🤝 Transmission
Monkeypox spreads mainly through close skin contact with blisters/pustules/crusts; condoms alone are not enough.
👥 Anyone can get infected
More frequent cases with Men who have sex with men; in principle each person infect.
💉 Vaccination provides the best protection
MVA-BN (Imvanex/Jynneos), mostly 2 doses at intervals of ≥28 days; not 100 %, but the best protection - Recommended for increased risk (e.g. changing partners).
🧭 Keeping an eye on the situation
Since 2022 there are outbreaks; the situation can change regionally - get tested if new symptoms appear and temporarily reduce contacts.
What is Mpox / monkeypox?
Mpox is an infectious disease caused by the Mpox virus (orthopoxvirus).
The course of the disease can vary greatly. In addition to general symptoms such as fever, headache or aching limbs and feeling ill, skin changes (lesions) often occur. These can also occur in the genital or anal area and can be associated with severe pain.
In recent years, an increasing number of Mpox cases have been observed in certain networks, including men who have sex with men. In principle, however, anyone can become infected with Mpox / monkeypox.
The disease can be particularly severe in people with a weakened immune system and require intensive medical care.
Transmission of Mpox / monkeypox
Mpox / monkeypox is mainly transmitted through close contact with the skin or mucous membranes. Infection is particularly possible through contact with blisters, pustules, scabs or other skin lesions. Body fluids can also pass on the virus.
Kissing, intensive physical contact and sex can increase the risk of infection. Condoms alone do not offer reliable protection, as monkeypox is mainly transmitted via direct skin contact. However, they can further reduce the risk.
Infection is possible from the onset of the first symptoms and continues until all skin lesions have completely healed.
Protection against monkeypox
Vaccination is the most effective protection against monkeypox. It can significantly reduce the risk of infection and protects in particular against severe courses of the disease.
In Germany, the Mpox vaccination is primarily recommended for people who have an increased risk of infection. This includes, for example, people with frequently changing sexual contacts or close physical contact with other people.
The vaccination usually consists of two doses, which are administered 28 days apart. Protection does not build up immediately, but gradually.
Vaccination can also be useful after close contact with a person suffering from Mpox (monkeypox). It can help to prevent the disease or mitigate its progression.
In addition to vaccination, it is important to look out for symptoms, avoid close physical contact and seek medical advice if you suspect you have monkeypox.
Other measures to reduce the risk of transmission of monkeypox include
- Do not share objects during sex, for example dildos or other sex toys.
- Be careful with symptoms and avoid physical proximity and sex until it is clear what is behind them.
In the case of sexual transmission, monkeypox can occur particularly at contact points such as the mouth, genital or anal area. Condoms can reduce the risk of symptoms in these areas, but do not offer complete protection as the virus can also be passed on via other areas of the skin.
Symptoms and possible consequences of monkeypox
When do symptoms occur?
After infection, the first symptoms can appear the very next day. They often begin after 5 to 11 days. In individual cases it can also up to 21 days until the first symptoms appear (incubation period).
Which symptoms are typical?
Monkeypox can progress in different ways. Some people have general symptoms first, while others are directly affected by the skin changes.
Typical symptoms are, for example
- General complaints such as fever, fatigue, headache and muscle or back pain, feeling ill
- Swollen lymph nodes
- Skin changes (lesions)They can start as spots or nodules, develop into blisters or pustules and later crust over (scabs/crusts).
Where can the skin changes occur?
The skin changes can occur in different places - for example on the face, hands or feet as well as in the genital or anal area. Depending on where they occur, they can be perceived as particularly unpleasant or painful.
How long does the disease last?
The symptoms can last for several days to weeks. Monkeypox often heals within 2 to 4 weeks It is crucial that all skin changes are completely healed.
Possible consequences and complications
In some cases, additional symptoms may occur, for example:
- Inflammation of the skin, when damaged areas become infected with bacteria
- Scarring after the lesions have healed
If you notice symptoms consistent with monkeypox, or if you have had close contact with a person who has been confirmed to have monkeypox, it is sensible to seek medical advice and reduce close physical contact until it is clear what is behind it.
Treatment / Therapy
- SymptomaticPain therapy, local wound/skin management, stool regulation for anal discomfort, fluids/protection
- Antiviral: Tecovirimat in specialised centres for severe courses/complications
- Wound careKeep lesions clean/dry, loose clothing, no manipulation/scratching
- Isolation/Sexpause until all lesions have completely healed (crusts have fallen off and new skin has formed)
Vaccination (pre- & post-exposure)
The following is used MVA-BN vaccine (Imvanex/Jynneos).
- Pre-exposure (before a risk)2 doses at intervals of approx. 4 weeks for people at increased risk (e.g. MSM with frequently changing partners, certain occupational groups).
- Post-exposure (after contact)Administer as early as possible (ideally within 4 days, up to 14 days it can still mitigate the course). Arrange an appointment quickly via specialised practices/health authorities.
Protection / Prevention
- Close skin contact / sex Avoid contact with people who have new, unclear skin changes
- Cover lesions, own towels/bed linen/toys, thorough hand hygiene
- Condoms/gloves/lubricant reduce additional risks, but do not replace skin contact protection
- Vaccination status check and take advantage of vaccination if necessary
- At events/parties: watch out for symptoms, stay at home at the first sign and get tested
What to do with ...
... Suspicion of monkeypox?
Contact doctor's surgery / AIDS service / doctor, organise PCR test, pause close contact / sex until then, cover lesions, use your own towels / laundry.
... positive test?
Clarify pain and wound care with the treating practice, isolation until complete healing. Inform contact persons (anonymously if possible) - they can receive a post-exposure vaccination if necessary.
... severe pain, abdominal/anal discomfort, difficulty swallowing, many lesions?
Acute medical clarification; in severe cases, antiviral therapy (Tecovirimat) is possible.
FAQ - Frequently asked questions about Mpox / monkeypox
Mpox often raises many questions - about infection, symptoms, vaccination and the right behaviour in everyday life. In this FAQ you will find short, reliable answers to the most frequently asked questions.
The "monkeypox virus" (Monkeypox virus or Mpox viruses) was first detected in monkeys. However, it is assumed that the viruses are actually mainly found in rodents (e.g. squirrels and rats). Transmission to humans is possible through bites, body fluids and consumption, for example.
The viruses sometimes cause very painful Skin changes (from rashes to nodules/blisters to pustules and sores that scab over). They usually heal on their own, but can leave scars.
From person to person monkeypox viruses" are mainly transmitted by close and prolonged skin-to-skin contact transferred, especially through contact with the skin lesions (rash, blisters, pustules, wounds, scabs).
The disease usually heals on its own, but can be extremely painfulespecially if the skin damage occurs in the anal or genital area. The pain can be so severe that treatment is only possible in hospital.
Also possible are bacterial infections, who sit „on the damaged areas“. The recommended or ordered treatment is also considered stressful. Insulation experienced that at least 21 days lasts. The RKI currently estimates the health risk for the general population to be low.
So far, HIV-positive people appear to be under functioning therapy and with a good immune status are not more at risk than others.
For people with severely weakened Immune system could be a higher Risk of infection and a higher risk of a more severe course. However, there is still a lack of reliable data on this.
People with HIV can also be vaccinated as long as their number of helpers is at least 100.
For people with weaker or weakened Immune system (100 to 750 Helper cells per microlitre of blood plasma), however, it has been observed that the vaccination effect may be lower.
The main transmission route for Mpox viruses („monkeypox viruses“) is close and prolonged skin-to-skin contact (e.g. when cuddling or having sex), especially contact with skin lesions (rashes, blisters, pustules, wounds, scabs).
Particularly infectious is the Liquid in the vesicles and from the Woundsthat occur after the vesicles burst, as well as the Scabthat forms above it.
The virus can also be transmitted through objects used during sex (e.g. sex toys) or through contact with textiles (e.g. clothing, bed linen, towels) to which scab residues containing Mpox viruses adhere.
Main entrance gates for the virus into the body are in the current outbreak the mucous membranes involved during sex (anal region, penis, oral cavity).
Detailed information: Monkeypox transmission
Symptoms can appear as early as the day after infection. They usually begin within 5 to 11 daysbut it can also take up to three weeks (Incubation period).
Typical are Sometimes very painful skin changes - from rashes/spots to nodules and blisters to pustules, wounds and scabs.
The skin changes often begin in the Face, in the genital or anal region. The pain caused by this can be so severe that it has to be treated in hospital.
Bacterial superinfections are also possible, i.e. inflammation of the damaged areas.
The "pox" usually heals on its own after two to four weeks, but can leave scars.
The skin changes are often caused by General symptoms such as fever, headache, muscle or back pain or swollen Lymph nodes initiated or accompanied.
Vaccination against smallpox was compulsory in the FRG until 1976 and in the GDR until 1982. Many people who were born before this time have this typical Smallpox vaccination scar on the upper arm. )
