Multi-country Monkeypox outbreak (Update 1)

After a meeting of the International Health Regulations Committee on the multi-country outbreak of monkeypox (MPX) on 21 July 2022, the World Health Organization (WHO) Director General declared the current MPX outbreak a Public Health Emergency of International Concern.

The current MPX outbreak was first observed in May 2022 in cases with no recent travel to Central or West Africa, and with no contact with infected animals. Over 21,000 cases have now been reported globally, with USA, Spain, Germany, UK and France each reporting more than 1000 cases as of 01 August 2022.

In Central and West Africa, where MPX is endemic, an increase in case numbers has also been observed, which may be due to enhanced surveillance and testing. Nigeria and Democratic Republic of Congo have reported over 100 cases. Cameroon, Central Africa republic, Congo have all reported small numbers of cases this year.

• See the WHO Health Emergency Dashboard for the latest daily data on total cases and deaths of monkeypox.
• See the WHO Monkeypox outbreak 2022 page for links to the latest situation reports and global trends.

WHO advise the following individuals should avoid undertaking international travel until they are no longer considered infectious / a risk to public health:

• those with confirmed, probable or suspected MPX
• those with signs and symptoms compatible with MPX
• those identified as a contact of a MPX case whilst undergoing health monitoring

Advice to Travellers

Monkeypox is an uncommon zoonotic infection that is rarely seen in travellers from endemic countries.

In the current outbreak, transmission between people is thought to be occurring through close skin to skin contact (including during sexual contact), or through droplet spread during close contact with a person infected with monkeypox. To date the majority of these cases have been noted in the gay, bisexual or men who have sex with men (GBMSM) community.

Symptoms in people commence with fever, a flu-like illness and swollen glands followed by the development of a blistering skin rash, resembling chickenpox.

Travellers to Central and West Africa should:

• observe meticulous hand hygiene if visiting or caring for ill friends and relatives
• avoid contact with primates and rodents and avoid consuming undercooked meat from these sources
• wear protective clothing, including gloves, if involved in the slaughter or care of animals in these regions

Travellers to any destination who may be sexually active during travel should:

• be aware of the risk of monkeypox, particularly if GBMSM
• practise safe sex
• avoid close, including sexual contact, with someone who is unwell and may have monkeypox

Travellers should be advised to seek medical help during, or for 21 days after travel if they develop symptoms of monkeypox and have:

• had close contact with someone who may have monkeypox, or
• returned from Central or West Africa: these travellers should also be screened for malaria

While a vaccine specifically against monkeypox is not available, the smallpox vaccine provides some protection.

• for information about the vaccine, see Smallpox and monkeypox: the green book, chapter 29
  

For further information see Monkeypox, Sexual Health Risks and LGBT travellers