Monkeypox: A Briefing for the InterAction Council, August 2022

Prepared by Dr Joanna Nurse, Strategic Advisor, InterAction Council

Key Messages:

  • A Public Health Emergency: The WHO declared Monkeypox a Public Health Emergency of International Concern on 23rd July 2022 – whilst the global risk is classed as moderate, the risk in Europe has been determined as high; the overall WHO goal is to stop human-to-human transmission.
  • Origins: Monkeypox has spread from squirrels, rodents, and monkeys, originally discovered in the 1970s as sporadic cases in rural tropical areas in Central and West Africa, and it is now endemic in over 10 African countries; in the last few years cases have spread to urban areas and increased in number since 2017.
  • Increased Spread Outside of Africa: Rates have increased from 3,000 cases in 47 countries in May, to 72 countries with over 14,500 confirmed cases in July 2022 and 26,500 cases in 81 countries at the beginning of August; Monkeypox has initially spread outside of Africa within interconnected social and sexual networks that currently mainly affect men within Europe and the Americas – however Monkeypox can infect anyone including women and children.
  • Health Complications: In Africa approximately 3-6% of cases have died from complications (including pneumonia, sepsis, and encephalitis), whilst a handful of deaths have been reported outside of Africa and is likely to increase; those most at risk include children, pregnant women, immuno-suppressed and older people.
  • Protection and Prevention: Public health measures, including self-isolation and contact tracing help to reduce transmission, whilst antivirals can reduce the severity of the disease; the Smallpox vaccine is about 85% effective in preventing Monkeypox and is recommended for high-risk contacts.
  • Risks: The Monkeypox virus is in the same family as Smallpox, and although less severe (3% fatality rate compared to 30%), there is a risk that the virus could mutate and/or cause serious loss to health and life if it continues to spread; widespread community spread is more likely if fear and stigma affects access to health services – emphasising the right to health for everyone and applying lessons from the HIV Pandemic response will be key to effectively preventing Monkeypox.

Monkeypox - Symptoms and Spread:

Initial Symptoms – typically start within 5-21 days of exposure and include a high fever and chills, a severe headache with all over aches, exhaustion, and swollen glands.

The Rash – starts a few days after the initial symptoms, typically occurring on the face, hands and feet but can occur anywhere including the genitalia, the mouth and eyes; the rash is similar to chickenpox, with skin lesions moving from flat to raised, then fluid filled before turning into crusts that dry and fall off; the rash lasts for 2-4 weeks, ranging from a few, to thousands of lesions; scarring from the rash can occur, including long-term blindness if the rash affects the eyes.

Spread – is mainly from close contact with the rash and skin lesions of an infected person or contaminated objects such as bed sheets, towels, or clothing; transmission can also occur from respiratory droplets from prolonged face to face contact and from mothers to babies via the placenta.

Further Information: