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Monkeypox

Monkeypox (MPX) is a zoonotic viral disease caused by the monkeypox virus (MPXV). The disease is endemic in areas of Central and West Africa. In these areas, MPXV circulates in wild animals with occasional transmission to humans. Although the precise reservoir in these areas is not known, wild rodents are believed to play a role in the transmission.

The virus can also spread from humans to humans, as is the case with this current outbreak affecting among other the EU/EEA countries. The clinical signs are similar to those of smallpox, but usually much milder. Human cases typically present with fever, rash, and swollen lymph nodes, and may lead to a range of medical complications.

EFSA’s role

In co-operation with the European Centre for Disease Prevention and Control (ECDC), which is monitoring human cases, EFSA’s experts are following the progress of the MPX outbreak closely, considering the possibility of transmission to animals in the EU.

Latest

An outbreak of monkeypox (MPX) occurring in humans in EU/EEA countries and other parts of the world has been detected in May 2022. The European Centre for Disease Prevention and Control is providing up-to-date information about the epidemiology of this event on its website, where the latest information (including the number of cases) is available.

Questions and answers

What is a zoonotic disease?

Zoonotic diseases are infections or diseases that can be transmitted between animals and humans.

Are monkeys the main reservoir for MPX?

No. The name comes from the fact that the MPXV was first discovered in a non-human primate, a macaque, in a zoo in Copenhagen in the late 1950s. Monkeys, like humans, are accidental hosts. 

What are the most common routes of transmission in Central and West Africa?

In endemic areas MPXV is mainly transmitted from infected animals to humans, and to other susceptible animals via bites and scratches from an infected animal, or by close contact with infected fluids. The handling of infected carcasses or raw meat is also believed to be a source of infection. In the EU/EEA such transmission pattern has not been recorded.

In the current EU/EEA outbreak, what are the most common routes of transmission?

So far in  the EU/EEA the majority of reported cases have been among men who have sex with men and transmission is thought to occur during sexual contact.

The virus spreads from person to person through close contact with the infectious material from skin or oral lesions, through respiratory droplets in prolonged face-to-face contact, and through contaminated objects. For more information on the number of human cases please check here.

Based on existing literature, which animals are susceptible to infection with MPX virus?

Detection of the MPXV or antibodies has been shown in a broad range of species, including non-human primates, opossums, different types of African squirrels and rats, dormice, African bush-tailed porcupine, and African hedgehog, among others. Other species found susceptible to the infection, which are more likely to be used as pets, are rabbits, hares, prairie dogs, and pet rodents.  

Do all susceptible animals show clinical signs?

No, not all susceptible animals show clinical signs. Several non-human primates show clinical signs when infected. Other species where clinical signs have been seen are, for example, different type of squirrels, prairie dogs and rabbits. The severity of the clinical signs varies with species but in general they show symptoms such as fever, lethargy and skin rashes and vesicles on the body and face and sometimes death.

Can I get monkeypox virus from my pet or wild animals in the EU/EEA?

Although no active surveillance for MPXV is currently ongoing in the EU/EEA, to date no cases in animals have been reported and there are no reports where humans have been infected by an animal in the current outbreak. The epidemiological enquires conducted so far have not linked the current EU/EEA outbreak to animals.

Before the outbreak, in the EU, a decision from the European Commission was already in place to address risks arising from MPX from imported animals by providing protection measures regarding MPXV.  Under this decision Member States shall prohibit the importation of rodents of non-domestic species and squirrels originating in or coming from third countries of the African sub-Saharan region and the USA.

Has transmission from humans to animals been reported?

Transmission from humans to animals has not been documented in the literature. However, this does not mean that transmission from humans to animals is not possible.

For this reason, if you are infected with MPXV the current advice is to apply common precautionary measures such as avoiding contact with your animal during the isolation period. Front-line veterinary care (veterinary clinics and hospitals) should be cautious when dealing with pets that live in a household with people who are infected and should remain alert.

If you are affected by MPX, and you suspect your pet shows compatible clinical signs, you should inform your veterinary practitioner/clinic. If needed, they will alert the relevant authorities in your country and advise on the measures to take.

Since the disease is a zoonosis, close collaboration between human and veterinary public health authorities is needed to manage exposed pets and prevent the disease from being transmitted to animals.

What happens in the event of an animal testing positive for MPXV?

In the event of a suspected or confirmed case in an animal, the Member State concerned should take the necessary precautions and measures according to relevant veterinary legislation.

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