Monkeypox

Monkeypox is a rare viral infection.

The risk of catching monkeypox in Scotland currently remains low.

Anyone can get monkeypox. However, currently most of the cases across Europe and the UK have been in gay, bisexual and other men who have sex with men (GBMSM).

You can catch monkeypox through close personal contact with someone who has the infection, such as during sex.

Read further information on monkeypox and safer sex

Symptoms of monkeypox

If you're infected with monkeypox, symptoms usually start 5 to 21 days later. The symptoms often get better by themselves over 2 to 4 weeks.

Symptoms of monkeypox can include:

high temperature (fever)
headache
flu-like symptoms, including muscle and back aches, shivering and tiredness
swollen glands that feel like new lumps (in the neck, armpits or groin)
a blistering rash that usually starts 1 to 5 days after other symptoms – the rash may start on the face or in the genital area and may spread to other parts of the body
inflammation of the rectum (proctitis) – for example pain or bleeding from your back passage

The skin lesions (pox) go through 4 phases:

Flat spots
Raised spots
Blisters
Healing by scabbing or crusting over

Monkeypox rash can sometimes be confused with other diseases that can look similar, like chickenpox. A diagnosis of monkeypox requires an assessment by a health professional and specific testing.

How monkeypox is spread

Monkeypox does not spread very easily between people. However, you can catch monkeypox from close contact with an infected person with monkeypox through:

touching blisters or scabs and having any skin contact (including sexual contact)
touching clothes, bedding, towels or personal items used by a person who has a monkeypox rash, blisters or scabs
coughs or sneezes from a person with monkeypox

How to reduce the spread

To reduce your risk of exposure to monkeypox you should:

avoid close contact, including sexual contact, with someone who is unwell and may have monkeypox
avoid touching the clothes, bedding or towels of a person who may have a monkeypox rash
avoid coughs and sneezes from a person who may have monkeypox
practice careful hand hygiene if visiting or caring for ill friends and relatives who may have monkeypox

Treating monkeypox

Monkeypox is usually a mild illness. Most people recover in 2 to 4 weeks.

However, in some cases if a person is really unwell, they may require hospital treatment in a specialist unit.

Vaccination to help protect against monkeypox

Monkeypox is caused by a virus similar to the one that causes smallpox. So vaccines designed for smallpox are considered effective against monkeypox.

Read about vaccination to help protect against monkeypox

What to do if you're worried you have monkeypox

Non-urgent advice: Phone your GP or sexual health clinic if:

You have symptoms of monkeypox and you identify as a gay, bisexual or other man who has sex with men (GBMSM).

Or, you have symptoms of monkeypox and regardless of your sexual orientation, in the last 21 days you've either:

been in contact with someone who has told you they think they have monkeypox or has had a positive test
had 1 or more new sexual partners
travelled to west or central Africa

Non-urgent advice: Phone a sexual health clinic if:

You have:

genital lesions (for example a blister or sore)
proctitis (for example inflammation, pain or bleeding from your back passage)

Find your local sexual health clinic

If your sexual health clinic is closed, phone your GP. If your GP is closed, phone 111. In an emergency phone 999.

You should stay at home, avoid close contact with others and get medical help by phone until you're assessed.

What to do if you have monkeypox and have been told to self-isolate

If you have monkeypox, your doctor or a health protection specialist will advise you to self-isolate at home. This will help prevent the spread of infection.

You'll have been provided with contact details of a medical team and you should contact them if you have any concerns. Get medical attention quickly if your illness is worsening. In an emergency, phone 999 and tell the call handler or operator that you have monkeypox infection.

How to self-isolate safely at home

You should:

not go to work, school, public areas, or any social gatherings
not have any visitors such as friends or family
stay 3 steps (1 metre) away from people you live with if you use your garden
postpone any non-essential medical or dental treatment
if you need any essential treatment, discuss this with your healthcare professional before you go
only leave your home for essential purposes such as emergencies, urgent medical appointments, or for urgent health and wellbeing issues

Avoid close contact with people you live with

People who live in the same household as someone with monkeypox are at the highest risk of becoming infected. This is because they are most likely to have close contact over a period of time. If you live with other people, they'll have been advised to isolate at home too and will be given further advice.

You should:

avoid physical contact with people you live with
keep at least 3 steps (1 metre) away from people you live with
avoid intimate and sexual contact with others
avoid close contact with young children, pregnant women and people with a weakened immune system – this is particularly important as they may be at higher risk of serious illness
sleep in a separate room if you can
use separate bedding, blankets and pillows from other people in your home
use a separate bathroom if you can
follow advice for cleaning
use separate towels, washcloths, toothbrushes and razors
eat in a separate room
ask the people you live with to bring your meals to you
do not share food and drinks
use separate cups, utensils and dishes from other people in your home
clean your hands regularly by washing with soap and water for 20 seconds – take care if you have extensive or ulcerated blisters or a rash on your hands

Cover your mouth and nose with disposable tissues when you cough or sneeze. Dispose of them in a bag. Place this bag in another bag and follow the instructions for disposing of waste. Wash your hands thoroughly with soap and water for 20 seconds.

If you are not able to follow this advice at any time during your self-isolation period, you should speak to your doctor or healthcare specialist.

If you need to leave your home for essential purposes

Make sure any blisters or rash on your body is completely covered. For example, by wearing a long-sleeved top and full-length trousers.

Wear a well-fitting surgical face mask or a double-layered face covering while you're outside your home.

Keep the time spent outside your home as short as possible.

Avoid contact with objects such as furniture in public spaces.

If you need to travel for essential purposes you should walk, cycle or drive yourself. If this is not possible, you can be driven by a household member as long as they are not pregnant or have a weakened immune system. You should wear a well-fitting surgical face mask or double-layered face covering while in the car.

If private transport is not available, public transport can be used. You should avoid busy periods. Cover any blisters or rash with cloth. For example using scarfs or bandages. Wear a well-fitting surgical face mask or double-layered face covering.

Ask friends or relatives to help with buying groceries, other essentials or collecting medication, or order them online. Friends, relatives and delivery drivers should leave items outside your home and should not come inside. They should not touch anything that you have touched.

Cleaning crockery and cutlery

Clean your own used crockery and cutlery. If you have one, use a dishwasher to clean and dry these items. Otherwise, wash your own crockery and cutlery using your usual washing up liquid and warm water and leave them to air dry.

If you have blisters or rash on your hands, wear single-use disposable gloves or reusable washing up gloves while washing up. Any reusable gloves should not be shared. They should be binned at the end of your isolation period.

Cleaning clothes and bedlinen

You should do your own laundry. Keep your laundry items separate from the rest of the household’s laundry. Wash them using your normal detergent, following manufacturer’s instructions.

If possible, use the highest temperature which the items can withstand.

Do not overload the washing machine – aim for half or two-thirds full. Avoid shorter 'economy cycles' (those which reduce water and save energy) until you have fully recovered.

When you're taking laundry to the washing machine, avoid shaking the laundry. This could spread virus particles into the air and onto surfaces in your home.

If you're carrying dirty laundry from one room to another you can place it in a large plastic bag or a container then take it straight to the washing machine.

If you do not have a washing machine, you can hand-wash your laundry using warm water and your normal detergent. This might be more effective in a large sink or bathtub.

Clean all surfaces when you have finished.

Cleaning surfaces around your home

You should regularly clean surfaces that you touch often. For example, door handles and light switches. Use a damp cloth to prevent dust from gathering on surfaces, especially in your bedroom.

Use your usual household cleaning products, such as detergents and bleach.

Take extra care if using bleach to clean surfaces. You should:

always follow the manufacturer’s instruction for diluting disinfectants
protect your eyes
thoroughly rinse the disinfectant off every surface once you have finished

Cleaning surfaces in a car

If you have to travel in a car with someone else, or have driven yourself alone in a car you normally share, wipe down all hard surfaces after the journey. You should do this using a standard detergent or detergent wipes. You should also wear gloves and a well-fitting surgical face mask or double-layered face covering.

Waste should be double bagged and disposed of following waste disposal advice.

Disposing of personal and cleaning waste

Put personal waste (such as used tissues) and disposable cleaning cloths in disposable rubbish bags.

Vacuum cleaner waste should be emptied carefully into a disposable rubbish bag. This includes disposable filters if your vacuum cleaner has one.

Put all disposable rubbish bags into a second disposable bag. Tie it securely before binning with your usual waste.

You should not put any waste into recycling bins until you have ended your self-isolation.

Pets

No cases of monkeypox have been reported in wild animals or pets in the UK. But it is possible that pets could become infected or contaminated with the virus through close contact with an infected person. They could then spread the virus to others.

If you have pets you should avoid close contact with them as much as you can and practice good hygiene.

If you have pets you should read and follow the guidance for pet owners who are isolating because of monkeypox from the Animal and Plant Health Agency.

Do not let pets sleep in the bed with you.

Wash your hands before and after handling pets or materials they have had contact with. For example, collars, leads, feed and feeding bowls, litter trays, bedding and toys.

Your pets should remain in the house with you but you may let them out to go to the toilet on a lead. Keep a 1 metre distance from other people and animals. Going outside should be kept to an absolute minimum while you're isolating.

If your pet needs veterinary care while you're isolating at home, do not take your pet to your usual veterinary practice. Phone them in advance to ask their advice. You may have to ask someone else to take your pet to the surgery for you.

Ending self-isolation

You should self-isolate at home until:

you have not had a high temperature for at least 72 hours
you have had no new blisters in the previous 48 hours
all your blisters have scabbed over
you have no blisters or ulcers in your mouth
any blisters on your face, arms and hands have scabbed over, all the scabs have fallen off and a fresh layer of skin has formed underneath

If you meet all of these points, you may be able to stop self-isolating. But, you should speak to your doctor or healthcare specialist first to discuss this. You should continue to avoid close contact with young children, pregnant women and people with a weakened immune system until the scabs on all your blisters have fallen off and a fresh layer of skin has formed underneath. This is because you may still be infectious until the scabs have fallen off.

After your self-isolation has ended you should cover any remaining blisters when leaving the house or having close contact with people in your household until all the scabs have fallen off and a fresh layer of skin has formed underneath.

Sexual activity

While you're self-isolating, you should refrain from sexual activity to reduce the risk of you passing the infection on to your partner. It's not known how long monkeypox virus remains present in semen and other genital fluid.

If you wish to resume sexual activity after your self-isolation has ended, you should use a condom for 12 weeks after your rash has scabbed over and scabs have fallen off. This is a precaution to reduce the risk of spreading infection to your partner.

Looking after your wellbeing

Staying at home for a period of time can be difficult, frustrating and lonely for some people. You or other household members may feel low. It can be more difficult if you don’t have much space or a garden.

You should take care of your mind as well as your body and get support if you need it. Stay in touch with family and friends over the phone or on social media.

Waverly Care offer one to one mental health and wellbeing support to people with monkeypox who are isolating, via video or phone calls. Anybody who would like this support should fill in the 'Looking for support' online form.

Read further advice on mental wellbeing