What can I do to avoid getting Mpox?

So far, the recent monkeypox infections in the Netherlands have involved MSM contact among people who frequently have sex with multiple partners. Avoid or minimise high-risk contacts to reduce your risk of getting monkeypox. If you are in a group that has a high risk of getting Mpox, you will be invited to get vaccinated in the near future. Vaccination reduces your risk of getting monkeypox, but it does not offer 100% protection.

What can I do to avoid giving Mpox to someone else?

Be alert for symptoms that could indicate Mpox, in yourself and in others. If you have symptoms, make an appointment with your General Practitioner or the Municipal Public Health Services (GGDs) to get tested for Mpox immediately. Avoid intimate contact or direct skin contact (including sex) until the test results are known. If you do have Mpox, cooperate with source and contact tracing by the GGD. The GGD can inform the people that you had high-risk contact with, so new infections can be prevented.

Can I get Mpox if I use a condom?

Be alert for symptoms that could indicate Mpox, in yourself and in others. If you have symptoms, make an appointment with the Municipal Public Health Services (GGDs) to get tested for Mpox immediately. Avoid intimate contact or direct skin contact (including sex) until the test results are known. If you do have Mpox, cooperate with source and contact tracing by the GGD. The GGD can inform the people that you had high-risk contact with, so new infections can be prevented.

Why is it difficult to predict future trends in Mpox cases?

The number of people infected with Mpox is still relatively low. Very limited data from source and contact tracing is available for some of these people. Due to the limited amount of information and the relatively long incubation period, it is difficult to accurately model how the disease will spread.

My child has a skin rash with bumps/blisters. Does my child have Mpox?

Children who have a blistering rash usually have chicken pox, especially if that virus is circulating in the child’s environment. There is no need to contact your GP, another doctor or your local Municipal Public Health Service (GGD). Do contact your GP or doctor (in person or by phone) if your child has been in contact with someone with a confirmed case of Mpox.

Note: The word ‘monkeypox’ is often used for impetigo on the islands of Aruba, Bonaire and Curaçao and in Suriname.

Can you only get Mpox once?

If you have already had monkeypox, you will not usually get it a second time. We do not yet know for sure whether this is also the case after vaccination.  You may still develop a skin rash (including blisters) from direct skin contact with someone who has monkeypox, and those blisters are contagious. 

Therefore, it is still important to have blisters examined by your GP or the Municipal Public Health Service (GGD). This applies even if you are vaccinated. If you test positive for Mpox, you must start self-isolating and follow the rules for isolation, and the GGD will start source and contact tracing.

Why is Mpox subject to mandatory reporting?

Mandatory reporting (A status) was introduced for monkeypox on Saturday, 21 May 2022. All suspected cases of a reportable infectious disease must be reported to RIVM, so measures can be taken as quickly as possible. Since limited information is available about the current outbreak at this time, mandatory reporting helps researchers compile all available information about the disease as fast as possible. This will help us find out how fast the disease is spreading and how contagious it is.

Is Mpox a sexually transmitted infection?

No, Mpox is not a sexually transmitted infection (STI). Monkeypox spreads easily through contact with the skin. When that happens, virus particles (for example from the blisters) can enter your body through the mucous membranes or through wounds, such as cuts or tears that are too small to notice. Because sexual intercourse, making love and kissing involve lots of skin contact, it is easy to transmit the virus during sex. 

Does Mpox occur in animals?

Mpox is a viral infection that originates from animals (zoonoses), caused by viruses that occur naturally in some rodent species in West and Central Africa. Countries in this region – such as Nigeria, DR Congo and Ghana – always see a few cases of Mpox among human patients every year. The recent Mpox infections among people in Europe were caused by contact with other monkeypox patients. This virus does not occur naturally in animals and rodents in Europe. However, it is not completely impossible for animals to become infected if they have prolonged close contact with people who have Mpox. The first case of a dog contracting the monkeypox virus from a human was recently confirmed in Europe; the dog was infected through direct contact with a Mpox patient.

Can pets be infected?

The monkeypox virus can infect rodents (squirrels, rats and mice), rabbits and monkeys. The rodents in Africa that are the natural hosts of the virus often show minimal symptoms from an infection. Monkeys and rabbits can develop respiratory symptoms, eye infections and skin abnormalities, and may also have a fever. Until very recently, monkeypox infection had never been confirmed in other animals, such as dogs, cats, cows, pigs, sheep and goats. The first known monkeypox infection in a dog was recently confirmed; the dog was infected through direct contact with a monkeypox patient.

Are people who are self-isolating allowed to have contact with pets and farm animals?

People who are self-isolating due to monkeypox are advised not to have direct contact with pets (such as dogs, cats, ferrets, rabbits and rodents) during that period. However, they can set out food and walk the dog. There are currently no indications that the vaccine could infect other species that are kept as pets, such as birds, reptiles or fish.
People who are self-isolating due to Mpox are also advised to avoid contact with farm animals such as cows, goats and pigs. They do not need to avoid contact with poultry (birds).
 

When should I contact my GP or the sexual health clinic about specific symptoms?

• Contact your GP or the sexual health clinic if you have blisters on your body – especially if the first blisters formed in the area around your anus or genitals or on your face. 
• Get in touch with your GP or the sexual health clinic if you have had any contact (including sexual contact) with someone who has monkeypox within the past three weeks.

Is there a self-test that I can use to check if I have Mpox?

No. If you think you might have Mpox, contact your GP, the Municipal Public Health Services (GGDs) or a sexual health clinic.

If source and contact tracing shows that I might have had contact with someone who has Mpox, where should I get tested?

The Municipal Public Health Service (GGD) notifies the contacts of a person infected with the monkeypox virus and tells them what needs to happen next.

When am I contagious, and for how long?

If you are infected, you can be contagious as early as two days before the skin rash or proctitis appears. Initial evidence suggests that the virus may be present in sperm even before someone develops any symptoms. You will remain contagious until all the scabs from the blisters must have fallen off and any proctitis symptoms have resolved fully. As a precaution, it is recommended to continuing using condoms during sex for 12 weeks.

Can I register as a high-risk contact for vaccination by the GGD?

If source and contact tracing shows that you are a high-risk contact, the Municipal Public Health Service (GGD) will contact you and tell you what needs to happen next, for example vaccination in the event of high-risk contact. You cannot contact the GGD to request a vaccination yourself. 

Does Mpox always involve multiple blisters, or could I have just one?

Some people develop blisters all over their body and others only have 1 blister. If you may have been exposed and have only one blister, then it is still possible that you might have Mpox. In that case, get tested by the GGD or your GP right away.

Am I already protected against monkeypox if I was vaccinated with the smallpox vaccine before 1975, in the context of the National Immunisation Programme?

Smallpox vaccines were administered in the Netherlands until 1974. These smallpox vaccines are no longer used, because the virus that causes smallpox (the variola virus) has been eradicated worldwide since 1980. The old smallpox vaccine on its own does not offer sufficient protection against Mpox.

Can I also get vaccinated against Mpox if I am not in the target group?

No, the vaccination is currently only available to people who have a higher risk of getting Mpox. You cannot request the smallpox vaccine yourself. A limited number of vaccine doses are available.

Is there any treatment or medicine for Mpox?

There is a registered medicine authorised for use to treat monkeypox in patients admitted to hospital with severe symptoms, but it is not yet available in the Netherlands.

Why is the smallpox vaccine not being offered to everyone?

Most of the recent Mypox infections so far have involved MSM contact (men who have sex with men) among people who frequently have sex with multiple partners. By vaccinating the high-risk group, the aim is to limit the outbreak. Also, a limited number of vaccine doses are available.