On 14/08/2024, the Director-General of the World Health Organization declared the resurgence of simian smallpox (mpox) in the Democratic Republic of Congo (DRC) and a growing number of African countries to be a public health emergency of international concern. 

In July 2022, the mpox epidemic affecting several countries led to the declaration of a public health emergency of international concern, as it had spread rapidly through sexual contact in a series of countries where the virus had never been seen before. The public health emergency was declared over in May 2023, following a steady decline in the number of cases worldwide.

If you have any questions about the monkeypox virus (symptoms, precautions, vaccination, …), the Ex Aequo team is availabe at 02 736 28 61, WhatsApp ‧or by e-mail at info@exaequo.be.

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TRANSMISSION

It is transmitted mainly by: 

- Skin or mucous membrane contact (mouth, sex, anus) with pimples or scabs, mostly during sex

- Droplets (sputum, sneezes, etc.)

In the following situations: 

- Long face-to-face droplet contact

- Close physical contact, especially during sex

- Sharing linen (clothes, sheets, towels, etc.), toiletries (razor, toothbrush), dishes, etc.

Today, monkeypox is not considered a sexually transmitted infection (STI), but sexual intercourse, with or without penetration, meets all the conditions for contamination. Having multiple partners increases the risk of exposure to the virus. If wearing a condom does not prevent entirely from a contamination, it might prevent the apparition of anal or genital lesions.

It is advisable to wash towels at 60°C and not to use other people's towels.

SYMPTOMS

Between 5 and 21 days after possible exposure, watch for the following symptoms 

  • Swollen and painful lymph nodes under the jaw, neck or groin
  • Pimples on the body (on the face, in the mouth, on the palms, soles of the feet, on the sex and anus, on the chest or limbs)
  • Fever, headache, muscle pain, fatigue

After a few days or weeks :

  • The pimples dry up and become scabs
  • The crusts fall off and the lesions heal

Most people recover within a few weeks. Most people heal within a few weeks. Exceptionally, these symptoms can be more severe, especially in immunocompromised people, children, pregnant women and the elderly. At this stage, the cases reported in Europe are mostly mild.

Click if you want to see pictures of pimples caused by monkeypox


RECOMMENDATIONS

If infection is suspected, e.g. through abnormal wounds, (sexual) contact should be avoided and it is advisable to go to a hospital emergency room where the necessary samples can be taken and tested (see contacts at the end of the page).

As long as symptoms are present, people with monkeypox are highly contagious. Self-isolation until the scabs have fallen off is recommended.

High-risk contacts, such as cohabitants and sexual partners, are advised to monitor their condition for 21 days for symptoms - taking into account the incubation period - and should not be quarantined. They may benefit from post-exposure vaccination within 4 days of high-risk contact. 

AFTER HIGH-RISK CONTACT

If you have had high-risk contact (sex, sharing dishes, etc.) with a person confirmed positive for monkeypox, you may have been infected. Here are some recommendations: 

  • If the contact took place less than 4 days ago (or 14 days if you are highly immunocompromised), you may be able to benefit from vaccination (see paragraph below)
  • Watch for symptoms for 21 days: rash, headache, fever, joint pain, swollen glands, fatigue. You can take your temperature several times a day to see if it is above 38°C. If you have symptoms, you can go to a testing centre (see below)
  • Avoid contact with people who are more vulnerable: children, pregnant people, elderly people, immunocompromised people
  • Avoid sharing your clothes, dishes (glasses, cutlery, etc.) with other people 
  • Avoid sexual relations and if this is not possible, try to have a permanent means of contact (preferably a telephone number) to notify your partners in case of a positive test
  • Wear a mask when talking face-to-face with others for several minutes
  • Avoid contact with domestic animals that can carry monkeypox

The Ex Æquo team remains available at 02 736 28 61 or by e-mail at info@exaequo.be

Source: AviQ, Sensoa, CHU de Liège, Sciensano, https://www.sexosafe.fr/

Info: https://www.stpierre-bru.be/mo...

VACCINATION 

Vaccination is available in Belgium, at HIV reference centers, for gay and bisexual men (MSM) and transgender people who have never received a dose, either in childhood or in 2022. 

The proposed vaccine is smallpox, not mpox. It also permits protection against mpox. In the event of contact, it can prevent or alleviate symptoms, but does not offer 100% protection. 

You'll find details of the centers in the next section. 


If you've been vaccinated against smallpox as a kid and you're not immunocompromised, you already have some protection (not 100% though). Here is a list of countries associated with the last year smallpox vaccine was mandatory. If you were born before those years, you've probably been vaccinated. 

France: 1979
Belgium: 1976
Luxembourg: 1977
Spain: 1977
UK: 1971
Germany: (1975 : ex-FRG, 1982 ex-GDR)
Italy: 1977
Brazil: 1973
Netherlands: 1974
USA: 1972 
Romania: 1980
Portugal: 1979

This is what the vaccination scar looks like. Beware, other vaccines can leave a scar. A scar is no proof of vaccination. 



Where to go get vaccinated?

Reminder, in Belgium, preventive vaccination is for men who have sex with men and transgender people who have never been vaccinated. Post exposition vaccination is possible after an exposition to an infected person that happened less than 4 days ago (or less than 14 days ago if you're immunocompromised). See the paragraph above.

If you already go to a centre for PrEP/HIV follow-up, we highly recommend you to book a vaccination appointment with the same hospital.

Région Bruxelles-Capitale (up to date)

CHU St. Pierre (Mia), Tel. 02 535 31 77 Rue haute 290 - 1000 Brussels, building 900. If you already have a mpox vaccine prescription you can directly book a nurse appointment. If not, you'll need to book a medical appointment first.

• Cliniques Universitaires Saint-Luc - 02 764 21 56 (only for PrEP/HIV patients being followed at St Luc)

• Hôpital Erasme - No vaccination at the moment.

• UZ Brussel - Waiting for info

https://www.uzbrussel.be/fr/ho...