Mpox
Mpox (previously known as Monkeypox) is still spreading in many countries, Sweden included, even if the spread has slowed down. The group most affected so far are men who have sex with men. Preventive vaccination has started in Stockholm for men who have sex with men.
Mpox is a fairly new disease and very little is know about it. Healthcare is constantly learning more about the course of the disease, routes of transmission, appropriate treatments, etc.
What we know today
This text (Swedish version) has been reviewed and approved by SöS/Venhälsan on 19th December 2022.
- Mpox is a highly contagious disease!
- The infection is easily transmitted from person to person.
- It is transmitted through contact skin to skin, skin to mucous membrane, mucous membrane to mucous membrane, through saliva and probably also semen. There are indications that the virus can also be spread via bedding and towels.
- It is contagious during sex. Condoms only provide limited protection – you can still have skin-to-skin contact on areas not covered by the condom.
- For most people, it takes 4-8 days before you feel or see any symptoms. For some, it can take up to three weeks.
- Common symptoms are fever, muscle and joint pain, swollen lymph nodes and rash, smallpox, which can appear anywhere on the body – not necessarily where the body contact was.
- Those who get the rash/pox in mucous membranes (anal/bowel, throat, mouth) often suffer from very severe pain. Until mid-December, about 10% of those infected in Stockholm had to be admitted to hospital for pain relief, drips and sometimes intravenous antibiotics due to various complications.
- In the media it is sometimes said that mpox is a mild disease. This is true in comparison with, for example, smallpox, Ebola and covid-19 (in people at risk, e.g. the elderly), which are all fatal infections. However, it is not at all true that the disease is mild in comparison to the usual sexually transmitted infections (eg chlamydia, gonorrhea and syphilis)! For being a sexually transmitted infection, mpox is an unusually aggressive infection, causing great suffering and discomfort to some. We have not yet seen the full consequences of the spread but are still in an early phase. Both Venhälsan and all authorities take this outbreak very seriously.
- The disease always goes away by itself, in most cases within about 2-4 weeks, but there are occasional cases that have taken longer than that. Antiviral medicine can be given in very severe cases to people who are hospitalized, but the medicine is still insufficiently tested in humans and is reserved for life-threatening cases.
- Vaccines are available that protect against both smallpox and mpox. It is believed that those who were vaccinated against smallpox in Sweden up to and including 1976 still have some protection against mpox, which is the reason why you then only need one dose of vaccine against mpox.
- Before the current outbreak of mpox started, there was only minimal production of smallpox vaccine because smallpox was effectively eradicated 40 years ago. The pharmaceutical industry is now manufacturing new vaccine, but this vaccine has a long manufacturing time and the whole world wants deliveries.
- Sweden has so far received a few deliveries of vaccines that are distributed by the Public Health Agency (Folkhälsomyndigheten).
- Post-exposure vaccination for mpox. The vaccine can be given to people who have been identified via contact tracing and who can be reached within four days from the suspected time of infection (if it is a child or a person with weak immunity due to e.g. cancer medication, the vaccine can be given in this way up to 14 days afterwards). The purpose of this is only to alleviate the symptoms of the disease. If a person has started to have suspicious symptoms, the vaccine has no effect at all, and must not be given!
- Preventive vaccination for mpox. Vaccination for preventive purposes started in September 2022. You can register your interest in vaccination via the app “Alltid öppet” (Always open) (it is good to download this and make sure it works!). Venhälsan is responsible for the vaccinations. Vaccines are offered, subject to availability, to all men in the group men who have sex with men, who feel that they are at risk of infection. If you have not been vaccinated against smallpox as a child, you should take 2 injections, 4 weeks apart. The protective effect seems to be around 80% according to what is now known.
- Mpox is a disease of general danger and therefore falls under the Infectious Diseases Act. This means that it is subject to notification, infection tracking is carried out and you must follow the doctor’s prescription and other instructions (written information about infection prevention regulations that you receive from the doctor). As a rule, this means isolation at home until the symptoms have completely passed, and you are also not allowed to have sex during that time. If you have been exposed to mpox and there is a high risk of contracting it, you must also not have sex during the incubation period, i.e. 3 weeks. Even then, you receive written information with infection prevention regulations.
- At the moment (December) you can only get tested if you have symptoms of mpox at Venhälsan and the Specialist Clinics for Sexual Health at SöS and Huddinge (both belong to Skin Clinic KS). Perhaps in 2023 you will also be able to test yourself for mpox at other receptions within sexual health in Stockholm, but this has not yet been decided. There is still no way to test whether you are a symptom-free carrier of the virus or whether you are already immune. Maybe such tests will come in the future.
What does SLM Stockholm do?
- We have a close collaboration with Venhälsan at Södersjukhuset and receive regular updates and information about the situation. We monitor and follow developments closely.
- We are actively working to spread and provide accurate information about this virus.
- We have assessed that we do not need to make any other changes today to our regular events.
- Our special interest groups have, in cases where they deemed it necessary, made certain changes.
What can you do?
- Take care of yourself, your loved ones, your friends, and our members and volunteers.
- Consider the risks of infection, especially in contact with casual partners, whom you may not know before.
- If you show any symptoms, or suspect you might have been infected – stay home and contact the health services on 1177.
- Mpox is very contagious and you might be a carrier even if you don’t show any symptoms!!