Recently, there have been reports of infections with monkeypox virus in several countries in Europe, e.g. the United Kingdom, Portugal, Spain, Italy, Belgium and Sweden, but the disease has also been detected in the United States and Canada. Most have had confirmation of monkeypox virus, but others have not yet. Monkeypox is caused by a virus closely related to smallpox (orthopox) which is mainly known in animals but also in humans. Animal-to-human transmission is rare as is zoonosis. The disease has so far been mainly diagnosed in Central and West Africa, but is now being diagnosed in Europe in individuals, some of whom have been in Africa and others have not. Transmission occurs in humans through close contact either as cough/sneezing droplets or as a contact infection with exudates that develops through skin rashes. Many of those who are now being diagnosed are men who have sex with men and it is thought likely that infection was transmitted through sexual contact in this group.

The incubation period of the infection (time from infection to onset of symptoms) is usually one to two weeks but can range as high as three weeks. The disease is usually mild and spontaneously progresses over a period of one to two weeks. However, approximately 3% of all infected patients may be severe and cause death, especially in immunocompromised patients and children. A defining feature of the disease is an itchy rash that often begins in the face and then moves down the body, including the genitals. This is followed by the rash developing pimples with varicella-like virus, which is infectious. Once the acne has dried, the individual is no longer infectious.

The disease picture may resemble other diseases such as chickenpox or syphilis, but diagnosis is confirmed by a study of the vacuoles' fluids. Vaccination with smallpox vaccines is considered to protect the patient from transmission of infectious diseases, but the availability of such vaccines is limited. Antiviral treatment tecovirimate is believed to be beneficial in treating the infection, but this drug is not on the market here. It should be noted that monkeypox is an extremely rare infection and it is not impossible to spread to Iceland. The general public and healthcare professionals are asked to keep the diagnosis in mind, especially for those who have been travelling abroad and have characteristic rashes.

The Chief Epidemiologist