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monkeypox

Mpox - what do we know so far?

Peer reviewed by Dr Krishna Vakharia, MRCGPLast updated by Lawrence HigginsLast updated 19 Aug 2024

The World Health Organization (WHO) has declared the mpox outbreak a global health emergency. The highly contagious disease - formerly known as monkeypox - has killed more than 500 people in Africa and new cases have emerged in Sweden and Pakistan.

We explore the rise in cases and what it means for you in the UK.

In this article:

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What is mpox?

Mpox was first discovered in 1958 when a group of monkeys kept for research became infected - this is how the disease got its former name. Mpox is mainly spread by wild animals in parts of central and west Africa. This isn't limited to monkeys - rodents are also carriers of the disease. Historically, transmission to humans has been relatively rare and mainly contained within central and western African countries.

Mpox types

There are two main types of mpox - Clade 1 and Clade 2. Clade 1 is responsible for the latest outbreak and is thought to be more contagious and deadly than clade 2.

Clade 1 is mainly found in central Africa.

Clade Ib, a new mutation of mpox, was discovered around September 2023. The new strain is thought to be responsible for the latest outbreaks in the Democratic Republic of Congo which has seen 13,700 cases of mpox resulting in more than 450 deaths since the start of 2024.

Up to 10% of those who have caught Clade 1 have died.

Clade 2, mainly found in West Africa, particularly Nigeria, spread throughout the world in 2022.

Around 1% of those who have caught Clade 2 mpox have died.

Why has the WHO declared an emergency in 2024?

WHO director-general Tedros Adhanom Ghebreyesus described the emergence and spread of a new variant of mpox as “very worrying” and called for a global response to save lives.

The WHO's declaration that mpox is a "public health emergency of international concern”. puts it into the same category as previous warnings for threats such as Ebola, Covid-19 and the 2022 mpox surge in Europe.

The current warning followed the Africa CDC saying that mpox has been found in at least 13 African countries - with cases up 160% and deaths increasing by 19% on the same period in 2023.

The WHO Committee Chair, Professor Dimie Ogoina warned: “The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe."

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Is mpox in the UK?

There have been no confirmed cases of Clade 1 or 1b mpox in the UK. In 2023 and up to 31 July 2024, a total of 286 cases of clade2 mpox have been reported in the UK - 91 of these cases were known to have been caught abroad.

In May 2022, when the WHO last declared an mpox emergency, there were 3,732 confirmed and highly probable cases of mpox in UK.

The authorities are warning against complacency. Dr Meera Chand, Deputy Director at the UK Health Security Agency (UKHSA), said: "The risk to the UK population is currently considered low. However, planning is underway to prepare for any cases that we might see in the UK."

The steps being taken in the UK to help prevent an mpox outbreak include:

  • Making sure health professionals are aware of the outbreak and can recognise cases quickly.

  • Making rapid testing available.

  • Developing systems for the safe care of people who have mpox to help prevent it spreading.

Is there a UK mpox vaccine programme?

In 2023, the UK introduced an mpox vaccine for those most at risk of exposure to the infection - this includes gay, bisexual, and/or men who have sex with men (GBMSM), as well as hospital staff who have come in close contact with someone who has mpox.

The vaccine reduced the spread of mpox - but as the number of cases in 2023 and 2024 shows, it did not eradicate it.

The vaccination programme is no longer running nationwide but if you’re eligible, some specialist sexual health clinics and certain health centres are offering the MVA vaccine. Check your NHS site for details where you can get a vaccine here:

The European Centre for Disease Prevention and Control (ECDC) advises that you should get vaccinated against mpox if you are travelling to the effected areas in Africa.

Mpox factsheet - FAQs

Q1. What happens if you get mpox?

The symptoms of mpox tend to develop between 5-21 days after you contract the virus. Usually, symptoms will then clear up of their own accord in 2-4 weeks.

First mpox symptoms:

These symptoms are often followed by a rash, which usually forms on your face then spreads to other parts of the body. This rash is made of raised spots on your skin which turn into pus-filled blisters. These blisters gradually form scabs which later fall off.

Q2. Does mpox leave scarring?

While severe scarring from these scabs is rare, pitted scars (hollow indents on the skin) or patches of darker or lighter colour (hyperpigmentation or hypopigmentation) may remain for some time after scabs disappear. It is thought that these scars could be visible for up to two years in roughly half of all cases.

Q3. Is mpox like chickenpox?

Chickenpox is another infectious disease that causes skin rash and often leaves scarring. This illness actually belongs to a completely different family of viruses to mpox, but it can be easy to confuse the symptoms. Dr Krishna Vakharia describes the main differences to look out for:

Chickenpox: "The rash tends to start around the tummy area and spreads. Uncommonly, the rash spreads to genitals, palms of hands, and soles of feet."

Mpox: "The rash mainly develops on the face and works its way downwards, commonly appearing on genitals, palms of hands, and soles of feet. Unlike chickenpox, the rash also forms blisters that have pus in them. Another key difference is that at the beginning, mpox causes swollen lymph glands but chickenpox doesn't."

Q4. Does mpox spread easily?

The virus is mainly spread by rodents - such as mice, squirrels, and rats - in parts of west and central Africa. You would need to come into close contact with an infected animal to catch the virus yourself - for example, eating or being bitten by an infected animal, or coming into contact with its blisters or body fluids.

According to Dr Rohde, the virus "typically enters the body through broken skin, inhalation, or the mucous membranes in the eyes, nose, or mouth".

Unlike COVID-19, the virus does not spread easily between people: "Mpox is hard to catch," says Dr Vakharia. "The infected person needs to be very close to you - often through skin-to-skin contact, or touching infected linen, clothes or towels, or by coughing or sneezing directly on you.

"Of course, good hand hygiene is important. Avoiding skin-to-skin contact, not touching the rash, or handling any of their clothes or bed linen is key to minimising the spread."

Q5. Does mpox hurt?

For most people, the illness is classed as mild. This being said, symptoms can be uncomfortable and irritating, and the rash may be particularly itchy and painful3. However, severe illness from the virus is rare and symptoms usually clear up within a few weeks.

Q6. Can you die from mpox?

There are two main strains of mpox virus. The one seen in the UK in 2023 is the West African version, which has a death rate in the order of 1%. The other, found predominantly in central Africa (Congo Basin), has a much higher death rate, possibly as high as 10%3.

Factors such as malnutrition, which increase the likelihood of severe illness and death, may mean that worldwide death rates are not directly relevant to the UK. So far, there have been no deaths from mpox reported in the UK.

If you are pregnant, there's also a risk that mpox can lead to complications and occasionally stillbirth. Children also have a higher risk of becoming more severely ill than adults.

Is mpox likely to cause another pandemic?

Mpox does not spread from person to person as easily as COVID-19 - so a pandemic is unlikely.

You're unlikely to catch mpox if:

  • You haven't recently been to central or west Africa.

  • You haven't been in close contact with an infected person - such as touching their skin or sharing their clothes or bed.

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What to do if you come into contact with mpox

UK Chief Medical Advisor guidance

  • If you notice unusual rashes or skin abnormalities (lesions), particularly if you have recently had a new sexual partner:

    • Limit your contact with others.

    • Contact a sexual health service or NHS 111 as soon as possible.

    • Phone ahead before attending a clinic in person.

  • A notable proportion of recent cases have been found in gay and bisexual men, so this group is encouraged to be alert to symptoms.

  • UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases:

    • These people are advised to isolate at home for up to 21 days.

There is no treatment that cures mpox, but the illness typically clears up on its own. The most effective method for both pre and post exposure to mpox is the smallpox vaccine. This is up to 85% effective.

You can check the latest government advice by visiting gov.uk.

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Article history

The information on this page is peer reviewed by qualified clinicians.

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