Mpox (Monkeypox)

Mpox (formerly monkeypox) is a viral disease that is usually transmitted from animals to humans. The disease is caused by the Monkeypox virus (MPXV), which is present in the wildlife (in certain small mammals) in several central- and west-African countries. In 2022, an outbreak occurred Europe and spread globally, in which the disease was transmitted between humans, mainly through sexual contact, although this type of transmission is not the most common form of transmission.

Mpox: the new old threat

Mpox symptoms usually appear 6–13 days (up to 21 days) after infection. The clinical manifestation of the disease include:

  • general, febrile symptoms (fever, headache, chills, physical weakness, lymph node swelling),

  • distinct rash (papule) on the skin and sores on the mucosa (e.g., in the mouth, nose, throat, or digestive tract),

  • back pain and muscle aches.

Within three days of experiencing the initial symptoms, the rash may spread quickly and eventually turns into small fluid-filled sacs known as vesicles. If the rash spreads throughout the body, it can also affect the palms of the hands and the soles of the feet. 

Most people experience mild to moderate symptoms that usually last two to four weeks, followed by a full recovery. Supportive care may facilitate recovery and reduce the risk for permanent lesions (e.g., scars on the skin).

Key facts

Risk for people

The severity of the disease can vary depending on several factors including how the virus is transmitted, how susceptible the person is to the virus, and how much of the virus a person is exposed to. 

Complications of mpox in areas where it is most common include: 

  • encephalitis

  • related bacterial skin infections

  • dehydration

  • conjunctivitis

  • inflammation of the cornea

  • pneumonia

  • long-term effects such as disfiguring scars and permanent corneal lesions. 

The mortality rate of mpox ranges from 0-11% in outbreaks, with young children being the most affected. Immunocompromised individuals are at a higher risk of severe disease and HIV-positive patients may experience more severe symptoms.

How it spreads

The MPXV is transmitted to people by close contact with infected animals or people, or by touching virus-contaminated materials. It enters the body through (often invisible) injuries or wounds in the skin, or the mucous membranes. Monkeypox can be passed from one person to another during sexual contact and the risk of infection increases after sexual exposure.

Vaccination and treatment

Most people completely recover from mpox without treatment. Treatment is primarily symptomatic and supportive (alleviation of fever, itchy skin, pain, and hydration), including the prevention and treatment of related bacterial infections.

Although there is no specific vaccine for mpox, the smallpox vaccine can be used to protect people exposed to MPXV. Once vaccinated, people can still become infected, but the severity of the disease and the risk for hospitalisation are reduced.

Protective measures

When someone is diagnosed with mpox, it is important they isolate themselves until their rash completely heals, as this indicates that they can no longer transmit the disease. General protective recommendations include:

  • Isolate yourself in your room and do not share household items with other members of the family.

  • Avoid contact with immunocompromised persons and other persons at risk for severe disease until the rash heals completely.

  • You can temporarily leave your home, but you should wear a medical face mask and make sure to cover the rash before going out.

  • Maintain good respiratory and hand hygiene and wear a face mask when in contact with other people.

  • Abstain from sexual activity until the rash heals completely.

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