Mpox: A Growing Concern for Travelers to Africa

Background
Mpox, caused by the MPXV virus, has two distinct clades: clade I and clade II. Historically, clade I has been associated with a higher risk of severe illness or death compared to clade II. In May 2022, a global outbreak of clade II mpox predominantly affected gay, bisexual, and other men who have sex with men.
Prior to 2024, clade I mpox was reported only in five Central African countries. However, recent cases in additional Central and East African countries mark the first known expansion of its geographical range, increasing the risk of spread beyond the region. In 2023, the Democratic Republic of Congo (DRC) reported its highest number of clade I mpox cases on record, with high case numbers continuing into 2024. Since July 2024, confirmed cases of clade I mpox have been reported for the first time in Burundi, Kenya, Rwanda, and Uganda, with some linked to the DRC. Sweden and Thailand have also reported cases in travelers with links to the current outbreak. Recently, a confirmed case of clade 1b mpox was reported in the UK in a traveler returning from Africa.
Mpox Symptoms and Management
Mpox can be transmitted through close contact with an infected person, animal, or contaminated material. Person-to-person spread can occur through direct contact with broken skin or scabs, bodily fluids, or contaminated objects and surfaces. The incubation period is between five and 21 days. Initial symptoms include high temperature, headache, muscle aches, backache, swollen glands, shivering, exhaustion, and joint pain. A rash or pus-filled lesions usually appear 1 to 5 days after the first symptoms, often starting on the face and spreading to other body parts.
Most patients experience a mild, self-limiting illness with recovery within three weeks. However, severe illness can occur, particularly in children, pregnant women, and immunocompromised individuals.
Advice for Travelers
Before you travel, check the Foreign Commonwealth and Development Office (FCDO) advice for your destination, including entry requirements and safety information. Ensure you are fit to travel, especially if you are pregnant or immunosuppressed, and check your travel health insurance.
The UK does not currently recommend pre-travel vaccination for mpox, but it may be appropriate for certain healthcare and humanitarian workers. Aid workers and health professionals should seek advice and training before traveling to affected areas.
While traveling, reduce your risk by avoiding contact with anyone who is unwell or has an unusual rash, washing hands frequently, and discussing health with sexual partners. If you develop symptoms, limit contact with others, seek medical advice, and follow local public health guidance.
Travelers should be aware that travel to mpox-affected areas may impact travel health insurance options and should discuss plans with their insurance company before departure.