Monkeypox – sometimes known as mpox - is a relatively rare disease that entered common public knowledge in 2022, as an outbreak spread within Europe including the UK. Cases are normally restricted to western and central Africa, usually causing only a mild illness.
Monkeypox is a virus from the same virus family as smallpox, a devastating condition that has been defeated worldwide but it is very different from the COVID-19 or chickenpox viruses. It is called monkeypox because it was first discovered in monkeys in 1958. It then took 10 years for the first cases to be recorded in humans, and the most likely transmission is still from animals to humans, rather than human-to-human.
There are two strains, one from western Africa and one from central Africa. The cases in Europe are the western African strain, which causes a milder illness. It's important to emphasise that only a small number of cases have reached Europe, and people are not severely unwell, but scientists are investigating why it seems to be spreading more quickly from human to human than previously.
One working theory is that now that COVID-19 restrictions have been lifted, people are travelling more, but have lost some natural immunity to fight viruses during the prolonged period of lockdowns and mask-wearing.
Like other viruses such as swine flu and COVID-19, it is possible for certain viruses to move from animals to humans. Monkeys don't seem to get unwell from mpox.
The virus enters the body through broken skin, the respiratory tract or mucous membranes (the eyes, nose, mouth and genitals). Humans can catch it from animals by a bite or scratch, bush meat preparation, direct contact with body fluids, or indirect contact via contaminated clothes or bedding. Recent cases in the UK have mainly been linked to men who are gay or bisexual.
Similar to flu viruses, human-to-human transmission of mpox is thought to occur primarily through respiratory droplets - you would need to be face-to-face and for a prolonged period - and these droplets are breathed in from coughs, sneezes or talking. It's also possible to pass on the virus through any forms of close contact such as sexual contact or contact with broken skin or bodily fluids such as blood, and from contaminated materials.
Monkeypox symptoms tend to begin with viral symptoms that we will all have experienced, especially in the COVID-19 era, such as fevers, muscle aches, tiredness, joint pains and headache. There may also be swollen, painful lymph nodes and a distinctive rash that develops a few dats after the symptoms start. This often begins on the face before spreading to other parts of the body, starting as lumps that get bigger, then fluid-filled, and which then scab over and dry out.
If you have come into contact with someone with monkeypox, there is a period where you may be infected but not yet be showing any symptoms. This is thought to be between five days and three weeks.
There is no specific treatment for the virus, but there are vaccines that can help to reduce the chance of infection. People who have had a high-risk contact with a proven case of monkeypox may be offered a vaccine to prevent them from developing symptoms.
Like other infections, people who are infected or have had high-risk contacts should self-isolate for 21 days – the time period they could still be carrying the infection and not showing symptoms. If people become unwell, they can receive supportive treatment in the hospital to help their body respond to the virus and recover.
You should call your doctor or sexual health clinic if you think you have been in contact with someone with monkeypox or you have symptoms that seem to fit.
The NHS is offering the smallpox (MVA) vaccine to people who are most likely to be exposed to monkeypox. These groups include:
healthcare workers caring for patients with confirmed or suspected monkeypox
men who are gay, bisexual or have sex with other men, and who have multiple partners, participate in group sex or attend sex-on-premises venues (staff at these venues are also eligible)
people who've been in close contact with someone who has monkeypox – ideally, they should have 1 dose of the vaccine within 4 days of contact, but it can be given up to 14 days after
If you feel you qualify for this vaccine, discuss this with your doctor.
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