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Monkeypox can be passed on through close contact including sex

Latest monkeypox information

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  • There have been a number of confirmed cases of monkeypox in the UK. Although monkeypox can affect anyone, the majority of those cases are among gay and bisexual men.
  • Monkeypox is transmitted through close contact, so is likely being passed on during sex rather than sexual transmission.
  • Everyone is being asked to be aware of the monkeypox symptoms, but it’s important gay and bisexual men are alert as it's believed to be transmitting through sexual networks.
  • If you have new unexpected or unexplained spots, ulcers or blisters anywhere on your body (including the face and/or genitals) or any of the other symptoms outlined below, then contact your local sexual health service by phone – not in person – or call 111 for advice.
  • Symptoms include fever, headache, muscle aches, backache, swollen glands, chills and exhaustion.
  • All calls to your GP, a clinic, 111 or our helpline THT Direct about monkeypox will be treated sensitively and confidentially, but it is important you are tested for monkeypox and cases are found.
  • Close contacts who have symptoms will be advised to isolate for 21 days.
  • Health protection teams are getting in touch with close contacts of anyone diagnosed with monkeypox. They will advise you what to do if you do not have symptoms.

The Government website has the latest information on monkeypox cases in the UK.

About monkeypox

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Monkeypox is a rare viral infection mainly spread by wild animals. It is very rare in the UK.

Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen glands, chills and exhaustion. New unexpected or unusual spots, ulcers and blisters can develop anywhere on the body, including the face, and other parts of the body including the hands, pubis and genitals (penis, testicles, vulva, front hole and anus). In many cases only one or a few spots or ulcers are being found.

Background on UK cases of monkeypox

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On 18 July 2022 the total number of monkeypox cases confirmed in the UK was 2,137. Most of these were diagnosed in England (2,050) and the majority of cases were in gay and bisexual men.

Monkeypox is usually a mild self-limiting illness, spread by very close contact with someone with monkeypox. Most people recover within a few weeks. Some people can become unwell and require hospital admission but most people are well enough to stay at home if they are able to self-isolate safely

Frequently Asked Questions (FAQs) about monkeypox

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What is monkeypox?

Monkeypox is a rare viral infection, and very rare in the UK. It is related to smallpox but less severe.

What are the symptoms of monkeypox?

Initial symptoms of monkeypox include fever, headache, muscle aches, backache, swollen glands, chills and exhaustion. New unexpected or unusual spots, ulcers and blisters can develop anywhere on the body, including the face and other parts of the body including the hands, pubis and genitals (penis, testicles, vulva, front hole and anus).

The spots can change and goes through different stages. They can look like chickenpox, anogenital herpes or syphilis, before finally forming a scab, which later falls off. Some people have only had one or a few spots.

Symptoms are usually mild enough to not require hospital admission and can last up to four weeks.

How is monkeypox transmitted?

Monkeypox does not spread easily between people. However, it can be caught from:

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

We're learning more from the latest cases, and while it is not thought monkeypox can be sexually transmitted, close contact during sexual activity can lead to transmission. This could include if your face, lips, hands or fingers (or other skin to skin contact during sex) comes into contact with monkeypox rash or lesions from having sex on their bedding or from respiratory fluids exchanged during kissing, oral sex or sneezing.

Do condoms prevent you catching or passing on monkeypox?

We always encourage use of condoms to prevent sexually transmitted infections (STIs). Monkeypox is not an STI by nature, though it can be passed on by direct contact during sex.

The spots, ulcers and blisters, which are most likely to pass on monkeypox, 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, including during sex.

Although it is not clear if monkeypox can be transmitted through genital secretions, UK Health Security Agency (UKHSA) is advising the precaution of using condoms for 12 weeks after a confirmed diagnosis of monkeypox.

UKHSA has set out guidance for semen testing for viral DNA for people diagnosed with monkeypox.

Monkeypox can also be passed on through contact with clothing, bedding and towels used by someone with monkeypox.

What can I do to reduce the risk of catching monkeypox?

Although monkeypox is rare, there are things you can do to reduce your risk of getting it.

This information is being reviewed carefully as we learn more about the latest cases identified in gay and bisexual men.

  • Do not share bedding or towels with people who are unwell and may have monkeypox.
  • Do not have close contact with people who are unwell or have symptoms of monkeypox.
  • You should wash your hands with soap and water regularly or use an alcohol-based hand sanitiser as you may have come into contact with skin lesions or secretions which might have ended up on your hands.

What happens when I test for monkeypox?

Currently most people with symptoms for monkeypox are tested in their local sexual health clinic. Tests are sent to the UKHSA laboratory to be analysed and you will be asked by your doctor to provide your name and contact information so they can subsequently inform you of the result of your test.

If you test positive, the Health Protection Team at UKHSA will contact you to complete a questionnaire to collect information about close contacts you have had in the past three weeks before your symptoms started. This will include people you live with, and any sexual partners or hook-ups you have met recently.

Close contacts will not be told any information about you. If you have concerns about people being contacted you can talk to the health professional who phones you with your test result. All information is handled privately and securely.

What should I do if I am a ‘close contact’?

Close contacts with symptoms should isolate for 21 days. If you test positive for monkeypox you will need to continue to isolate until the last spot or ulcer has scabbed over and fallen off.

You no longer need to isolate if you do not have symptoms. However, UKHSA has issued guidance for close contacts, depending on the risk of you developing monkeypox:

Medium risk advice (category 2)

  • Contact NHS 111 or a sexual health clinic if you develop a fever or any of the other monkeypox symptoms.
  • Avoid skin to skin contact with others, such as hugging and kissing.
  • Refrain from sexual or intimate contact.
  • Avoid international travel if possible; travel insurance may also not be valid for people advised not to travel.
  • Let health or dental facility staff know they’re a close contact before attending for health or dental care.

High risk advice (category 3)

Follow the above advice, and:

  • UKHSA recommends avoiding close contact with children aged under 5 years, pregnant women and those who have an impaired immune system.
  • If you work with children aged under 5 years, pregnant women or those who have an impaired immune system, UKHSA or their employer might inform them if they need to take time off – this decision will be based on a personalised clinical assessment.

Am I at greater risk if I’m HIV positive?

There is limited evidence on monkeypox in people living with HIV, and most is based on research in countries where access to HIV treatment is low, and overall health outcomes are worse than in the UK.

At the moment people living with HIV should follow the same advice as the general population. Should evidence emerge that people with weakened immune systems are at greater risk of monkeypox, or ill-health from catching the virus, then updated information and advice will be made available.

Does monkeypox affect PrEP effectiveness?

No. PrEP (pre-exposure prophylaxis) is still effective. People who use PrEP should continue to take it.

Can monkeypox be treated?

Treatment for monkeypox aims to relieve symptoms. The illness is usually mild and most people recover in two to four weeks.

People with likely or confirmed monkeypox can isolate at home until they have recovered if they are well enough and able to self-isloate. A small number of people may need to stay in a specialist hospital, so the symptoms can be treated.

Most people with monkeypox recover within a few weeks. UKHSA are advising people who recover to use condoms during sex for up to 12 weeks after they were exposed to monkeypox. However, it is important to remember that you can still pass it on through skin to skin contact whilst you have a monkeypox rash, or spots, ulcers and blisters.

What should I do if I think I have monkeypox?

Do not attend a clinic, hospital or your GP in person, unless they arrange an appointment.

Contact your GP, call 111 or your local sexual health clinic if:

  • You have a new unexplained rash or lesion on your body, especially the face or genitals.
  • You have been in contact with someone who has monkeypox in the last three weeks.

Is there a vaccine for monkeypox?

Yes. A safe smallpox vaccine, called Imvanex is available and currently offered to close contacts of people diagnosed with monkeypox and healthcare professionals who are seeing potential monkeypox cases. The vaccine reduces the likelihood of symptomatic infection and severe illness.

UKHSA has announced plans to make the vaccine more widely available – this will include gay and bisexual men who are more likely to be exposed to monkeypox.

People are advised not to come forward for the vaccine until contacted.

The vaccine can be given to people living with HIV. However, if your CD4 count is less than 100 then you may not respond as well to the vaccine, which means you could be vulnerable to catching monkypox, even if you’ve been vaccinated. If you are identified as a close contact who is eligible for the vaccine you should have a conversation with your doctor about whether you should have the vaccine.

Where can I get more information?

It's important to get information from a reliable source such as the NHS or the government (the UK Health Security Agency or Department of Health and Social Care). We'll also be updating the information on our website if and when the situation changes and the advice is different.

Here are some more sources of information:

General information on monkeypox from NHS.

Latest Monkeypox updates from UKHSA.

General guidance on monkeypox from UKHSA.

BHIVA rapid statement on monkeypox virus.

HIV i-Base Monkeypox: Q&A and update.

Queer Health from The Love Tank: Everything we know about monkeypox so far.

You can also contact our THT Direct helpline on 0808 802 1221.

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  • This story was first published Friday 20 May and is being updated as we get new information.