There has recently been an increase in monkeypox cases within the UK, however the risk of catching it remains low. Monkeypox can affect anyone; however the majority of monkeypox cases in the UK continue to be in gay, bisexual and other men who have sex with men (MSM), with the infection being passed on mainly through close contact between people in interconnected sexual networks. Therefore, these groups in particular are advised to be aware of the symptoms, especially any new rashes or lesions on any part of their body. If you have symptoms of monkeypox please contact a sexual health service or call NHS 111. For more information, please visit nhs.uk.
Monkeypox is a rare disease that is caused by infection with monkeypox virus. It is not usually passed on easily between people.
The most likely route of monkeypox transmission is close physical contact, such as through:
It may also be possible to catch monkeypox by eating meat from an infected animal that has not been cooked thoroughly, or by touching other products from infected animals (such as animal skin or fur).
If you get infected with monkeypox, it usually takes between 5 and 21 days for the first symptoms to appear.
The first symptoms of monkeypox include:
If you have a rash with blisters and have either:
Call your local sexual health service, stay at home and avoid close contact with other people, including sharing towels or bedding, until you've been told what to do. Please call the clinic before visiting.
Tell the person you speak to if you've had close contact with someone who has or might have monkeypox, or if you've recently travelled to central or west Africa.
If you have any concerns at all about any symptoms, or you are unable to contact a sexual health clinic, call 111 for advice. You can be assured that all calls or discussions will be treated sensitively and confidentially.
The risk of monkeypox is low to the UK public. Contact a sexual health clinic or NHS 111 if you need urgent advice.
Monkeypox is not usually passed on easily between people and can only be passed on from person to person through direct physical contact. The spread of monkeypox may also occur when a person comes into contact with an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth).
The most likely route of monkeypox transmission between people is through close physical contact, such as:
Anyone identified as a close contact of an infected individual will be contacted by the relevant teams. If anyone is concerned they may have been in contact with someone displaying monkeypox symptoms, they should call NHS 111 if they need urgent advice.
The incubation period for monkeypox is between 5 and 21 days.
Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. It can also be passed on through other close physical contact with a person who has monkeypox or contact with clothing or linens used by a person who has monkeypox.
Treatment for monkeypox is mainly supportive, but newer antivirals may be used. The illness is usually mild and most of those infected will recover within a few weeks without treatment. High-quality medical and nursing supportive care will be provided to individuals to manage symptoms.
The smallpox (MVA) vaccines are not made to be routinely used in any country, so global supplies are limited. The UK has procured more than 100,000 doses to cover this outbreak and the vaccine batches will become available as each batch is manufactured and supplied. Every dose is needed to protect those who are most likely to get the infection and to help curtail the outbreak.
Some sexual health services will be contacting those people who are likely to be at increased risk of getting monkeypox, for example those who have had a recent sexually transmitted infection, to come in first. Other services will offer vaccine alongside other appointments, for example for HIV PrEP.
First doses will be prioritised during this outbreak. The offer of a second dose will be considered if the outbreak continues. Local NHS services are identifying and contacting people who are a priority for vaccination and will continue to work with local partners to make sure those who may be eligible know how and where to get jabbed. People should not come forward and should instead wait to be contacted.
While monkeypox will be mild for many, some of the symptoms can be painful and uncomfortable. Some people can become more seriously unwell and require hospitalisation. In addition to protecting yourself, the vaccine may also help limit the transmission of the virus to your close contacts.
The vaccine hasn’t been used at such a large scale before so vaccine effectiveness data is limited at this stage of the outbreak – we will be monitoring this just as with all vaccines used in this country. However, based on available data we would expect the vaccine to provide some protection against symptoms. This means that you still need to be aware of monkeypox symptoms as the vaccine won’t provide complete protection.
One dose of MVA vaccine is offered to help modify or reduce the symptoms of disease and should also help to kick-start your protection for the future. In this outbreak we are prioritising giving the first dose to as many eligible people as possible and then a second dose will be considered.
The vaccine has a very good safety profile. Like all vaccines it can cause side effects, but most of these are mild and short-lived and not everyone gets them.
Side effects may be more common in people who have previously received a dose of live smallpox vaccine. These people only need a single dose of MVA to boost their existing protection.
The vaccine has a good safety profile in those living with HIV. However, the immune response to the vaccine could be reduced in severely immunosuppressed individuals.
The most recent cases are predominantly in gay, bisexual, and other men who have sex with men. They have no travel links to a country where monkeypox is endemic, so it is possible they acquired
the virus through community transmission. As the virus spreads through close contact, we are asking these groups to be alert to any unusual rashes or lesions on any part of their body and to
contact a sexual health service if they have concerns.
The UK Health Security Agency takes any concerns about hate crimes or discrimination seriously. The monkeypox virus is passed on through close contact and a notable proportion of the cases identified to date have been among gay and bisexual men and other men who have sex with men.
We have asked these groups in particular to be aware of the symptoms so people are informed and able to manage their own health. We have worked closely with many partners, including third sector organisations that work closely with gay and bisexual men and other men who have sex with men, to develop messaging. This work has included advising healthcare professionals on how to discuss this topic sensitively and we are developing best practice guidance and targeted communications to reach groups who may be at higher risk. We are proactively sharing advice to the public as well as information to health professionals to try and tackle disinformation, both in the media and within local communities.
Monkeypox isn’t transmitted through sex but can be transmitted through close skin-to-skin contact with someone carrying the virus. Sexual health clinics are a good option for people with symptoms because they have expertise in infectious diseases, are experienced with infection control, and are regularly accessed by many people. While they are a good option for people worried about symptoms that could be monkeypox, they can also offer advice and treatment if people don’t have monkeypox but are suspected of having a sexually transmitted infection.
We always encourage use of condoms to prevent STIs. Monkeypox is not a sexually transmitted infection by nature, though it can be passed on by direct contact during sex. Contagious lesions, through which infections are most likely to be passed on, can appear on any part of the body so condoms will not necessarily prevent transmission of the virus between two people who are in direct contact. The infection can also be passed on through contact with clothing or linens used by a person who has monkeypox.
This is a rare and unusual situation. The UK Health Security Agency is rapidly investigating the source of these infections because the evidence suggests that there may be transmission of the monkeypox virus in the community, passed on by close contact. Monkeypox remains rare in the UK and the risk to the general public remains low. The UK Health Security Agency and the NHS have well-established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed.
The UK Health Security Agency are urging anyone with unusual rashes or lesions on any part of their body, especially their genitalia, to immediately contact their local sexual health service. We are contacting any potential close contacts of the cases to provide health information and advice.
The UK Health Security Agency and the NHS have well-established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed.
We continue to engage with partners across the sector to ensure people are aware of the signs and symptoms and what action to take, including working with partners across the sector at pace to deliver training webinars about monkeypox to clinicians to increase knowledge and awareness of this infection, which is unusual in clinical settings in the UK.
