Washington DC, United States — Cases of monkeypox have been reported to the World Health Organization (WHO) from several non-endemic countries with no direct travel links to an endemic area.

The Pan American Health Organization (PAHO)/WHO has prepared a comprehensive questions and answers page to update the general public on the outbreak and address any concerns that may arise.

Is there a vaccine against monkeypox?

There are several vaccines available for the prevention of smallpox that also provide some protection against monkeypox. A newer vaccine that was developed for smallpox (MVA-BN, also known as Imvamune, Imvanex, or Jynneos) was approved in 2019 for use in preventing monkeypox and is not yet widely available. WHO is working with the manufacturer to improve access. People who have been vaccinated against smallpox in the past will also have some protection against monkeypox. The original smallpox vaccines are no longer available to the general public, and people below the age of 40–50 years are unlikely to have been vaccinated since vaccination against smallpox ended in 1980 after it became the first disease to be eradicated. Some laboratory personnel or health workers may have been vaccinated with a more recent smallpox vaccine.

Is there a treatment for monkeypox?

Monkeypox symptoms often resolve on their own without the need for treatment. It is important to take care of the rash by letting it dry if possible or covering it with a moist dressing to protect the area if needed. Avoid touching any sores in the mouth or eyes. Mouth rinses and eye drops can be used as long as cortisone-containing products are avoided. Vaccinia immune globulin (VIG) may be recommended for severe cases. An antiviral that was developed to treat smallpox (tecovirimat, commercialised as TPOXX) was also approved for the treatment of monkeypox in January 2022.

What do we know about the outbreak of monkeypox identified in several countries in May 2022 ?

Several countries where monkeypox is not endemic have reported cases in May 2022. As of May 19, 2022, cases are being reported from over 10 countries in non-endemic areas. Additional cases are being investigated. For the latest information, please see here. With the exception of cases sporadically reported in travellers from endemic countries, cases in non-endemic areas that are not linked to travel from endemic countries are not typical. At the present time (as of May 2022) there is no clear link between the cases reported and travel from endemic countries and no link with infected animals. We understand that this outbreak is concerning for many, especially people whose loved ones have been affected. What is most important right now is that we raise awareness about monkeypox among people who are most at risk of infection and provide advice on how to limit further spread between people. It is also important that public health workers are able to identify and care for patients. It is essential that no one stigmatise anyone who is affected by this event. WHO is working to support the member states with surveillance, preparedness and outbreak response activities for monkeypox in affected countries. Studies are under way in affected countries to determine the source of infection of each identified case and actions to provide medical care and limit further spread.

Is monkeypox a sexually transmitted infection?

Monkeypox can spread from one person to another through close physical contact, including sexual contact. It is currently not known whether monkeypox can be spread through sexual transmission routes (eg, through semen or vaginal fluids), but direct skin-to-skin contact with lesions during sexual activities can spread the virus. Monkeypox rashes are sometimes found on genitals and in the mouth, which is likely to contribute to transmission during sexual contact. Mouth-to-skin contact could thus cause transmission where skin or mouth lesions are present. Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis. This may explain why several of the cases in the current outbreak have been identified amongst men seeking care in sexual health clinics. The risk of becoming infected with monkeypox is not limited to people who are sexually active or men who have sex with men. Anyone who has close physical contact with someone who is infectious is at risk. Anyone who has symptoms that could be monkeypox should seek advice from a health worker immediately.

Are men who have sex with men at higher risk of catching monkeypox?

Monkeypox is spread from person to person through close physical contact. The risk of monkeypox is not limited to people who are sexually active or men who have sex with men. Anyone who has close physical contact with someone who is infectious is at risk. Anyone who has symptoms that could be monkeypox should seek advice from a health care provider immediately. This includes people who have connections to communities where cases have been reported. Several of the cases that have been reported from non-endemic countries have been identified in men who have sex with men. These cases were identified at sexual health clinics. The reason we are currently hearing more reports of cases of monkeypox in communities of men who have sex with men may be because of positive health-seeking behaviour in this demographic. Monkeypox rashes can resemble some sexually transmitted diseases, including herpes and syphilis, which may explain why these cases are being picked up at sexual health clinics. It is likely that as we learn more, we may identify cases in the broader community

What is WHO’s response to stigmatising messaging circulating online related to monkeypox?

We have seen messages stigmatising certain groups of people around this outbreak of monkeypox. We want to make it very clear that this is not right. First of all, anyone who has close physical contact of any kind with someone who has monkeypox is at risk, regardless of who they are, what they do, who they choose to have sex with, or any other factor. Secondly, stigmatising people because of an illness or a disease is unacceptable. Stigma is only likely to make things worse and stop us from ending this outbreak as fast as we can. We need to all pull together to support anyone who has been infected or who is helping to take care of people who are unwell. We know how to stop this disease, and how we can all protect ourselves and others. Stigma and discrimination are never okay, and it is not okay in relation to this outbreak. We are all in this together.