Recently, the Director-General of the World Health Organization (WHO) declared monkeypox to be an acute threat to public health in the world. Apapox is considered to meet the 2005 IHR criteria as an unusual event (disease) which threatens public health in other states due to its transnational spread and which may require a coordinated international response. The declaration provides the WHO with a tool to coordinate measures and is a warning and a call to the nations of the world to act in concert and stop the spread of the virus. This is the seventh such declaration since 2005, the others being due to influenza H1N1 (swine flu), polio, zinc virus, ebola virus infection (twice) and COVID-19.

Ten cases of monkeypox have been diagnosed in Iceland, but no serious illnesses have occurred. All are men of middle age and all but two of these infections are traced to other countries. This week, a risk assessment vaccine for monkey pox was introduced in Iceland. More vaccines are expected in the near future.

What is monkey pox?

Apapox is a disease causing virus of the same name. Apapox often improves spontaneously, meaning that symptoms usually resolve within two to four weeks without treatment.

What are the symptoms I should be aware of? Symptoms can range from mild to severe:

• rashes in the face, hands, feet, eyes, mouth, around the anus or genitals.

  • Rashes may be pimples, blisters, ulcers.

• inflammation and pain in the rectum

• heat

• inflamed/enlarged lymph nodes

• headache

• muscle pain

• Fatigue/loss of energy

The rash may precede or follow other symptoms. Wounds and rashes may begin on the hands, neck and face and may spread to the rest of the body. The rash can also be subtle and localised as genitalia. The rash is usually painful and uncomfortable.

In this outbreak, most – but not all – cases have been diagnosed so far in gay, bisexual and other men who have sex with men, with sores and rashes appearing around the genitals or around the anus or in the mouth.

It is important to note that anyone in close physical contact with a infectious individual can become infected with monkeypox, regardless of age, sex or sexual orientation.

How does monkey pox spread? Apapox is not easily spread from person to person. To get infected with monkeypox, you need to have close contact for a longer period with someone who already has monkeypox, or be in contact with contaminated items such as towels, bedding. Direct contact with the skin by rashes or wounds of someone with monkey pox is particularly risky.

Our advice includes that:

• Use safe sex, including limiting the number of partners and avoiding sex with strangers. Condoms may reduce but not completely eliminate the risk of monkey pox

• Hand sanitiser with soap and water or hand sanitiser

What should I do if I suspect I have monkey pox? If you have symptoms that are suspicious of monkey pox, you should:

• Avoid large gatherings, parties, festivals and large events.

• Call the outpatient department of the Landspítali University Hospital or the primary healthcare clinic.

• Do not have sex until you have seen a doctor and confirmed that you have no infection/improvement.

• Take a monkey pox test, as recommended by a doctor.

What should I do if monkeypox is confirmed?

• Follow , including:

  • Isolate yourself until the symptoms go away (when the last crust has fallen off).

  • Take a break from sex. As a precaution, you should use a condom during sex for 12 weeks after healing.

  • Avoid close contact with people who are more susceptible to serious disease caused by monkeypox (pregnant women, young children, immunocompromised people).

  • Tell health authorities about exposed individuals so they can be informed and protect themselves and others. If you do not think you can share this information, please consider contacting the party yourself.
    

• For further details see WHO.

• Poster in Icelandic and English

The Chief Epidemiologist