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Mpox (Monkeypox)

Introduction

Mpox (Monkeypox) is a rare viral infection that causes a high temperature (fever) and a body rash lasting a few weeks. In recent times it has become more common, including in the UK.

Recommendations for Travellers

Currently the risk to most travellers is small, and vaccination against mpox infection is not recommended for the majority of people:

It is rare for travellers to Africa to become infected with mpox.

  • Prior to 2022, mpox mainly occurred in remote parts of Central and West Africa when a person had contact with animals infected with mpox.
  • Since May 2022 there has been an increase in mpox cases detected in the UK, Europe and other countries around the world, among people who had no history of travel to Africa.

There are broadly 2 types of mpox, known as Clade 1 and Clade 2.

  • Clade 1 mpox is usually more severe.
    • It has mostly occurred in parts of central and west Africa, but recently cases have increased and started to spread to nearby African countries.
    • See the list of affected countries: GOV.UK Clade I mpox: affected countries
  • An outbreak of Clade 2 mpox occurred in 2022
    • Most of the reported cases across Europe and the UK have been in men who are gay, bisexual or have sex with men (GBMSM), so it's especially important to be aware of the symptoms, and how to prevent infection if you're in these groups.

The risk is greater if you:

  • have close personal contact, including during sex, with a person who has the infection and who has symptoms
  • have contact with contaminated items including bedding, towels, clothes from an infected person, including if you are caring for them and/or sharing a household with them
  • come into close contact with infected animals, animal products and/or surfaces or objects that are contaminated with the virus

Prevention for Travellers

If you are travelling to Central or West Africa you should:

  • avoid close contact with monkeys and rodents (for example rats, mice, squirrels), including their blood and other parts, and avoid eating undercooked meat from any animals
  • wear protective clothing, including gloves, if you are involved in the slaughter of, or care and/or treatment of animals (e.g. veterinary work, agriculture etc)
  • practice careful hand hygiene, especially if visiting or caring for ill friends and relatives

If you plan to be sexually active during travel to any destination, you should:

  • be aware of the risk of mpox
  • talk to sexual partners about their sexual health, ask if they have symptoms and always practise safe sex
  • avoid close physical contact, including sexual contact, with someone who is unwell and may have mpox
  • always share contact details with new sexual partners to help limit further spread of infection if you become infected
  • maintain good personal hygiene and wash hands often, avoid touching eyes, nose and mouth with unwashed hands
  • know the symptoms of mpox and check yourself regularly; be aware it can take up to 3 weeks for symptoms to appear after contact with an infected person
  • seek health advice and isolate yourself from others whilst waiting to get tested if you have symptoms of mpox

If you are planning humanitarian work in a country affected by Clade 1 mpox, you should seek advice and training from your employer/organisation before you travel, and register with the UKHSA Returning Workers Scheme (RWS). Further information on the Returning Workers Scheme is available here.

After Travel

You should always seek medical advice during, and for 21 days after travelling if you develop symptoms of mpox and:

  • you have returned from Central or West Africa
    • also make sure you are checked for malaria if returning from these countries as the symptoms might appear similar

or

  • you have had close contact with someone who may have mpox

For further information on what to do if you have symptoms of mpox in the UK see:

Vaccine

Vaccines designed for smallpox also offer protection against mpox and are being offered to people in high-risk groups to help prevent mpox.

  • Vaccination against mpox infection is not recommended for the majority of people.
  • The UK does not currently recommend pre-travel vaccination for mpox.

The vaccination against mpox is only available through the NHS to those at high risk of exposure, and is not currently available to purchase privately or at a pharmacy. For more information about the mpox vaccine, including information on high-risk groups and eligibility, see:

Overview of the Disease

Mpox is caused by the mpox virus. It does not spread readily between people.

Some animals in Africa, including rodents (rats, mice and squirrels) can carry the infection.

Infection can be caught from:

  • infected animals in Central or West Africa
    • close contact with infected animals including touching them or eating their undercooked meat increases your risk

or

  • close contact with a person with mpox from their:
    • rash (having skin contact, including during sex)
    • clothes, bedding, towels or personal items
    • coughs or sneezes

The virus enters the body through broken skin (even if not visible), the respiratory tract or the mucous membranes (eyes, nose, or mouth).

The Illness

After becoming infected with mpox, symptoms usually start between 5 to 21 days later and usually get better by themselves over a few weeks. People with a weakened immune system may take longer to recover.

For some people, the first symptom of mpox is a rash, while others may have different symptoms first.

Common symptoms include:

  • rash
  • high temperature (fever)
  • headache
  • sore throat
  • flu-like symptoms, including muscle and back aches, shivering and tiredness
  • low energy levels
  • swollen glands (that feel like new lumps) in the neck, armpits or groin

A blistering rash may appear anywhere on the body, including:

  • the face, mouth and throat
  • palms of hands, soles of feet
  • groin and genital areas

The rash changes from being flat spots, to raised spots, to blisters and then scabs over, similar to that of a chickenpox rash.

  • The spots may be itchy and painful
  • The number of spots can vary from a few to several thousand.
  • People are contagious until all the scabs have fallen off and the sores have healed, which can take approximately 10 days up to three weeks.

Treatment

There is no specific treatment for mpox and it usually gets better by itself. Medicines that help pain, fever and discomfort from the rash can be taken.

  • In some cases, if a person becomes more seriously unwell, they may require treatment in hospital.

People with mpox should stay at home, isolate, and avoiding close contact with others to ensure they can’t pass on the infection.

For further information on what to do if you are worried you have mpox, see:

Further information

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