Answers to common questions about monkeypox

Monkeypox is a disease caused by the monkeypox virus. It is commonly found in central and west Africa and is occasionally identified in other countries. It is called monkeypox because it was first detected in monkeys. An outbreak is currently taking place in numerous countries in the WHO European Region and other regions that do not typically have cases.

Symptoms of monkeypox typically include a fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes and, most typically, a skin rash or lesions. The rash usually begins within 1–3 days of the start of a fever. Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and can then crust, dry up and fall off. The number of lesions on one person can range from a few to several thousand.

The rash tends to be concentrated on the face, palms of the hands and soles of the feet. A genital and perianal rash has been reported mostly commonly in the current outbreak.

Symptoms typically last between two and four weeks and go away on their own without treatment. In some individuals, they can lead to medical complications and, rarely, death. People with underlying immune deficiencies, young children and pregnant women may be at risk of more serious symptoms.

People with monkeypox are infectious while they have symptoms (normally 2–4 weeks). You can catch monkeypox through close physical contact with someone who has symptoms. The rash, bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Clothing, bedding, towels or objects like eating utensils/dishes that have been contaminated with the virus from contact with an infected person can also infect others.

Ulcers, lesions or sores in the mouth can be infectious, meaning the virus can spread through saliva. People who closely interact with someone who is infectious, including health workers, household members, sexual partners and commercial sex workers, are therefore at greater risk for infection.

If you think you have symptoms or have been a close contact of someone with monkeypox, get in touch with your health worker for advice, testing and medical care. If possible, self-isolate and avoid close contact with others, including abstaining from sex. Take the steps listed above to protect people close to you from becoming infected.

Monkeypox can spread through close skin-to-skin contact during sex, including kissing, touching, and oral and penetrative sex with someone who has symptoms. Monkeypox rashes or skin lesions have been found on genitals and in the mouth, which is likely to contribute to transmission during sexual contact. Mouth-to-skin contact could cause transmission where skin or mouth lesions are present.

It currently is not known whether monkeypox can be spread through semen or vaginal fluids. People who have symptoms should avoid sexual contact with others and, until we know more, should continue using condoms after they recover.

You can reduce your risk by avoiding close contact, including sexual contact, with people who have suspected or confirmed monkeypox. If you need to have close contact with someone who has symptoms, encourage them to self-isolate or cover any skin lesion if they can (with a light bandage or clothing over the rash, for instance). When you are physically close to each other, both of you should wear a medical mask. Avoid skin-to-skin contact
whenever possible and use disposable gloves if you have any direct contact with lesions.

Regularly clean your hands with soap and water or an alcohol-based hand rub, especially after contactwith the person who is infected, their clothes, bed sheets, towels and other items or surfaces they have touched or with which they may have come into contact, or their rash or respiratory secretions (from utensils and dishes, for example). You should wash clothes, towels, bedsheets and eating utensils with warm water and detergent and wear a mask when handling any clothes or bedding. Clean and disinfect any contaminated surfaces and dispose of contaminated waste (such as dressings) appropriately.

Monkeypox is spread from person to person through close contact. The risk of monkeypox is not limited to men who have sex with men. Anyone who has close contact with someone who is infectious is at risk. One possible explanation for cases of monkeypox during this outbreak being reported more commonly in communities of men who have sex with men is that these communities may be more aware of health risks and seek care more often. Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may explain why these cases are being picked up at clinics for sexually transmitted infections. It is likely that as we learn more, we may identify cases in the broader community.

Not at all, but it’s what people do at these festivals and parties that matters, because sexual contact with multiple partners could put people at higher risk of being infected or spreading monkeypox unknowingly. We need to be aware of what can be done to minimize the risk and be vigilant in protecting each other and the community.

People should enjoy themselves, but in a safe way. Think about how to lower your risk by, for example, engaging in safe sexual behaviour, limiting the number of your sexual partners, practising good hygiene like regular handwashing and avoiding close physical contact with someone who has symptoms consistent with the disease.

Find more information on monkeypox in the European Region here. Check your local official sources for the situation near you.

Both smallpox and monkeypox viruses belong to the Orthopoxvirus genus of the Poxviridae family, so the smallpox vaccine also provides cross-protection against monkeypox. The vaccine helps the immune system recognize and fight the virus.

Vaccination significantly reduces the risk of developing a severe form of the disease.

A third-generation smallpox vaccine, Imvanex, is registered in the European Union and is given to adults to protect against smallpox.

The availability of this vaccine is limited, so in order to allow the rapid control of outbreaks, the US-made vaccine „Jynneos“ is also  allowed for use in the European Union.

Lithuania received 1,400 doses of the „Jynneos“ vaccine, which the European Commission bought and proportionately distributed to the Member States of the European Union.

Mass vaccination of the population against monkeypox is not carried out, only those persons who had high-risk contact with the sick person can be vaccinated. Such individuals are identified by specialists of the National Public Health Center (NVSC) by interviewing a patient with monkeypox. After assessing the degree of risk, NVSC specialists can recommend immunoprophylaxis and refer to one of the five vaccinating institutions (Vilnius, Kaunas, Klaipėda, Šiauliai or Panevėžys). The doctor of the vaccinating institution will assess the health status of the person who had contact and make the final decision on vaccination.

Persons from the age of 18 years can be vaccinated with the „Jynneos“ vaccine. The vaccination schedule consists of two doses administered 4 weeks apart. Individuals who have previously received one dose of live smallpox vaccine are recommended to receive another dose of the vaccine.

The monkeypox vaccination is recommended within four days of high-risk contact with an infected person. If the vaccine is given 4–14 days after the day of high-risk exposure, vaccination can help reduce the severity of symptoms associated with monkeypox infection. The final decision on vaccination is made by the doctor.

The most common side effects of the „Jynneos“ vaccine are pain, redness, swelling, itching and stiffness at the injection site, as well as muscle pain, headache and tiredness.

The „Jynneos“ vaccine does not cause smallpox, monkeypox or other diseases. Even after vaccination, it is important to continue to protect yourself from contracting monkeypox. Avoid close contact with the skin of person with  monkeypox, including intimate contact.