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Monkeypox – What Are The Risks At Home And Overseas
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William Cooper

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After the huge disruption to people’s lives all around the world caused by COVID-19, the rise of monkeypox may be a concern for anyone working, moving or travelling overseas.

However, there are many key differences between COVID-19 and monkeypox. Let’s have a look at the facts about monkeypox and how you can be reassured about the risks, at home and abroad. Don’t forget to look into international health insurance if you plan to relocate abroad.

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What is monkeypox?

Monkeypox is a rare infection, which was first discovered in the 1950s, when two outbreaks occurred in monkeys used for research. However, despite its name, the source of the disease is still unknown.

The World Health Organisation (WHO) is currently working with international experts to rename the virus, after concerns about offending cultural, social or ethnic groups, and the rise in discriminatory language around the name.

Before 2022, cases were almost unheard of outside central and western Africa, and were confined to people who were linked to those countries. Monkeypox can be caught from infected rodents or primates as a result of a bite, or contact with body fluids.

It can be spread from person to person through:

  • Sharing clothing, bedding or towels used by someone with the rash
  • Contact with blisters or scabs (including during sex)
  • Coughs or sneezes

It may also be possible to catch it by eating undercooked meat from an infected animal, or through contact with animal skin or fur.

Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks

Why is monkeypox spreading?

According to Statista there are a number of reasons for this. The smallpox vaccination is effective against monkeypox, but younger generations won’t have had the jab, since the vaccination programme ended in the early 1970s.

Deforestation and climate change are altering the conditions potentially infectious species need to survive, and causing them to shift territories and spread infection. Additionally, increasing global travel means diseases can now be carried around the world.

Monkeypox: confirmed cases worldwide – mapped

Monkeypox confirmed cases mapped as of August 2022 - Monkeypox – What Are The Risks At Home And Overseas?

The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980

What are the symptoms of monkeypox?

Signs of monkeypox are similar to those of smallpox, but milder.

According to World Health Organization, the most reported symptoms are:

  • a pimple-like rash or blistering
  • fever
  • muscle aches
  • headaches
  • backache
  • chills
  • fatigue
  • swollen lymph nodes

Monkeypox isn’t related to chickenpox and is rarely fatal. Most people recover within a few weeks without treatment.

Anyone can get monkeypox, however there is an extremely low risk unless you have been in close contact with someone who has symptoms, or you have travelled to west or central Africa.

The case fatality ratio of monkeypox has historically ranged from between 0–11% in the general population and has been higher among young children
In recent times, the case fatality ratio has been around 3–6%

Is there a vaccine for monkeypox?

As the monkeypox virus is similar to the one that causes smallpox, vaccines designed for smallpox can be effective in preventing or reducing the severity of monkeypox.

According to the World Health Organisation (WHO)’s interim guidance, mass vaccination against Monkeypox is not required. A one-time or two-stage vaccination may be recommended for those believed to be at high risk of contracting monkeypox, such as those travelling to high risk areas, or healthcare workers and scientists who may come into contact with it.

On 21st June 2022, the UK Health Security Agency (UKHSA) recommended that some gay and bisexual men at higher risk of exposure to monkeypox should be offered vaccines to help control the recent outbreak of the virus.

Although anyone can contract monkeypox, data from the latest outbreak shows higher levels of transmission within – but not exclusive to – the sexual networks of gay, bisexual and other men who have sex with men.

For people who have been in contact with positive cases, a post-exposure vaccine is recommended, but all cases should be assessed on an individual basis.

Medical care can vary widely between countries
Find out which countries have the best healthcare in the world

Monkeypox: confirmed cases worldwide by date

Monkeypox culumative confirmed cases by date - Monkeypox – What Are The Risks At Home And Overseas?

Will monkeypox be as bad as COVID-19?

Although monkeypox is attracting a lot of attention, especially in the wake of COVID, there is no comparison between the two, and no threat of global pandemic. The key differences are:

  • Monkeypox does not spread easily, and only in certain circumstances
  • It doesn’t spread from human to human very easily
  • Infected people can be identified and isolated or treated as appropriate
  • Outbreaks are easier to contain
  • There is an effective vaccine where necessary

How can I protect myself and my loved ones from monkeypox?

It’s best to keep up to date with the latest guidance on the World Health Organization website or from your national health authority. If you a nurse or a healthcare professional, it is crucial to keep yourself up-to-date, so continue to check the CDC and WHO websites for updates.

  • You can reduce your risk by limiting contact with people who have suspected or confirmed monkeypox.
  • If you do need to have physical contact with someone who has monkeypox because you are a health worker or live together, encourage the infected person to self-isolate and cover any skin lesion if they can (e.g., by wearing clothing over the rash).
  • When you are physically close to them, they should wear a medical mask, especially if they are coughing or have lesions in their mouth. You should wear one also.
  • Avoid skin-to-skin contact whenever possible and use disposable gloves if you have any direct contact with lesions.
  • Wear a mask when handling any clothes or bedding if the person cannot do it themselves.
  • Regularly clean your hands with soap and water or an alcohol-based hand rub, especially after contact with the person who is infected, their clothes, bed sheets, towels and other items or surfaces they have touched or that might have come into contact with their rash or respiratory secretions (e.g., utensils, dishes).
  • Wash the person’s clothes, towels and bedsheets and eating utensils with warm water and detergent.
  • Clean and disinfect any contaminated surfaces and dispose of contaminated waste (e.g., dressings) appropriately.
Woman packing suitcase for a trip, including face masks and travel-sized antibacterial hand gel - Monkeypox – What Are The Risks At Home And Overseas?

Does my insurance cover me for monkeypox?

Health insurance

Most health insurance policies will cover expenses arising from viruses, which would include monkeypox. However, you need to check your policy to see if it covers diseases caught through overseas travel or in specific situations, such as healthcare, which might put you at higher risk.

It’s also worth noting that many policies don’t cover illness contracted within a specified period of buying the policy.

Life insurance

As monkeypox is very rarely serious, and even more rarely fatal, the risk to providers of life insurance is low, and it is unlikely that any policy will exclude it.

However, if you are in any doubt, and especially if you are, or plan to be, at higher risk, you should check with your insurer.

Travel insurance

As well as cancellation, curtailment and medical treatment, travel insurers now know they need to include cover for additional costs, such as having to self-isolate. At the moment, monkeypox will usually be covered under general illness provisions.

However, if you are planning to travel, especially to high-risk areas, such as west and central Africa, you need to check your policy carefully to make sure you have cover.

Can I buy expat insurance if I’ve had monkeypox?

At the moment, there’s no medical guidance on the long-term effects of monkeypox, so there’s no specific advice on buying expat cover after having the virus.

However, the situation is ongoing, and expats who have had monkeypox or may be at risk of contracting it, might be advised to keep an eye on the news or ask for advice before buying insurance.

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Monkeypox – comomon questions

Here are some commonly asked questions about monkeypox:

The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. It was only later detected in humans in 1970.

Monkeypox is commonly found in central and west Africa where there are tropical rainforests and where animals that may carry the virus typically live.

People with monkeypox are occasionally identified in other countries outside of central and west Africa, following travel from regions where monkeypox is endemic.

In most cases, the symptoms of monkeypox go away on their own within a few weeks, but in some individuals, they can lead to medical complications and even death.

Newborns, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.

Complications from severe cases of monkeypox include skin infections, pneumonia, confusion and eye infections which can lead to loss of vision.

Around 3–6% of reported cases have led to death in endemic countries in recent times, often in children or persons who may have other health conditions.

It is important to note that this may be an overestimate because surveillance in endemic countries is limited.

Monkeypox symptoms often resolve on their own without the need for treatment.

It is important to take care of the rash by letting it dry if possible or covering with a moist dressing to protect the area if needed.

Avoid touching any sores in the mouth or eyes. Mouth rinses and eye drops can be used as long as cortisone-containing products are avoided. Vaccinia immune globulin (VIG) may be recommended for severe cases.

An antiviral that was developed to treat smallpox (tecovirimat, commercialized as TPOXX) was also approved for the treatment of monkeypox in January 2022.

It’s best to keep up to date with the latest guidance on the World Health Organization website or from your national health authority.

Peace of mind when you go overseas

Moving to another country can be challenging, especially when new health risks are emerging. But you can ensure peace of mind by making sure you have the right international health insurance.

At William Russell we have nearly 30 years of looking after expatriates and helping them manage the many differences in culture and experiences, providing world class global health insurance, as well as guidance and tips for settling into a new life overseas.

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