Mpox (Monkeypox) Frequently Asked Questions

What is mpox?
Mpox is a viral zoonotic disease that historically occurred mostly in tropical rainforest areas of Central and West Africa and has spread to other regions. Zoonotic diseases can spread between animals and humans.

The mpox virus is part of the same family of viruses as variola virus which causes smallpox. It is a rare viral illness that can become serious. For most people, symptoms will clear up on their own after 2 to 4 weeks.

Mpox can spread through close contact (including sexual contact) with a person with mpox, through direct contact with infected wild animals or it can also be spread through contact with contaminated materials. Mpox does not spread easily between people. It takes close contact to spread. The biggest risk of spread between people is through sexual contact or close contact with household members.

There are 2 major genetic groups (clades) of mpox, Clade I and Clade II. Clade I (formerly known as Central African or Congo basin clade) has two sub-clades I(a) and Ib. Clade II (formerly known as West African clade) consists of two subclades (IIa and IIb). Clade IIb was the clade (genetic group) circulating in the 2022 global outbreak.

Why is mpox in the news now?
Mpox is in the news now because there has been an unprecedented recent increase in the number of mpox cases identified in Africa. There is a large outbreak that has been ongoing in the Democratic Republic of Congo (DRC) since December 2022. The upsurge of mpox cases in the DRC is being driven by outbreaks associated with two sub-clades of the mpox virus, clade Ia and clade Ib. In recent weeks, cases of Clade Ib have been seen in neighbouring countries, Rwanda, Burundi, Kenya and Uganda. The type of mpox that is causing concern in Africa is caused by clade Ib whereas the 2022 multi-country outbreak of mpox was caused by clade IIb. No cases of clade Ib mpox have been detected in Ireland. For further information visit HPSC website.

How does mpox spread?
You can catch mpox if you:

  • Come in contact with the rash, rash fluid or scabs of a person who has mpox, especially if you are caring for the sick person, living with the sick person, or if you are the sexual partner of a sick person.
  • Touch objects contaminated by an infected person such as bed linen, towels or clothing.
  • Are in close contact with an infected person and breathe in the virus which can be passed on when they cough or sneeze.
  • Are a healthcare worker caring for someone with mpox without using appropriate infection prevention and control precautions including person protective equipment.

You can also catch mpox in countries where mpox is found naturally in animals if you:

  • Touch or handle an animal that is infected with mpox
  • Are bitten or scratched by an animal with mpox
  • Eat bushmeat that is infected with mpox (especially if it has not been thoroughly cooked, or if the meat is still bloody)
  • Touch objects contaminated by infected animals (such as bedding), or products from infected animals (such as animal hides).

An infected person can pass the infection on to another person whom they are in close contact with (especially sexual partners, and household members). Occasionally, mpox can be passed to other people who are in close contact with the sick person.

Risk of severe disease
Although mpox cases are usually not life-threatening, some people may be more likely to get severely ill, including:

  • people with severely weakened immune systems
  • children younger than one year old
  • people with a history of eczema
  • people who are pregnant.

What are the symptoms of mpox?
Mpox symptoms can appear in two stages, however, some people may only have a rash:

  • Initial symptoms: The first stage usually begins with a sudden onset of fever (higher than 38.50C) and chills, followed by a bad headache, swollen glands (in the neck, under the arms, in the groin) and exhaustion. There may also be muscle ache, backache, cough and runny nose, and gastrointestinal symptoms (vomiting and diarrhoea). Not everyone with mpox has these initial symptoms.
  • Rash: 1 to 3 days after the fever starts, an itchy rash appears. It may first appear on the face and spread to other parts of the body. The rash generally is only seen on the face, palms of the hands, soles of the feet and occasionally in the mouth. The rash starts like pimples, that grow and turn into sores. Scabs then form, which eventually drop off. Following sexual contact, the rash can also be found in the genitals and around the anus and may not spread elsewhere. Not everyone will experience all the symptoms of mpox. Rash in the anogenital area, or complications of the rash such as rectal pain, may be the main symptom. Some people may have only a small number of lesions. The images below (courtesy of UKHSA) show the different stages of the mpox rash.

Monkeypox rash UK image 2

Images courtesy of UK Health Security Agency

Mpox infection is usually a self-limiting illness and most people recover within weeks, although it can occasionally cause severe complications, including death. Further information on mpox symptoms can be found on the HSE website.

Symptoms begin 5 to 21 days after exposure to the virus. You should seek medical advice straight away if you develop any of these symptoms after:

  • returning from overseas
  • being in contact with a case in Ireland or overseas.

Who is at risk of catching mpox from a person with mpox?
Mpox can be passed to other people who are in close contact with someone with mpox. Contact with household members or sexual contact poses the biggest risks of person-to-person spread. It is important that any further spread of the infection is stopped, therefore, household and sexual contacts, and any other people who had close contact eg sharing a bed or living in the same household as with the person with mpox, will be monitored for three weeks to make sure they don’t develop symptoms.

How long is a person infectious with mpox?
If a person catches mpox, they generally begin to develop symptoms after about 1 to 2 weeks (but symptoms can take up to 3 weeks to appear). The person is infectious (they can pass the infection on to other people) from the point at which they develop a fever (or just before the rash appears if they don’t have a fever), until their rash is completely healed.

How long are people sick with mpox?
People with mpox generally recover in 2 to 4 weeks, depending on the severity of their infection.

How is mpox diagnosed?
If mpox is suspected, samples are taken from the skin rash and sent to a specialist lab. If you don’t have a rash but have other symptoms, a swab from your throat might be taken.

Can mpox be treated?
Most people require no, or only supportive, treatment for mpox. This may include simple pain relief. Antiviral treatment may be needed in patients with more severe disease. Antibiotics may be required if the lesions become infected.

Vaccines can be given either before or after a person is exposed to the virus, but before exposure is recommended for the best protection. Vaccinations for mpox are indicated for people who are a close contact of someone with mpox and for people who are deemed at higher risk of exposure may be offered the vaccine (e.g., gay, bisexual and men who have sex with men (gbMSM) and others at high risk). Further information on vaccine recommendations is available on the National Immunisation Authority (NIAC) website.

If you have mpox, it is important to take care of your mind as well as your body, stay in touch with family and friends virtually and reach out for help or support if you ever need it.

A list of public STI services is available on the HSE’s Sexual Wellbeing website https://www.sexualwellbeing.ie/sexual-health/hse-sti-services-in-ireland.html.

Is there a vaccine against mpox?
Yes, there is a vaccine against mpox. In response to the 2022 multi-country outbreak, the HSE delivered a vaccination programme to vulnerable risk groups. In Ireland, more than 5,000 people were fully vaccinated against mpox with two doses of vaccine, with 11,000 doses administered. The vaccination campaign contributed to controlling the spread of infection, there have been low numbers of mpox cases notified in 2024 in Ireland, compared to 227 cases in 2022. The latest case numbers for mpox in Ireland can be found on the HPSC Notifiable Disease Hub. Given the emergence of a new clade of mpox in Africa, Clade 1b, and the declaration of a Public Health Emergency of International Concern (PHEIC) by the WHO in response, HSE will now consider if there is a requirement for a new vaccination programme. Ireland has a sufficient supply of mpox vaccines, through the EU HERA Joint Procurement Action, that will meet any likely needs over the next few months.

What are the differences between the 2022 global outbreak and the current epidemic in Democratic Republic of Congo and neighbouring countries?
In 2022, mpox cases were reported in countries where mpox didn’t regularly occur, an unprecedented global mpox outbreak then followed. In the 2022 outbreak, mpox was transmitted between humans, mostly through sexual contact. This global outbreak was caused by MPOX Clade II. Many of the cases were in men who self-identify as gay, bisexual or other men who have sex with men (gBMSM). As a small number of cases due to clade IIb continue to occur in Ireland, the HSE advises those who self-identify as gbMSM to be alert to any unusual rashes or vesicular lesions (fluid filled blisters) on any part of their (or their partner’s) body, including their genitalia and anus. If they do notice any such changes, they should contact their local STI Clinic or their General Practitioner (GP) for advice. They should keep away from other people and not engage in sexual contact until they have been seen.

The current mpox epidemic in Democratic Republic of Congo that has spread into neighbouring countries is due to Clade I mpox, evidence is still emerging in relation to transmission routes but multiple modes of transmission are being reported, including household and sexual transmission.

How do I reduce my risk of mpox?

  • If travelling to affected areas on the African continent, refrain from sexual or other close contact with individuals with possible or known mpox infection and with those with visible lesions or other mpox compatible symptoms.
  • Avoid close, skin-to-skin contact with people who have a rash that looks like mpox and animals that carry the monkeypox virus
  • Condoms may be useful to reduce mpox transmission during some types of sex, but because mpox can be transmitted through close contact with rash on parts of the body that condoms don't cover, they won't offer full protection.
  • If you have a rash, contact your local sexual health clinic. Keep away from other people and do not engage in sexual contact until you have been seen. A list of public STI services is available on the HSE’s Sexual Wellbeing website https://www.sexualwellbeing.ie/sexual-health/hse-sti-services-in-ireland.html

I think I have an mpox rash, what do I do?
If you have a rash that looks like an mpox rash or symptoms that are suggestive of mpox, contact your local sexual health clinic or general practitioner. Keep away from other people and do not engage in sexual contact until you have been seen. If you have had recent travel or links to the affected areas in Africa, please inform your sexual health clinic or general practitioner.

Who is a close contact of a person with mpox?
A person with mpox infection may pass on the infection to close contacts from the time they have symptoms until the rash is fully healed. A close contact is someone who has been in close proximity to the person with mpox (this can mean sexual or household contacts and health & care workers caring for the patient) during the time the person may have been infectious.

Public Health doctors will ask the person with mpox who they were in contact with during the time that they had symptoms. Public Health doctors will then determine who needs to be followed up as a close contact. Close contacts will be asked to monitor themselves for symptoms of mpox for 21 days. Depending on how a person was exposed, the clade of the virus and their personal circumstances, some close contacts may be advised to reduce contact with vulnerable people (those with very weak immune systems, pregnant women, and young children) and avoid close physical contact. Some contacts may need to avoid sexual contact during their period of monitoring.

In which countries is mpox found naturally in animals?
Monkeypox virus is found naturally in certain Central and West African countries. Mpox has been found in Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ivory Coast, Liberia, Nigeria, the Republic of the Congo and Sierra Leone. Mpox is not found naturally in animals in Ireland.

For the latest advice for travellers go to: Mpox News

Version 5.4
Last updated: 28 August 2024