ECDC presents monkeypox response options, as nine EU/EEA countries report cases

23 May 2022

In a Rapid Risk Assessment published today, the European Centre for Disease Prevention and Control (ECDC) recommends EU/EEA countries focus on prompt identification, management, contact tracing and reporting of new monkeypox cases. Countries should also update their contact tracing mechanisms, the diagnostic capacity for orthopoxviruses, and review the availability of smallpox vaccines, antivirals and personal protective equipment for health professionals.

As of 23 May 2022, 67 confirmed cases had been reported in nine EU/EEA Member States (Austria, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden) and at least an additional 42 suspected cases were under investigation. The currently diagnosed human monkeypox cases are primarily among men who have sex with men, which suggests that transmission may take place during intimate relations. Transmission may occur through close contact of mucosa or non-intact skin with infectious material from the lesions, or through large respiratory droplets during prolonged face-to-face contact.

“Most of the current cases have presented with mild disease symptoms, and for the broader population, the likelihood of spread is very low,” said Andrea Ammon, ECDC Director. “However, the likelihood of further spread of the virus through close contact, for example during sexual activities among persons with multiple sexual partners, is considered to be high.”

Stella Kyriakides, European Commissioner for Health and Food Safety, added “I am concerned about the increased number of reported monkeypox cases in the EU and globally. We are closely monitoring the situation, and whilst currently the likelihood of spread in the broader population is low, the situation is evolving. We all need to remain vigilant, ensure that contact tracing and adequate diagnostics capacity is in place, and ensure that we have the necessary vaccines, antivirals and personal protective equipment for health professionals available. We have been in close contact with Member States since the first reports of cases of the monkeypox virus in the EU and stand ready to actively support and coordinate the EU response with all assets at the EU’s disposal. The EU Health Security Committee will discuss monkeypox tomorrow, and our Health Emergency Response and Preparedness Authority (HERA), ECDC and EMA are working closely together to ensure that information on the epidemiological situation and the availability of vaccines and treatments is ensured.”

The monkeypox virus can cause severe disease in certain population groups, such as young children, pregnant women and immunosuppressed persons. Further investigations are needed to accurately estimate the level of morbidity and mortality in this outbreak.

If human-to-animal transmission occurs, and the virus spreads in an animal population, there is a risk that the disease could become endemic in Europe. As such, there needs to be a close intersectoral collaboration between human and veterinary public health authorities to manage exposed pets and prevent the disease from being transmitted to wildlife.

Infected persons should remain isolated until scabs fall off and should especially avoid close contact with immunosuppressed persons and pets. Abstaining from sexual activity and close physical contact is also advised until the rash heals. Most cases can remain at home with supportive care.

Close contacts of monkeypox cases should self-monitor for the development of symptoms for 21 days after the last exposure. ECDC will continue to monitor developments closely and will update the risk assessment as new data and information become available.