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Traveler Summary

Key Points

  • Monkeypox is a viral infection that occurs in Central and West Africa, acquired through ingestion of contaminated meat from wild animals (bush meat) in the rainforest or through direct contact with fluids and secretions from infected persons or animals.
  • Minimal risk exists for travelers going to affected countries, unless they handle or consume bush meat.
  • Symptoms include fever, chills, headache, and blisters, which begin on the face and may spread to other body parts.
  • Consequences of infection include bacterial infections, dehydration, and brain inflammation. Death may occur in about 10% of cases.
  • Prevention includes avoiding risk behaviors, such as contact with infected persons or animals or handling or consuming bush meat.
  • Smallpox vaccine is effective for prevention, but the vaccine is not commercially available for travelers.

Introduction

Monkeypox is a viral disease primarily transmitted from infected animals to humans or from infected humans to other humans; it occurs in certain West and Central African countries. No vaccine exists for monkeypox; however, smallpox vaccine is effective for prevention, and older persons who received this vaccine decades ago may still be protected.

Risk Areas

Monkeypox is most commonly found in Democratic Republic of the Congo, but recent outbreaks have been occurring in tropical rainforests in the Congo basin and West Africa, including in Central African Republic, Liberia, Nigeria, Republic of the Congo, and Sierra Leone.

Transmission

Monkeypox is transmitted to humans via direct contact with droplets (bodily fluids, respiratory secretions, or lesion material) from infected animals through bites, scratches, or intact skin or through ingestion of contaminated bush meat in the rainforest. Human-to-human transmission may occur through inhalation of infected respiratory droplets or contact with bodily fluids, lesion material, or contaminated clothing from infected persons.

Risk Factors

Risk exists for travelers going to affected areas and is higher for persons without a history of smallpox vaccination who:

  • Live, work, or participate in recreational activities in proximity to infected animals
  • Live in forested areas
  • Handle or consume bush meat
  • Sleep on the floor in affected areas
  • Come in contact with infected bodily fluids or sleep in the same room/bed with an infected person

Symptoms

Symptoms most commonly appear 5 to 21 days (typical range: 7-14 days) following exposure and include fever, chills, extreme tiredness, head and muscle aches, and blisters, which begin on the face (most affected) and spread to other parts of the body (especially the palms and soles).

Consequences of Infection

Complications can include bacterial infections, difficulty breathing, pneumonia, inability to eat due to painful lesions in the mouth, dehydration (from vomiting and diarrhea), eye involvement, and brain inflammation. Death occurs in about 10% of symptomatic cases.

Need for Medical Assistance

Travelers who develop symptoms of monkeypox, especially persons with compromised immunity, should seek immediate medical attention for evaluation of the need for postexposure treatment.

Prevention

Nonvaccine

Avoid handling or consuming bush meat and avoid direct contact with rodents or other infected animals (sick or dead). Avoid contact with blood or bodily fluids from infected persons (who should be in isolation in a medical facility) or materials (e.g., clothing) that have been in contact with an infected animal or person. Practice rigorous disinfection techniques in case of accidental contact.

Vaccine

Smallpox vaccine is effective for prevention, but the vaccine is not commercially available for travelers. Stockpiles are controlled by public health authorities and may be available for certain types of health care workers and researchers.