Mpox (Monkeypox)

The monkeypox virus is largely spread through close and primarily sexual contact. Cases of the disease are generally mild. A vaccination is available.

Name

After a series of consultations with specialists around the world, the WHO has now begun using the name ‘mpox’ for what was formerly referred to as the disease ‘monkeypox’. The change is intended to avoid any stigmatisation of persons contracting the virus. The FOPH is also adopting the new ‘mpox’ name.

Virus and transmission

The monkeypox virus is a member of the orthopoxvirus family. The virus is primarily transmitted through direct contact of the skin or mucous membranes, or via contact with infected secretions from one or more blisters or lesions on the skin or the mucous membranes of a person already infected. The monkeypox virus can also spread via scabs, respiratory secretions and bodily fluids; and pregnant women who are infected can transmit the virus to the foetus via the placenta. Whether the virus can also be transmitted via semen, vaginal secretions, urine and/or faeces has not yet been established.

Pathology

The disease mpox may develop within five to 21 days after close contact with an infected person. The severity of its symptoms varies from case to case. Some infected persons develop only isolated and mild symptoms. The skin rash is often unremarkable, with few or only isolated blisters or pimples. These blisters and pimples – lesions – may be painful or itchy, and can develop at any stage in the course of the disease. The infection may also cause flu-like symptoms (such as fever, chills, headache, muscle ache, backache, a sore throat and similar) and/or symptoms in the genital and anal area (pain, bleeding, inflammation).

A person with mpox may be infectious themselves from the time the first symptoms appear until the skin rash has disappeared, i.e. until the last scabs have fallen off.

No long-term effects of an mpox infection have yet been detected. Immunocompromised persons, infants, children and pregnant women seem to be at higher risk of developing a more severe case of the disease.

Spread and incidence

The monkeypoxvirus virus is likely to have originated among rodents in West and Central Africa, which may have then passed it on to humans. A few occasional cases or minor outbreaks of the disease had been reported from these West and Central Africa regions up to May 2022. Elsewhere, apart from one outbreak in the USA in 2003, only isolated cases had been reported, among persons who had recently travelled to the regions concerned.

Exceptionally large numbers of mpox infections were first seen worldwide – and in Switzerland, too – in summer 2022. The World Health Organization (WHO) declared this mpox outbreak a Public Health Emergency of International Concern on 23 July 2022.

Only sporadic cases of mpox have been reported since autumn 2022. What has been observed – in Switzerland and worldwide – is that the cases reported have particularly (but not exclusively) involved men who have sex with men (MSM) and trans persons with changing male sexual partners. The risk of infection for the broader population is low.

Prevention

Persons at risk can basically protect themselves from mpox infection by adapting their behaviour. A preventive vaccination (Jynneos® from Bavarian Nordic) may also be administered, subject to an individual risk/benefit analysis with a healthcare professional. Responsibility for organising and performing such vaccinations lies with the cantons, who will also determine where these can be administered. Information on vaccination possibilities and the appropriate specialist healthcare professionals is available from the cantonal health authorities. Anyone wishing to receive an mpox vaccination must seek prior medical advice on this from a specialist healthcare professional.

The treatment of mpox consists primarily in treating its symptoms. In particularly severe cases, an antiviral therapy may also be conducted. The medicine required for this is available in Switzerland.

The costs of vaccination against Mpox (vaccine and inoculation) will be covered by health insurance from 1 January 2024. Further information can be found in a leaflet (available in German (PDF, 137 kB, 22.12.2023) and French (PDF, 133 kB, 22.12.2023)).

Further information is also available at:
The Swiss AIDS Federation
Dr. Gay
 

Last modification 08.01.2024

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