Monkeypox (MPX)

This page includes guidance on Monkeypox symptoms, pathways for testing, support, vaccination, and prevention tips.

Monkeypox is a rare viral infection. It is related to smallpox but less severe.

Recent cases in London have been in gay, bisexual, and other men who have sex with men. The current outbreak has not been linked to travel to countries where monkeypox is endemic. At present monkeypox is being acquired through community transmission.

What are the symptoms?

If you get infected with monkeypox it usually takes between 5 and 21 days for the first symptoms to appear. The most common symptoms of monkeypox, include:

Fever

(a high temperature)

Muscle aches

Chills and exhaustion

Headaches

Swollen Lymph Nodes

Rash

A rash usually starts one to five days after the first symptoms. It often begins on the face and spreads to other parts of the body including the genitals or anus before forming a scab which then falls off.

The disease 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.

More information regarding symptoms can be found on the NHS website.

Frequently Asked Questions

The virus can spread if there is close contact between people through:

  • touching clothing, bedding or towels used by someone with monkeypox
  • touching monkeypox skin blisters or scabs
  • the coughs or sneezes of a person with monkeypox

We have learnt from the current outbreak that whilst monkeypox is not thought to be sexually transmitted, close contact during sexual activity can lead to transmission.

If you think you have monkeypox symptoms – however mild:

  • Contact NHS 111 or call your local sexual health clinic immediately (find yours here). Your call will be treated sensitively and confidentially.
  • Avoid close personal or sexual contact with others until you know that this is not monkeypox.
  • Please contact clinics ahead of your visit and avoid close contact with others until you have been seen by a clinician. Your call or discussion will be treated sensitively and confidentially

Treatment for monkeypox is mainly supportive. The illness is usually mild and most of those infected will recover within a few weeks without treatment.

The most effective way to protect yourself from monkeypox is to get vaccinated.

A smallpox (Modified Vaccinia Ankara (MVA)) vaccination is being offered to people who are most at risk. To offer as wide-scale community protection as possible only one dose of the vaccine is currently being offered to those eligible. A second dose is only being offered to those most at risk.

The vaccination does not guarantee protection against monkeypox, but it is effective at reducing the likelihood of symptomatic infection and severe illness.
It is important to remain vigilant to monkeypox symptoms even when vaccinated.

More information on the vaccine can be found in the UK Health Security Agency’s (UKHSA) Monkeypox Vaccination Strategy: https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy

The MVA vaccine has primarily been either a subcutaneous or intramuscular injection – this means under the skin or into the muscle. However, On 22 August 2022, UKHSA announced a pilot scheme offering intradermal administration of the vaccine.

Intradermal injection is a safe and clinical approach and is sometimes known as ‘fractional dosing’. It involves injecting a lower dose of the vaccine at different angle in the skin which offers the same level of protect and stretches supply further.

The current process distributes vaccine to those most at risk of transmitting monkeypox. NHS England have identified those who meet this criterion. Your local NHS Trust (hospital) will contact you by text and/or telephone to schedule a vaccination appointment with you.

You should wait to be contacted by your local NHS Trust.

The UKHSA currently recommends the vaccine is offered to these groups first:

  • Gay, bisexual, and other men who have sex with men at highest risk of exposure – this includes those who have multiple sexual partners, participate in group sex, or attend sex on premises venues.
  • Healthcare workers, including front line staff in sexual health clinics who are assessing any suspected cases.
  • People who have already had close contact with a patient with confirmed monkeypox.

Only one dose of the vaccine is being offered to those people eligible for vaccination. UKHSA have stated a second dose may be offered if the outbreak continues and supply increases.

Once more vaccine supply become available, people outside of these initial groups will be considered for their vaccination.

More information on the vaccination priority groups and roll out can be found here: https://www.gov.uk/government/publications/monkeypox-vaccination-resources/monkeypox-waiting-for-your-vaccination

Whilst the best protection is getting vaccinated, there are risk reduction behaviours which can be adopted. By adopting the suggestions below, on their own or in combination (recommended), you will reduce the likelihood of getting monkeypox. The suggestions should be considered based on which best suit your lifestyle and need.

  • Consider reducing your number of sexual partners or ‘take a break’ – there is evidence that the current outbreak is being spread during sex and within gay and bisexual sexual networks. Reducing the number of sexual partners or even taking a break until you are able to get vaccinated should be considered although this strategy may not be appropriate for everyone.
    Monkeypox is not thought to be sexually transmitted. Although, transmission has been linked to the intimacy and close contact occurring whilst having sex.
  • Contact tracing – If you are hooking up with someone new, please consider sharing details so that you can get in touch if you develop symptoms later. Although it is appreciated this is not always possible.
  • Remain vigilant to monkeypox symptoms – Check your body for any unusual blisters, spots, or rashes as this may be monkeypox. If possible, encourage sexual partners to do the same before having sex. If you suspect you have monkeypox you should call 111 or your local sexual health clinic.
    More information on monkeypox symptoms can be found here: https://www.nhs.uk/conditions/monkeypox/
  • Do not share bedding or towels with people who are unwell and may have monkeypox.

More Information