M-pox (previously called Monkeypox) is an infection that is usually spread by wild animals in parts of central or west Africa. However, at the moment, the spread of infection is mostly through close physical contact between people. Currently, there is an ongoing multi-country outbreak of m-pox with more than 25,000 confirmed cases of m-pox in Europe, North America and many other countries worldwide. The World Health Organisation has now declared this as a Public Health Emergency of International Concern.
Is there m-pox in Ireland?
The Health Protection Surveillance Centre (HPSC) has now been notified of 225 confirmed cases of m-pox in Ireland as of December 2022. For each case, Public Health is following up with those who had close contact with the case while they were infectious. Public health risk assessments have been undertaken, and those who were in contact with the cases are being advised on what to do in the event that they become ill.
Most of the cases in Ireland do not have a travel link to a country where m-pox is common and have most likely acquired this infection in Ireland. Many countries have reported that the cases are mostly, but not exclusively, in gay and bisexual men or other men who have sex with men. However, anyone can be infected with m-pox and it is important not to refer to the virus as only impacting gay and bi men or men who have sex with men.
How do you get m-pox?
In Ireland, it is most likely that you would get m-pox infection through close physical contact with someone who has the infection. However, it does not spread easily between people. The biggest cause of spread between people is through sexual contact or close contact with family members.
Sexual contact can include:
It can also be spread through:
- Touching clothing, bedding or towels used by someone with the m-pox rash
- Touching m-pox skin blisters or scabs
- The coughs or sneezes of a person with the m-pox rash
What are the symptoms of m-pox?
It usually takes between 5 and 21 days for the first symptoms to appear.
The first symptoms of m-pox may include some of the following symptoms:
- Rectal pain and bleeding (proctitis)
- A high temperature (38 degrees Celsius or higher)
- A headache
- Muscle aches
- Swollen glands
- Shivering (chills)
A rash usually appears 1 to 5 days after the first symptoms, although sometimes the rash can be the only symptom. The rash often begins on the face and then spreads to other parts of the body. If m-pox has been spread through sexual contact, the rash can first appear around the genital and anal area.
The rash is sometimes confused with chickenpox. It starts as raised spots, which turn into small blisters filled with fluid. These blisters eventually form scabs which later fall off. The symptoms usually clear up in 2 to 4 weeks and people with the infection will be supported by their doctor and public health to isolate during this time.
Overwhelmingly, most people isolate at home. Sometimes if people are not able to isolate themselves, for example if they are sharing a bedroom, then the public health team can help arrange free, short-term accommodation. Sometimes people may need additional support from the hospital team. This can include for symptoms like itching, pain management or if there is inflammation of the rectum and difficulty passing a bowel motion.
There are some medications to treat m-pox, but supply is very limited internationally at present. The vast majority of patients get better themselves and do not need any treatment specifically for m-pox. Some patients need antibiotics if there is a suspicion of an STI or a skin infection on top of the m-pox skin lesions. Very occasionally people with a very weak immune system or very young babies can get a severe illness. No one has died in developed countries to date.
I think I might have m-pox, what should I do?
It can be upsetting if you think you might be sick and is important to get the medical treatment you need as soon as possible. If you have symptoms of m-pox it is important that you contact your GP (doctor) or local STI clinic immediately for advice. If you’ve been in close contact with someone who is known to have m-pox, you’ll be contacted by health professionals. If medical experts feel you need testing this will most likely be done at a hospital. This will mean a short visit and you will be expected to isolate at home until results are back.
The risk of m-pox infection is overall quite low for the general population however if you have any concerns it is always best to contact your GP or a sexual health clinic.
Can I get the m-pox vaccine in Ireland?
Anyone, regardless of who they have sex with, can get m-pox. However, currently, the outbreak in Ireland is primarily in sexually active gay and bisexual men, and men who have sex with men. If you are part of this group you have been identified as at risk of exposure to the virus.
The government has confirmed that people who are at the highest risk of getting m-pox are being prioritised for vaccination.
You will be offered a vaccine if you had syphilis between December 2021 and July 2022 and are a:
- Gay man
- Bisexual man
- Man who has sex with men
- Transgender person
There are currently 11 vaccination centres in Ireland that offer the m-pox vaccination. Visit HSE.ie for up-to-date information on vaccine availability and to book your vaccination.
How to book an m-pox vaccine in Ireland?
Appointments are not currently available for the m-pox vaccine. Once they become available again, you can book a m-pox vaccine appointment online if you are over 18 and you:
- Are in an at-risk group
- Have not had m-pox
- Have not had a m-pox vaccine or you have only received your first dose
If you have already received your first dose you can book your second dose online. Wait 4 weeks since your first dose. Tell your vaccinator that this is your second dose. The HSE will not ask about your sexual behaviour or sexual history when you book online or when you are being vaccinated.
What is the treatment for m-pox?
Most treatment is supportive, this means that the team will treat you for any symptoms eg itch, painful spots or difficulty passing a bowel motion. The illness is usually mild and most people recover in 2 to 4 weeks.
How can I protect myself against m-pox?
There are many great options to help protect your sexual health, but none of them are 100% effective. Condoms are a great way to prevent common STIs like Chlamydia but don’t always work against m-pox infection. Going for an STI check or taking a home STI testing kit with a partner before having sex, can be a great way of protecting yourself and those you have sex with against STIs and HIV. These can be ordered for free at SH24.ie for most counties around Ireland. Another option is going to your GP or a local sexual health clinic. M-pox is a very specific test and won’t be found on a routine STI screen, therefore you’ll have to attend a clinic to get this if you have any symptoms. If you think you could have m-pox it is important to speak to your healthcare provider before attending a clinic in person.
Looking out for sores or symptoms on a partner’s genitals before having sex with them, can help to identify m-pox or STIs that they may not be aware of. If you do see any signs that someone may have m-pox or an STI, do not have sex with them until you know for certain it is ok to do so. Asking someone about their sexual health history is the responsible thing to do before having sex, and it should not be taken as an insult if someone asks you about yours. Going for a sexual health check with someone before having sex is a great way to protect both your own and your partner’s sexual wellbeing.
Visit HSE.ie for more information on monkeypox.
Reducing stigma around m-pox
It can be worrying when there is an outbreak of a virus and often the media can frame outbreaks of disease in extreme ways, increasing fear and misinformation. It is important when discussing m-pox that we understand that the risk of infection is overall quite low and that although certain people may be more at risk of getting the virus, it is not an outbreak that affects only specific groups. Anyone can get m-pox, and similarly to COVID-19 or any other virus, it is not a person’s fault if they become ill. We can all help reduce stigma around monkeypox by sharing factual information on the virus. Follow us on social media to share our posts on the topic.
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