Hieda update – Monkeypox virus (25 May 2022)

Posted: 25th May 2022

Following the global outbreak of Monkeypox, please find below a briefing on the current situation.

What is Monkeypox?

Monkeypox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC), and since then the infection has been reported in a number of central and western African countries. Most cases are reported from the DRC and Nigeria.

How many cases have been confirmed?

Currently 71 cases in the UK (as of 24.05.22). There has been a small number of cases identified in the USA, Portugal, Spain and other regions worldwide.

Some positive cases have a recent history of travelling to Nigeria, but most are unconnected and do not have a travel history outside of the UK. This is currently being further investigated.

While the current outbreak is significant and concerning, the risk to the general population remains low.

How is it spreading?

The virus does not usually spread easily between people. Methods of transmission include:

  • contact with clothing or linens (such as bedding or towels) used by an infected person
  • direct contact with monkeypox skin lesions or scabs
  • coughing or sneezing of an individual with a monkeypox rash.

Monkeypox is usually a self-limiting illness, and most people recover within a few weeks.

The incubation period is the duration/time between contact with the infected person and the time that the first symptoms appear. The incubation period for monkeypox is between five and 21 days.

A notable proportion of the cases identified to date have been among people who are gay, bisexual and men who have sex with men, so the UKSHA are asking these groups to be aware of the symptoms.


The illness begins with:

  • fever
  • headache
  • muscle aches
  • backache
  • swollen lymph nodes
  • chills
  • exhaustion.

Within one to five days after the appearance of fever, a rash develops, often beginning on the face and then spreading to other parts of the body, predominantly hands, feet and genitals. The rash changes and goes through different stages before finally forming a scab which later falls off. The rash is often mistaken for chickenpox.

An individual is contagious until all the scabs have fallen off and there is intact skin underneath. The scabs may also contain infectious virus material.

Initially, the rash looks like acne spots with whiteheads, these then ulcerate and become a small circular pustule with a clear centre before crusting over. Pustules can vary in size.


Generally, monkeypox cases are mild and people tend to recover within weeks. UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases and are advising those who have been risk assessed and remain well to isolate at home for up to 21 days.

In addition, UKHSA has purchased supplies of a safe smallpox vaccine (called Imvanex), and this is being offered to identified close contacts of someone diagnosed with monkeypox to reduce the risk of symptomatic infection and severe illness.

Vaccination against smallpox can be used for both pre and post-exposure and is up to 85% effective in preventing monkeypox. People vaccinated against smallpox in childhood may experience a milder disease.

Anyone with unusual rashes or lesions on any part of their body, especially their genitalia, should contact NHS 111 or call a sexual health service if they have concerns.

Infection control

Prevention of transmission of infection by respiratory and contact routes is required. Appropriate respiratory isolation is essential for suspected and confirmed cases. Scabs are also infectious, and care must be taken to avoid infection when handling bedding, clothing, and so on.

Policy and procedure

Member schools are advised to follow their Infection Controls Policy for infectious diseases where cases are suspected or diagnosed. Cases will also be reported to and managed by the UKSHA.

At risk people

Pregnant women are advised to contact their midwife if they are exposed to a case of monkeypox. Efforts should be made to avoid contact with a suspected case. Monkeypox may increase the chances of a stillbirth according to the NHS.

For further updates and references:

If you would like any further advice or support regarding Monkeypox, please do get in touch with the Hieda Team via info@hieda.org.uk or +44 (0)207 798 1580

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