Monkeypox can be transmitted through close contact with a person who already has the infection, including direct contact during sex, and can also be passed on by contact with clothing or linens used by a person who has the disease.

On 30 May 2022, Public Health Scotland (PHS) confirmed the fourth case of monkeypox in the country.

As of 29 May 2022, the UK Health Security Agency (UKHSA) identified 172 cases of monkeypox in England, while on 26 May 2022, Public Health Wales (PHW) and the Public Health Agency (PHA) confirmed the first cases of monkeypox in Wales and Northern Ireland respectively, though the UKHSA have reported a second case in Northern Ireland. Further, the European Centre for Disease Prevention and Control (ECDC) reported an additional 118 cases from 12 EU and EEA member states, as of 25 May 2022.

Initial symptoms of monkeypox include:

• fever
• headache
• muscle aches
• backache
• swollen lymph nodes
• chills
• exhaustion

A rash can develop, often beginning on the face, then spreading to other parts of the body, including the genitals. The rash changes and goes through different stages before finally forming a scab, which later falls off. 

• People with possible, probable or confirmed monkeypox should avoid contact with other people until their lesions have healed and the scabs have dried off. Cases can reduce the risk of transmission by following standard cleaning and disinfection methods and washing their own clothing and bed linen with standard detergents in a washing machine.
• Cases should also abstain from sex while symptomatic, including the period of early symptom onset, and while lesions are present. Whilst there is currently no available evidence of monkeypox in genital excretions, as a precaution, cases are advised to use condoms for eight weeks after infection and this guidance will be updated as evidence emerges.
• If people with possible, probable or confirmed monkeypox infection need to travel to seek healthcare, they should ensure any lesions are covered by cloth and wear a face covering and avoid public transport where possible.
• Contacts of someone with monkeypox will also be risk assessed and told to isolate for 21 days if necessary.
• Where possible, pregnant healthcare workers and severely immunosuppressed individuals, as outlined in the Green Book, should not assess or clinically care for individuals with suspected or confirmed monkeypox. This guidance will be reassessed as evidence emerges.
• The minimum recommended personal protective equipment (PPE) for staff working with confirmed cases includes fit tested FFP3 respirators, aprons, eye protection and gloves. For possible or probable cases minimum recommended PPE for staff includes fluid repellent surgical facemasks (FRSM), gowns, gloves and eye protection.
• Within non-domestic residential settings, such as adult social care, prisons, homeless shelters and refuges, individuals who are clinically well should be managed in a single room with separate toilet facilities where possible. Close contacts of confirmed cases should be assessed for vaccination. 

People with monkeypox are advised to avoid contact with their pets, its bedding and litter for 21 days.

Dr Nick Phin, Director of Public Health Science and Medical Director, PHS said:

“Anyone with an unusual blister-like rash or small number of blister-like sores on any part of their body, including their genital area, should avoid close contact with others and seek medical advice if they have any concerns.

“Public Health Scotland (PHS) continues to work with NHS Boards and wider partners in Scotland and the UK to investigate the source of these infections.

“We have well established and robust infection control procedures for dealing with such cases of infectious disease and these are being strictly followed and the overall risk to the general public is low.”