Halton Pharmacy Clinical Team, Leeds
July 21, 2026
6 min read
Reviewed by GPhC Pharmacist at Halton Pharmacy
Monkeypox first entered mainstream public health awareness during the 2022 global outbreak, which was the first time the virus had spread sustainably outside of sub-Saharan Africa. Since then, two distinct clades of mpox have been of international concern. Clade Ia and Ib, predominantly affecting the Democratic Republic of Congo and neighbouring central African countries, is generally more severe. Clade Ib, has also had cases throughout Spain, California, the Netherlands, Italy and Portugal all with no travel history. Clade II, which drove the 2022 global outbreak, has been associated with lower case fatality rates but wider geographic spread. For UK travellers planning trips to the DRC, Uganda, Rwanda, Burundi, and neighbouring countries, mpox is a clinically relevant travel health consideration in 2026.
Mpox is caused by the mpox virus, an Orthopoxvirus related to but distinct from smallpox (variola) virus. Transmission occurs through close physical contact with infectious lesions, bodily fluids, or contaminated materials, and through respiratory droplets during prolonged close contact. Zoonotic transmission from contact with infected animals (rodents, primates) is the primary transmission route in endemic settings. In the 2022 global outbreak, sexual transmission through close skin to skin contact during sexual activity was the dominant transmission route. Animal to human transmission remains the main concern for travellers to endemic regions in central Africa.
The incubation period is typically five to twenty-one days. Symptoms include fever, headache, muscle aches, swollen lymph nodes (often painful), followed by a characteristic rash that progresses through defined stages from macules to papules to vesicles to pustules to crusted scabs. The rash can affect the face, palms, soles, genitals, and perioral area. Illness typically lasts two to four weeks.
The risk of mpox for most UK travellers is low. Standard tourist activities in affected countries carry very low exposure risk. Elevated risk exists for travellers with close skin contact with potentially infected individuals, wildlife hunters or those handling wild animals in endemic areas, healthcare workers in affected countries without appropriate PPE, and travellers visiting areas experiencing active Clade I outbreaks.
The WHO classified mpox Clade I as a Public Health Emergency of International Concern (PHEIC) in August 2024 according to NATHNaC, however the World Health Organisation (WHO) stated that the mpox situation was no longer an international concern. Travellers to the DRC and neighbouring countries should monitor FCDO travel advice and NaTHNaC country-specific guidance closely before and during travel, as the situation is evolving. Halton Pharmacy recommends a travel health consultation for all patients planning travel to the DRC or neighbouring countries to discuss current mpox risk alongside the full vaccination and malaria prevention requirements for East and Central Africa. |
The MVA-BN vaccine (Imvanex in the UK, Jynneos in the US) is a third-generation smallpox and mpox vaccine with an effectiveness of 70-80%. It is a non-replicating modified vaccinia Ankara vaccine given as two doses four weeks apart. In the UK, MVA-BN is available on the NHS to specific groups at highest risk, including eligible sexual health clinic attendees during outbreak periods. It is offered as a routine vaccination for GBMSM at highest risk of infection and other individuals who have frequent or intimate contact with the GBMSM network It is not routinely available as a travel vaccine for all travellers to endemic countries. Travellers to high-risk areas who may be eligible for mpox vaccination should discuss this with their GP, sexual health clinic, or travel health provider well in advance of travel. The UKHSA publishes current eligibility criteria.
For travellers to endemic areas, the following precautions are recommended: avoid close contact with individuals with active skin lesions, avoid contact with wild animals particularly rodents and primates, avoid consuming wild game or bushmeat, use appropriate PPE if working in a healthcare setting, practice safer sex during travel, and maintain good hand hygiene. Any traveller who develops a fever, rash, or swollen lymph nodes within three weeks of return from an affected country should seek medical assessment promptly and inform their clinician of their travel history.
Monkeypox is a viral infection that spreads mainly through close physical contact with an infected person, contaminated materials or infected animals. For most travellers the risk is low, but it is important to follow travel health advice for your destination and avoid close contact with anyone who has symptoms
Reduce your risk by practising good hand hygiene, avoiding close contact with anyone who has a rash or other symptoms of mpox, avoiding contact with contaminated bedding or clothing, and following local public health guidance. Vaccination is not routinely recommended for all travellers but may be appropriate for some people at higher risk.
If you develop symptoms such as a rash, fever, swollen lymph nodes or muscle aches after travelling, seek medical advice promptly and tell your healthcare professional about your recent travel history. Avoid close contact with others until you have been assessed
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