risk assessment

Monkeypox: ECDC says risk to wider population is 'low' but that countries should prepare

As of Saturday, there were 92 confirmed cases of the disease in countries where monkeypox is not endemic.

LAST UPDATE | May 23rd 2022, 3:45 PM

THE ECDC HAS said that the likelihood of the spread of monkeypox in the wider population was “low” but that local health officials should take a number of preparatory actions. 

In a risk assessment published today, the the European Centre for Disease Prevention and Control (ECDC) said that a total of 85 cases of monkeypox acquired in the EU have been reported in eight EU Member States in the past week. 

The member states are Belgium, France, Germany, Italy, Netherlands, Portugal, Spain and Sweden. 

This is in addition cases that have been confirmed in the UK, with Scotland recording its first case today following 20 in England. 

Northern Ireland’s Public Health Agency has said that there have been no recorded cases as yet in the north, with the HSE saying there have been none recorded in the Republic of Ireland. 

Monkeypox does not spread easily between people but human-to-human transmission can occur through through close contact with infectious material from skin lesions of an infected person. 

It can also be spread through respiratory droplets in prolonged face-to-face contact and droplets of a contaminated person, as well as shared items such as bedding and towels.

The ECDC said today that the predomincance of the current outbreak among men having sex with men, and the nature of the presenting lesions in some cases, suggests transmission occurred during sexual intercourse.

“Based on ECDC’s epidemiological assessment, the likelihood of monkeypox spreading in persons having multiple sexual partners in the EU/EEA is considered high,” the Europe-wide health agency said. 

Although most cases in current outbreaks have presented with mild disease symptoms, monkeypox virus  may cause severe disease in certain population groups, such as young children, pregnant women, immunosuppressed persons.  

The ECDC added: “A balance should be kept between informing those most at risk but also communicating that the virus does not spread easily between people the risk to the broader population is low.”


Overall, the ECDC’s message to national health officials is to focus on prompt identification, management, contact tracing and reporting of new monkeypox cases.

Monkeypox is from the same family of as the smallpox virus but is clinically less severe than smallpox. The he ECDC is therefore also encouraging countries to review the availability of smallpox vaccines. 

Although the virus is only fatal in a small number of cases, it can cause uncomfortable symptoms for weeks and there is no cure for it.

Initial symptoms of monkeypox infection include a fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion.

Patients will also develop a rash, which starts on their face and spreads to the mouth, and raised red spots that develop into blisters within three days.

switzerland-who-assembly Director General of the WHO Dr Tedros Adhanom Ghebreyesus addresses delegates on the first day of the 75th World Health Assembly. SALVATORE DI NOLFI SALVATORE DI NOLFI

Speaking earlier today, the director general of the World Health Organisation said that monkeypox is among the “formidable” challenges the world is facing. 

Dr Tedros Adhanom Ghebreyesus was speaking at the opening of the 75th World Health Assembly in Geneva on Sunday, where the health agency was discussing the outbreak of monkeypox. 

The WHO said that as of Saturday, there were 92 confirmed cases of the disease in countries where monkeypox is not endemic, including in the UK, France, Germany, Spain, Australia, Canada and the United States. 

“Of course, the [Covid-19] pandemic is not the only crisis in our world,” Ghebreyesus said in his opening remarks. 

“As we speak, our colleagues around the world are responding to outbreaks of Ebola in the Democratic Republic of Congo, monkeypox and hepatitis of unknown cause and complex humanitarian crises in Afghanistan, Ethiopia, Somalia, South Sudan, the Syrian Arab Republic, Ukraine and Yemen,” he said.

We face a formidable convergence of disease, drought, famine and war, fuelled by climate change, inequity and geopolitical rivalry.


Scotland has recorded the first case of monkeypox in the country, Public Health Scotland (PHS) has confirmed today.

Dr Nick Phin, the medical and public health science director of the PHS has said that the person is being treated in line with nationally agreed protocols.

“Close contacts of the case are being identified and provided with health information and advice. This may include the offer of vaccination,” he said. 

While no cases have been confirmed in Northern Ireland, the head of health protection at NI’s Public Health Agency Dr Gillian Armstrong said that an multidisciplinary incident management team (IMT) has been established here prepare for any cases. 

“Monkeypox is usually a mild self-limiting illness and most people recover within a few weeks,” she said. 

The infection can be passed on through close contact with someone with the infection, or contact with clothing or linens used by a person who has monkeypox. However, the virus does not usually spread easily between people and the risk to the Northern Ireland population is considered low.


Most people recover within several weeks and monkeypox has only been fatal in rare cases.

US President Joe Biden has said that people should be on guard against the disease which has the potential for “consequential” impact, if it were to spread further.

Biden, on his maiden trip to Asia as president, said in Seoul that health officials have not fully briefed him about “the level of exposure” in the United States.

“But it is something that everybody should be concerned about,” he told reporters before boarding Air Force One to fly to Tokyo.

“It is a concern, in that, if it were to spread, it would be consequential,” he added.

“We’re working on it hard to figure out what we do, and what vaccine if any might be available for it.”

The first US case in the recent global spate was reported on 18 May in Massachusetts, which was joined on Sunday by Florida.

Health authorities said they were investigating the southern state’s first presumptive case of monkeypox in someone who had recently traveled abroad.


The UK Health Security Agency (UKHSA) guidance now recommends that people who have had “unprotected direct contact or high-risk environmental contact” should isolate for 21 days.

This includes no travel, providing details for contact tracing and avoiding direct contact with immunosuppressed people, pregnant women and children under 12.

Those who are considered at high risk of having caught monkeypox may have had household contact, sexual contact, or have changed an infected person’s bedding without wearing appropriate PPE.

UKHSA also advises that they are offered a smallpox vaccine.

The guidance comes after Dr Susan Hopkins, chief medical adviser for UKHSA, warned that monkeypox is spreading through community transmission.

So far the agency has confirmed 20 cases in the UK.

Hopkins said updated figures for the weekend will be given today as she warned of more cases “on a daily basis”.

With reporting from Rónán Duffy. © AFP 2022 and the Press Association.

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