Mpox (monkeypox) and MS

• Is mpox the same as monkeypox?
• How many people have mpox (monkeypox) in the UK?
• Is mpox (monkeypox) dangerous if I have MS?
• What are the symptoms of mpox (monkeypox)?
• How do you catch mpox (monkeypox)?
• Can I have a mpox (monkeypox) vaccine if I’ve got MS?
• What do I do if I think I have mpox (monkeypox)?
• Am I immunosuppressed?
   

Is mpox the same as monkeypox? 

Mpox is the same disease as monkeypox. The World Health Organisation (WHO) started using the name mpox in November 2022. You'll still see people using both names for the disease.

How many people have mpox (monkeypox) in the UK?

There was an outbreak of mpox in the UK during 2022 and 2023 that affected around 4,000 people. Almost all the cases were in England, most in London. But by spring 2024 numbers had dropped to a handful of cases each month after a vaccination programme among high risk groups.

The vast majority of people infected were men who got the virus during sex with another man. But mpox isn’t a disease that’s only spread through sex. It can be spread through other types of close contact. So anyone could get mpox. That’s why it’s important to know about the symptoms, and what to do if you think you might have it.

August 2024: a new strain of mpox (Clade 1b)

Fast forward to August 2024, and a new strain of the mpox virus hit the headlines. The European Centre for Disease Prevention and Control has said it’s highly likely that we’ll see an outbreak of this new, easier to pass on strain in Europe. Several cases of this new type have now been reported in the UK.

In mid-August 2024 the WHO declared a ‘health emergency of international concern’ in light of an ongoing major outbreak of a new strain of mpox virus. This is affecting various countries in Africa south of the Sahara. So far cases outside of Africa are very rare, with just one in Sweden in someone who had visited Africa. The risk of a large outbreak among the general public in the UK remains very low.

This new type of virus is called Clade 1b (the 2022/2023 outbreak was Clade 2). Clade 1, including 1b, causes a more severe illness, and is believed to have a higher risk of death.

Around three in a 100 people infected with the new strain have died in the current outbreak in Africa. And children have been more affected in the latest outbreak compared to the earlier one. Up to one in ten children infected with the new strain have died there. Children, pregnant women and people with a weakened immune system are more likely to get more severe symptoms.

The new strain is spread in the same ways as the earlier type of the virus but seems to spread more easily.

Experts believe the existing vaccine used against mpox will work just as well against the new strain. Vaccines are being sent to Africa, and the NHS is preparing for an outbreak in the UK.

Just as with the earlier strain, advice with the new version of the virus is to:

• keep an eye out for mpox symptoms
• self-isolate if you’ve been diagnosed with mpox or you’re showing symptoms. This includes avoiding close contact with people you live with
• If you live with someone who has mpox, you don’t need to isolate unless you get symptoms

Read the UK Government advice on isolating if you or someone you live with has mpox

Read the latest UK Government data on monkeypox (mpox) cases

Is mpox (monkeypox) dangerous if I have MS?

Monkeypox (mpox) is usually mild and most people get better in a few weeks without treatment. There’s no reason to think this would be different for most people with MS.

But monkeypox can be more severe:

• for children
• if you’re pregnant
• if you’re immunosuppressed
   

Do people die from mpox (monkeypox)?

The milder type of mpox seen in the 2022/2023 outbreak resulted in very few deaths. No one died of mpox out of the 4,000 or so UK cases in that outbreak. Across Europe only one person in a thousand who got mpox died.

The new strain seen in this 2024 outbreak is more likely to cause death, but this is still unlikely. Out of each 100 adults who get the new strain, around three have died.

What are the symptoms of mpox (monkeypox)?

The first symptoms of monkeypox include:

• a high temperature
• a headache
• muscle aches
• backache
• swollen glands
• shivering
• exhaustion

Between 1 and 5 days after the first symptoms, a rash like chickenpox usually appears. Often it starts on the face, the spreads to other parts.

These symptoms usually clear up after 2 to 4 weeks.

How do you catch mpox (monkeypox)?

You can catch mpox from:

• touching clothing, bedding or towels used by someone with the monkeypox rash
• touching the skin blisters or scabs
• the coughs or sneezes of someone with the rash

In the earlier 2022/2023 outbreak most people in the UK were gay or bisexual men. They caught the virus, often in other European countries, during sex or through other close skin contact in men-only venues and parties.

The NHS says you're extremely unlikely to have mpox if:

• you haven’t recently been to Africa
• you haven’t been in close contact with someone who has mpox (such as touching their skin or sharing bedding)
   

How can I reduce the risk from mpox?

To reduce the risk of getting mpox, the NHS recommends:

• regularly washing hands with soap and water or an alcohol-based hand sanitiser
• avoiding close contact with anyone you know who has symptoms

Read the UK Government advice about reducing the risk of catching mpox

If you’re a gay or bisexual man

Gay and bisexual men were the most affected by mpox during the 2022/2023 outbreak. So the UK Government had specific mpox advice for them. This included:

• checking for symptoms
• having the vaccine if offered it
• avoiding sex or going to places where they might pass the virus on if they thought they might have mpox

This is likely to remain the advice if the new strain starts to be seen in the same groups of men.

Read the latest UK Government mpox updates

Read the UK Government advice about the vaccine for monkeypox

If you work in health or social care

If you work in health or social care, your employer should take precautions to help avoid the spread of monkeypox.

This might include the use of PPE (Personal Protective Equipment) and the opportunity for some workers to be vaccinated.

If you’re immunosuppressed, you might want to talk to your employer about avoiding high risk settings, like working directly with people who’ve got monkeypox.

Read the UK Government advice about the vaccine for monkeypox

Can I have a mpox vaccine if I’ve got MS?

There isn't a vaccine specifically against mpox. Instead people get the smallpox vaccine. It offers a good level of protection, stopping people getting mpox in up to 85% of cases. In other words, it stops 17 out of every 20 infections.

Most people with MS can take the smallpox vaccine.

At the moment the government isn’t asking everyone to get vaccinated against mpox.

You might be offered the vaccine by the NHS if: 

• you’ve been in close contact with someone who has mpox
• you have certain jobs in health or social care
• you're a man who has sex with other men 
   

Can I take the vaccine if I’m immunosuppressed?

If you’re immunosuppressed and you’re offered the smallpox vaccine, you should discuss it with a neurologist. It’s a ‘live vaccine’, so there might be a greater risk from the vaccine than for people who aren’t immunosuppressed.

Having MS doesn’t mean you are immunosuppressed. But some disease modifying therapies (DMTs) could mean you’re immunosuppressed.

The UK Government says that even people who’re severely immunosuppressed can use the vaccine. But because of the possible greater risk they say a specialist should give advice. A neurologist can help explain the benefits and risks.  

What do I do if I think I have mpox?

If you develop monkeypox symptoms, you should contact NHS 111 or call a sexual health clinic immediately. If you’re immunosuppressed, let your MS team know too. If you’re pregnant, let your maternity team know.

Stay at home and avoid close contact with other people until you've been told what to do.

Am I immunosuppressed?

MS itself doesn’t make you immunosuppressed. But some DMTs can affect how well your immune system works, especially in the first few months after having the treatment. If you’re immunosuppressed like this, it can make you more likely to get some types of infections, or get a more severe form of them.

The drugs listed below might make you more likely to get a more severe case of mpox. If your treatment involves one of them, you should avoid contact with people diagnosed with mpox (or who might have been exposed to it). If you think you’ve been in contact with mpox, contact a doctor as soon as you can.

• alemtuzumab (Lemtrada)
• cladribine (Mavenclad)
• fingolimod (Gilenya)
• ocrelizumab (Ocrevus)
• ofatumumab (Kesimpta)
• ozanimod (Zeposia)
• ponesimod (Ponvory)
• siponimod (Mayzent)
• HSCT
   

The chances of catching monkeypox in the UK are extremely low. But you might want to be especially careful with hand hygiene, and avoid contact with people who you know have been exposed to mpox.

Read the latest from the UK government about monkeypox