everyone is encouraged to ensure they exchange contact details with sexual partners, to help limit further transmission where cases occur.
  • Avoid touching contaminated items such as bedding/clothing or sharing eating utensils/cups, food or drink with a person who has, or may have, monkeypox.
  • Wash hands often with soap and water or an alcohol-based hand sanitiser containing at least 60% alcohol. Keep your hands away from your eyes, nose, and mouth. If you need to touch your face, make sure your hands are clean.
  • Avoid animals when traveling.
  • For advice for people with HIV, see the British HIV Association (BHIVA) statement on monkeypox virus

If you are concerned about monkeypox or if you notice a rash, blisters or lesions, or other symptoms, particularly if you have recently had a new sexual partner:

  • limit your contact with other people
  • get medical advice locally if you are abroad. Call ahead before going to a healthcare facility. If you are not able to call ahead, tell a staff member as soon as you arrive that you are concerned about monkeypox
  • check with a health professional that you are fit to travel
  • If you are diagnosed with monkeypox you should not have sex while symptomatic and while lesions are present. Use condoms for 12 weeks after infection. This is a precaution to reduce the risk of spreading the virus to a partner. 

If you develop monkeypox or suspected monkeypox overseas, you should follow local public health advice. You may be required to self-isolate, or you may be hospitalised or put into a quarantine facility until you are no longer considered to be infectious to other people. While the infection is mild for many, it can cause severe symptoms and hospitalisation in some. 

Check your travel health insurance cover before you go.

If you develop symptoms on return to the UK, seek medical advice by telephone, see current NHS guidance

The NHS is offering smallpox vaccination to people who are most likely to be exposed to monkeypox. This includes some healthcare workers, some men who are gay, bisexual or have sex with other men, people who have been in close contact with someone who has monkeypox.


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