Monkeypox was discovered in 1958 when outbreaks of a pox-like disease were found in monkeys that were held in a lab for research purposes. The first human case was identified in 1970 in a nine year old child in the Democratic republic of Congo. However, it was not until the first outbreak in the USA in 2003 that monkeypox was declared a disease of global health importance.
Poxvirus’ can occasionally be transmitted to humans through direct contact with these animals (if they are infected) and can result in human-to-human transmission, as is the case of this recent outbreak of monkeypox.
On the 7th May 2022, the first recent confirmed case of monkeypox was identified within the UK. Following on from this, cases across Europe, the USA and Canada started increasing.
What are the symptoms of Monkeypox?
The initial symptoms of monkeypox include:
- a high temperature
- flu like symptoms, including a sore
- muscle aches
- swollen glands
- shivering (chills)
- joint pain
- proctitis (pain in the back passage)
- may also include anorectal pain and
Monkeypox symptoms usually begin within 3 weeks of exposure to the virus.
Within 5 days of the onset of symptoms, a rash may appear on the face and progress to the mouth, anus, and genitals. The presence of skin lesions have been identified as another symptom of monkeypox.
According to the British Medical Journal, a recent clinical study across 16 countries revealed that of 528 cases, 95% presented with a rash, 73% presented with anal and genital lesions, and 41% had lesions near their nose and mouth.
Some people may experience all or only a few symptoms, others only experience a rash.
What does Monkeypox look like?
Monkeypox may resemble Molloscum contagiosum, other rashes such as chickenpox or shingles, and it may even resemble herpes depending on where the rash appears. If the rash appears in the genital area during the early stages of infection it may narrow the possibilities and lead to a quicker diagnosis.
As medical understanding of the current outbreak of monkeypox develops, many studies are discovering that lesions may not always appear in clusters but rather appear individually and remain in a single site. Of course, this can differ across individual cases.
What complications can Monkeypox lead to, if untreated?
As Monkeypox is a self-limiting disease (it resolves on its own), there are little-to-no long term complications that the infection can lead to for most people. The most common complication is the scarring that it may leave behind, however, this is purely an aesthetic complication. In newborn babies, children and people with immune deficiencies, there may be an increased risk of developing more serious symptoms from Monkeypox.
Can you have Monkeypox without any symptoms?
It is unlikely that you can have Monkeypox without experiencing any symptoms. However, due to the fact that many new cases aren’t following the patterns of previous cases, it is slightly more difficult to predict whether the symptoms present are those of Monkeypox.
What causes Monkeypox?
Monkeypox is caused by a similar virus that also caused smallpox, but is proving to be a much milder infection. In people, Monkeypox is spread through contact with an infected person’s rash or bodily fluids, including respiratory droplets. Close personal contact, sexual or otherwise, can cause a person to become infected.
What factors can increase the likelihood of getting Monkeypox?
As Monkeypox spreads via close contact, those who engage in sexual activity with someone who is showing symptoms may have an increased likelihood of contracting Monkeypox. This includes oral and penetrative sex, as well as touching and kissing.
Furthermore, an individual’s likelihood of catching Monkeypox is increased if they have multiple partners and/or are men who engage in sexual activity with other men (MSM). It is important to note that Monkeypox does not limit itself to MSM and is not a sexually transmitted infection. Anyone who is in close contact with someone showing symptoms is at risk of catching the virus.
Although there are no known cases of Monkeypox amongst individuals who are HIV positive, immunosuppression may cause a more severe reaction to the Monkeypox virus.
Can I get Monkeypox even if I wear a condom?
Condoms are always recommended to protect yourself and others when engaging in sexual intercourse. However, they do not protect you from catching Monkeypox because it is not, by definition, a sexually transmitted infection.
The reason that Monkeypox can be passed onto others through sexual intercourse is because of the close contact between two bodies. The lesions and rashes caused by Monkeypox can appear anywhere on the body, and therefore, wearing a condom will not protect you from contracting Monkeypox.
Can you tell who gave me Monkeypox?
Monkeypox is hard to trace unless it is passed on by a confirmed case and you are notified by that individual.
How can I prevent getting Monkeypox?
There are many things that you can do to prevent yourself from getting Monkeypox. These include:
- Being aware of the symptoms and initiating a conversation with any partners or close contacts who may be displaying symptoms.
- Avoiding close contact (including any form of physical touch, kissing, or having sex) with someone who is showing signs of Monkeypox rash, lesions, or open sores. Or has been contact with a confirmed case? Incubating time is about three weeks – possible asymptomatic shedding
- Avoid using shared objects with someone who has Monkeypox, this includes objects such as utensils, bedding, towels, clothing, and in general trying to avoid anything and anywhere that the person with Monkeypox has been using.
Monkeypox is diagnosed by a PCR test on a viral swab taken from one or more vesicles or ulcers.
Results are available in 4 working days and costs £180.
Learn more about Testing
Can Monkeypox be treated?
There is no specific treatment available for Monkeypox at this moment. However, the good news is that it is a self-limiting disease, meaning that it usually resolves on its own and does not tend to leave long-lasting health issues.
How is Monkeypox treated?
Monkeypox can either be treated by no treatment (i.e., allowing the infection to run its course and leave the body once the incubation period is over) or vaccines can be used.
How effective is the treatment for Monkeypox?
It is important to remember that the treatment is used to relieve symptoms, not to cure the infection. From this perspective we can assess the treatment effectiveness by how well it resolves symptoms, which is high.
How long does the treatment take to work?
Most individuals recover within 2-4 weeks without the need for medical treatment or intervention.
What happens if I have symptoms after finishing my treatment?
Please contact us for further assistance.
Will my partner also need treatment?
Your partner will only need treatment if they test positive or are symptomatic.
Do I need a follow up after finishing my treatment?
Ideally a confirmatory test should be performed to ensure that you are negative.
Can I take anything at home to help?
Simple over the counter painkillers such as ibuprofen and paracetamol can be used to help as long as you have no allergies to these medications and no medical conditions that mean you should not take them.
How does the Monkeypox vaccine work?
A modified smallpox vaccination known as MVA (Modified Vaccinia Ankara), or Imvanex which is the official brand name, is being offered to individuals who are most at risk to help protect them against the virus. The vaccine is much safer than the smallpox vaccine and hopes to reduce the severity of the infection due to the close nature between Monkeypox and smallpox. There is a limited supply of the MVA vaccine, therefore, one dose is being offered to those who present a higher risk of contracting the virus. Once there is a bigger supply, more doses will be offered.
Does the Monkeypox vaccine cure Monkeypox?
No. Vaccines work by giving your body a small dose of the disease or virus; your body then produces antibodies to fight the disease or virus. When the disease re-enters your body, the body recognises it and initiates a response to destroy it.
The Monkeypox vaccine exists to limit the symptoms of the disease rather than to cure it as vaccines do not cure diseases but rather provide a level of protection or immunity. Therefore, if you were to ever contract Monkeypox, and you have been vaccinated against it, your body would be able to fight it off at a much stronger level.
Who should get vaccinated against Monkeypox?
The UK Health Security Agency recommends that the MVA is offered to:
- Healthcare workers who are currently caring for, or due to care for, patients with confirmed Monkeypox cases. This includes healthcare workers within sexual health clinics.
- Gay, bisexual, or other men who have sex with men (MSM) who are at high risk. This refers to those with multiple partners.
How effective is the Monkeypox vaccine?
The vaccine is effective 4 days after exposure to the virus. However, it can still be offered up to 14 days after exposure if you are at high risk of ongoing exposure or at risk of developing a more serious case of the virus.
It is important to remember that the vaccine does not prevent you from contracting the virus but instead works to limit the severity of the symptoms should you contract it.
When is the best time to have the Monkeypox vaccine?
If you are considered high risk, such as gay, bisexual, or other men who have sex with men (MSM), have multiple partners, have weak immune systems (such as children, or adults with health issues), workin high risk settings such as sexual health clinics or hospitals, or are travelling to a high risk country, the best time to get the Monkeypox vaccine is before any potential exposure occurs.
I have already taken a course of the Monkeypox vaccine. Can I still get a booster?
Boosters are available to those who are deemed high risk. However, you will be advised whether a second dose is needed.
Can I have the Monkeypox vaccine if I already have Monkeypox or have been exposed to it?
The vaccine ideally should be taken 4 days after exposure to the virus. However, it can still be offered up to 14 days after exposure if you are at high risk of ongoing exposure or at risk of developing a more serious case of the virus.
Are there any side effects?
As with all vaccines, there are possible side effects. The most common side effects to the Monkeypox vaccine are:
- aching muscles
- joint pain, pain in the extremities (hands and feet)
- loss of appetite
- pain, redness, swelling, hardness, itching, discolouration, a lump or bruising at the injection site
If you have atopic dermatitis (atopic eczema), you may experience the following symptoms:
- Intense skin reactions such as redness, swelling and itching
- Other general symptoms such as headache, muscle pain, feeling sick or tired
- A flare-up or worsening of your skin condition
If you are concerned about any side effects that you are experiencing, call 111. If you are experiencing difficulty breathing, confusion, continuous fainting or prolonged unconsciousness, call 999 immediately. These symptoms typically occur within 15 minutes of vaccination and may indicate a serious allergic reaction and therefore, should be taken seriously.
Fainting is much more common after vaccination. If you do pass out, lie down on your back with your legs raised. If this does not make you feel better, call 111.
Where can I get the Monkeypox vaccine?
Currently, the Monkeypox vaccine is only available in the NHS and is free of charge. There is a limited supply of doses available so high risk individuals are being prioritised, however, this is due to change once more supplies are available.
What is the long term prognosis for someone who has Monkeypox?
Whilst information on the topic is still growing, it seems that most patients who have had Monkeypox will go on to live life as normal. Most cases are usually mild and self-limiting, and most patients will recover within 2 to 4 weeks without treatment.
Most individuals have no complications. However, you may experience aesthetic complications such as scarring from the lesions and scabs. In some rare cases, blindness can occur.
Once treated, am I immune from getting Monkeypox again?
Unfortunately, there is no clear data whether or not you can get Monkeypox again if you have had it before.
Is there anything I can do to prevent Monkeypox from returning?
The vaccine being used against Monkeypox is shown to be 85% effective at preventing you from acquiring the infection.
It is recommended to avoid contact with anyone who is showing symptoms, and having an honest and open discussion with any new potential partners about their current health will aid your understanding on whether they may be at risk of contracting or passing on the virus.
Will my children also get Monkeypox?
Young children are more likely to contract Monkeypox if they have been in close contact with a symptomatic person. They are also more likely to generally develop different rashes and illnesses as they grow, therefore, by keeping an eye out for any potential Monkeypox symptoms (in particular rashes with lesions or blisters) you will be able to monitor your child’s health.
How can Monkeypox affect me during pregnancy?
The World Health Organisation (WHO) states that Monkeypox can be transmitted to the fetus during pregnancy by the placenta, to the newborn child during close contact after birth and while breastfeeding. It is not confirmed whether pregnant women are more susceptible to the virus, or whether the infection is more severe during pregnancy.
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Page reviewed by Dr. Manoj Malu (Clinical Director) & Magdelena Nowacka
With assistance from Shannon Abraham
Last reviewed date: 1 September 2022
Next review due: 1 September 2025
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- NHS: Monkeypox
- Johns Hopkins Medicine: Monkeypox
- Cleveland Clinic: Monkeypox: Causes, Symptoms, Treatment & Prevention
- BMJ: Monkeypox: New clinical symptoms are identified in confirmed cases
- GOV.UK: Monkeypox
- AAD: Dermatologist explains what the monkeypox rash looks like
- CDC: Monkeypox
- Fenway Health: Monkeypox and gay and bisexual men: Fact sheet
- ECDC: Questions and answers on monkeypox
- Terrence Higgins Trust: Monkeypox in the UK
- CDC: How to Protect Yourself | Monkeypox | Poxvirus
- ASM: Monkeypox: When to Get Tested and What to Do if Exposed
- British Society for Immunology: How vaccines work
- NHS inform: Vaccination to help protect against monkeypox
- Cureus: Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation
- ASM: Monkeypox: What We Do and Don’t Know About Recent Outbreaks
- BMJ: Best Practices – Monkeypox
- International Society of Ultrasound in Obstetrics and Gynaecology: Monkeypox and pregnancy: what do obstetricians need to know?
- MotherToBaby: Monkeypox