Monkeypox is a rare infection most commonly found in west or central Africa. There has recently been an increase in cases in the UK, but the risk of catching it is low.
Monkeypox can be passed on from person to person through:
- any close physical contact with monkeypox blisters or scabs (including during sexual contact, kissing, cuddling or holding hands)
- touching clothing, bedding or towels used by someone with monkeypox
- the coughs or sneezes of a person with monkeypox when they’re close to you
In parts of west and central Africa, monkeypox can also be caught from infected rodents (such as rats, mice and squirrels) if:
- you’re bitten
- you touch its fur, skin, blood, body fluids, spots, blisters or scabs
- you eat its meat and it has not been cooked thoroughly
Monkeypox in the UK
Although more people have been diagnosed with it recently, only a small number of people in the UK have had monkeypox and the risk remains low.
You’re extremely unlikely to have monkeypox if:
- you have not been in close contact (such as touching their skin or sharing towels, clothes or bedding) with someone who has monkeypox or has monkeypox symptoms
- you have not recently travelled to west or central Africa
Anyone can get monkeypox. Though currently most cases have been in men who are gay, bisexual or have sex with other men, so it’s particularly important to be aware of the symptoms if you’re in these groups.
What is Monkeypox
Monkeypox is a rare disease caused by the monkeypox virus. It leads to rash and flu-like symptoms. Like the better known virus that causes smallpox, it’s a member of the family called orthopoxvirus.
Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in groups of monkeys being used for research. It’s spread mainly through human contact with infected rodents, but can sometimes be spread through skin-to-skin contact with a person who is infected. There are two known types (clades) of monkeypox virus — one that originated in Central Africa and one that originated in West Africa. The current world outbreak (2022) is caused by the less severe West African clade.
Monkeypox is not an STI
For further information:
- NHS website
- Queer Health Info (sex-positive guides and links to live streams between Will Nutland and doctors)
- UK Health Security Agency (UKHSA)
- UKHSA isolation guidance
- CDC (pictures of the different ways Monkeypox may present – the latest guidance is that clients are most commonly seeing them on their face first)
- World Health Organisation (WHO)
This page was updated on 26 August 2022
We know there are a lot of questions surrounding Monkey Pox, and information about Monkey Pox, the seriousness of the virus, vaccination options has been unclear.
We have answered some of the basic questions surrounding Monkey Pox.
The most effective way to protect yourself from monkeypox is to get vaccinated.
A smallpox (Modified Vaccinia Ankara (MVA)) vaccination is being offered to people who are most at risk. To offer as wide-scale community protection as possible only one dose of the vaccine is currently being offered to those eligible. It is expected that second doses will be offered when possible.
The vaccination does not guarantee protection against monkeypox, but it is effective at reducing the likelihood of symptomatic infection and severe illness.
It is important to remain vigilant to monkeypox symptoms even when vaccinated.
More information on the vaccine can be found in the UK Health Security Agency’s (UKHSA) Monkeypox Vaccination Strategy: https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy
The MVA vaccine has primarily been either a subcutaneous or intramuscular injection – this means under the skin or into the muscle. However, there is evidence that administering the vaccine intradermally offers the same protection with a lower dose.
On 22 August 2022, UKHSA announced a pilot scheme offering intradermal administration of the vaccine. The safe and clinical approach, also known as ‘fractional dosing’, involves injecting a lower quantity of the vaccine at an angle in the skin which offers the same level of protection. If the initial pilot is successful, it is likely this will be the norm in September and will stretch vaccine supply fivefold.
There are currently low vaccine supplies in the UK.
If you have not already been contacted by your local NHS Trust or sexual health clinic, and have an existing scheduled vaccination appointment, it is unlikely you will be able to get a pre-exposure vaccine until supply increases.
If you have a scheduled vaccination appointment you should still attend, unless told otherwise.
Post-exposure vaccination is only being reserved for those close contacts who are at highest risk of severe illness – people with immunosuppression, children under the age of 5 years and pregnant women.
UKHSA have procured an additional 100,000 vaccines which are expected to arrive in late September.
The current monkeypox outbreak is global and cases have been identified in over 85 countries. In response, there has been a sudden global demand for the smallpox vaccination.
Furthermore, the World Health Organisation (WHO) officially declared smallpox eradicated in 1980. As a result, manufactures of the smallpox vaccine are not equipped to rapidly increase production at such short notice.
The UKHSA have overseen the procurement of the vaccine for the UK.
The current process distributes vaccine to those most at risk of transmitting monkeypox. NHS trusts have identified those who meet this criterion and will contact individuals by text and/or telephone to book an appointment for their vaccination.
Whilst some walk-in clinics have taken place in London it is unclear whether these will resume when the next batch of vaccine supply arrives in late September.
If you do not already have a booked appointment to get vaccinated, it is likely you will have to wait until late September for additional supply to arrive. When the next batch of vaccines arrive, please wait to be contacted for your vaccination appointment.
The UKHSA currently recommends the vaccine is offered to these groups first:
- Gay, bisexual, and other men who have sex with men at highest risk of exposure – this includes those who have multiple sexual partners, participate in group sex, or attend sex on premises venues.
- Healthcare workers, including front line staff in sexual health clinics who are assessing any suspected cases.
- People who have already had close contact with a patient with confirmed monkeypox.
Only one dose of the vaccine is being offered to those people eligible for vaccination. UKHSA have stated a second dose may be offered if the outbreak continues and supply increases.
Once more vaccine supply become available, people outside of these initial groups will be considered.
More information on the vaccination priority groups and roll out can be found here: https://www.gov.uk/government/publications/monkeypox-vaccination-resources/monkeypox-waiting-for-your-vaccination
Whilst the best protection is getting vaccinated, there are risk reduction behaviours which can be adopted until the vaccine supply increases. By adopting the suggestions below, on there own or in combination (recommended), you will reduce the likelihood of getting monkeypox. The suggestions should be considered based on which best suit your lifestyle and need.
- Consider reducing your number of sexual partners or ‘take a break’ – there is evidence that the current outbreak is being spread during sex and within gay and bisexual sexual networks. Reducing the number of sexual partners or even taking a break until you are able to get vaccinated should be considered although this strategy may not be appropriate for everyone.
Monkeypox is NOT sexually transmitted and wearing a condom will not stop you getting monkeypox. Transmission has been linked to the intimacy and close contact occurring whilst having sex.
- Contact tracing – If you are hooking up with someone new, please consider sharing details so that you can get in touch if you develop symptoms later. Although it is appreciated this is not always possible.
- Remain vigilant to monkeypox symptoms – Check your body for any unusual blisters, spots, or rashes as this may be monkeypox. If possible, encourage sexual partners to do the same before having sex. If you suspect you have monkeypox you should call 111 or your local sexual health clinic.
More information on monkeypox symptoms can be found here: https://www.nhs.uk/conditions/monkeypox/
- Do not share bedding or towels with people who are unwell and may have monkeypox.
Contacts of monkeypox cases at high risk of having caught the infection should self-isolate for 21 days
- Monkeypox resource page – Queer Health/The Love Tank: https://www.queerhealth.info/projects/monkeypox
- UKHSA official Monkeypox guidance (including info on epidemiology, transmission, diagnosis, treatment and infection prevention and control): https://www.gov.uk/guidance/monkeypox
- Monkeypox vaccines to be piloted in smaller but equally effective doses – UKHSA Press Release on the intradermal vaccination pilot and change of post-exposure priority groups:
