Mpox – What Are The Risks At Home And Overseas?

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

Mpox (previously known as monkeypox) is a rare infection most commonly found in west or central Africa. Let’s have a look at the facts about mpox 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.

What is mpox?

Mpox 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. This virus is similar to the smallpox virus, although less severe. Mpox is not related to chickenpox.

Before 2022, cases were almost unheard of outside central and western Africa, and were confined to people who were linked to those countries. In 2023, researches discovered a variant of the virus that has mutated to be more severe.

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 of a person with mpox when they are in close proximity

Animal to human transmission is possible from infected rodents (such as rats, mice and squirrels) if you come into contact with their skin or fur, you are bitten, or eat undercooked meat from an infected animal.

Why is mpox spreading?

Mpox is common in remote villages in Africa, and has been in countries such as the Democratic Republic of Congo for many years. However, it’s unclear where the surge of outbreaks since 2022 originated.

There are currently a number of different outbreaks happening simultaneously and the disease has been seen in Burundi, Rwanda, Uganda and Kenya. The number of cases has jumped dramatically – up 160% compared with the same period last year.

There are two types of the mpox virus:

• Clade I causes more severe illness and deaths. Some outbreaks have killed up to 10% of the people who get sick, although more recent outbreaks have had lower death rates. Clade I is endemic to Central Africa.
• Clade II is the type that caused the global outbreak that began in 2022. Infections from clade II mpox are less severe. More than 99.9% of people survive. Clade II is endemic to West Africa.

It’s thought that a genetic mutation of clade II is transmitted much more efficiently from person to person and this has allowed it to sweep quickly across the globe – particularly as global travel increased following the COVID pandemic lockdowns. In July 2022, the clade II strain of mpox was found in over 100 countries, including some in Europe and Asia. Clade I also appears to have mutated to be more severe (clade Ib) and can pass from person to person through sexual contact.

Declaring the outbreak as a public health emergency will ensure governments are proactive in coordinating their responses to the virus.

Mpox: confirmed cases worldwide – mapped

What are the symptoms of mpox?

Signs of mpox 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
• exhaustion
• swollen lymph nodes

Some people discover a rash as their first symptom, which begins as a flat sore which develops into a blister filled with liquid and may be itchy or painful – these can appear anywhere on the body. Others may present different symptoms first.

Anyone can get mpox. Children, pregnant people and people with weak immune systems are at risk of complications from mpox. However, there is a low risk unless you have been in close contact with someone who has symptoms, or you have travelled to west or central Africa.

Is there a vaccine for mpox?

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

The two vaccines currently in use for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization.

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 mpox, such as those travelling to high risk areas, or healthcare workers and scientists who may come into contact with it.

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

Although anyone can contract mpox, 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.

Mpox: confirmed cases worldwide by date

Will mpox be as bad as COVID-19?

Mpox is attracting a lot of attention, especially in the wake of COVID. A serious epidemic anywhere in the world is a concern for everyone; as we saw first hand how quickly the COVID-19 virus spread.

However, mpox is not a new virus and does not spread in the same way as COVID-19. The key differences are:

• Mpox is not airborne, and typically requires close, skin-to-skin contact to spread
• Infected people can be identified and isolated or treated as appropriate
• Outbreaks are easier to contain
• There is an effective vaccine where necessary

A previous global outbreak of mpox was brought under control in 2022 by the use of vaccines. The World Health Organization declared the mpox outbreak a public health emergency of international concern to increase awareness and ensure the coordination of a global mpox response, mobilising the required resources.

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

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 mpox.
• If you do need to have physical contact with someone who has mpox 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.

To prevent the spread of mpox, if you have the mpox virus you should isolate at home if your symptoms are mild.

Does my insurance cover me for mpox?

Health insurance

Most health insurance policies will cover expenses arising from viruses, which would include mpox. 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

It’s quite unlikely that a life insurance policy will specifically exclude the mpox virus. However, if you’re 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, mpox 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 mpox?

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

However, the situation is ongoing, and expats who have had mpox 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.

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 over 30 years’ experience 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.