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Article

Advice if you have been exposed to monkeypox infection (close contact)

This article contains advice if you who have been in contact with a person who has monkeypox.

This article contains advice if you who have been in contact with a person who has monkeypox.


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Who is considered to be a close contact?

A close contact has been in contact with a person who has been diagnosed with confirmed monkeypox  during the infectious period of their disease course. Close contacts will be contacted by the health service in the municipalities in connection with contact tracing, or by the infected person.

Close contacts are divided into low- and high-risk categories based on their degree of exposure to infection. Prolonged and / or intimate contact entails a particular risk of transmission. In the ongoing outbreak (discovered in May 2022), sexual contact has often been the mode of transmission. The health service will tell you which group you belong to and how you should be followed up. Close contacts should monitor their own symptoms and contact the health service if they develop symptoms (see fact box).

If you are considered to be a high-risk contact

If you are considered to be a high-risk contact, for example, having had intimate or sexual contact with, or living with an infected person, it is recommended that you avoid any form of close contact with other people (including sex with a condom), for 21 days after the last exposure. During this period, you should especially avoid contact with people with weakened immune systems, pregnant women, young children (under 6 years) and frail elderly people. You should also avoid contact with animals / pets.

It is recommended that you measure your temperature twice per day and monitor your own symptoms. Contact a doctor if you develop a fever, rash, muscle aches or swollen lymph nodes.

You can go to work, school and other activities as normal. If you work with groups with an increased risk of a severe disease course (children under 6 years of age, pregnant women, frail elderly people and people with weakened immune systems), you should discuss whether there is a need to make alternative work arrangements with your doctor.

You must not donate blood, biological material or organs in the period up to 21 days after your last contact with an infected person.

If you are considered to be a low-risk contact

If you have no symptoms, you can live as normal.

You should monitor your own symptoms, measure your temperature daily and consult a doctor if you develop a fever, rash, muscle aches or swollen lymph nodes.

You must not donate blood, biological material or organs in the period up to 21 days after your last contact with an infected person.

What should you do if you develop symptoms?

If you suspect that you are infected with monkeypox and develop symptoms, you should isolate yourself and avoid close contact with humans and animals / pets until a negative test result confirms that you do not have monkeypox. It is especially important to avoid contact with people with weakened immune systems, pregnant women, young children and frail elderly people.

You will be given information by the health service in your municipality about what to do if you develop symptoms. You should contact a doctor to make an appointment, informing them about the suspicion of monkeypox, so that examination and testing can be arranged.

Preventive measures at home

Monkeypox virus can survive in bedding, clothing and on surfaces, especially where it is dark and cool. If you have had visitors or people staying over in the last 15 days who showed symptoms and later tested positive for monkeypox, the following is recommended:

  • Wash all textiles (towels, sheets, blankets etc.) that might have been in contact with skin or soiled by biological materials (semen, faeces, blood, urine and other bodily fluids) with hot water, minimum 60°C.
  • Clean areas that could have been contaminated by biological materials (semen, faeces, blood, urine and other bodily fluids) with a cleaning agent (non-organic) according to the manufacturer’s instructions. Use disposable wipes. If a household bleach is used for disinfection, mix the required amount to a concentration of 5 %.
  • Use protective equipment during cleaning, for example disposable gloves and a facemask.
  • Clean your hands afterwards, also when gloves were used. Dirty or moist hands should be cleaned using soap and water, otherwise you can use hand sanitizers.

What happens if you are diagnosed with monkeypox?

If you get a confirmed diagnosis with monkeypox, you should go into isolation immediately.

Contact tracing will be initiated if monkeypox is detected. You are considered to be contagious from the onset of the first symptoms (fever, headache, etc., or from 48 hours before the onset of the rash if this is the only symptom) and as long as you have the rash, i.e., until the scabs have dried up and new skin has formed underneath. It is important to notify all your close contacts throughout this period.

 

ABOUT MONKEYPOX

How is monkeypox transmitted?

Monkeypox is caused by a virus (monkeypox virus) and causes disease with fever and rash. The disease is known to be transmitted from animals to humans in some African countries. In the current outbreak (discovered in May 2022), we see transmisson between people via close contact with blisters, body fluids and droplets. Sexual contact with an infected person involves an increased risk of becoming infected and is the most common mode of transmission in the ongoing outbreak, which so far has mainly affected men. Kissing can also pose a transmission risk. For droplet transmission to occur, close contact over a longer period of time (hours) is usually required.

How long can you be infected before developing symptoms?

The time from infection until symptoms appear is 5-21 days (usually 6-13 days).

What are the symptoms of monkeypox?

The first symptoms are usually fever, fatigue and headache. Muscle aches and stiffness are common. Some people may develop swollen lymph nodes, with an itchy and / or painful rash developing at the same time or after a few days. The rash develops into blisters, which crust over to form scabs that eventually fall off. Scarring can occur.

In the ongoing outbreak (discovered in May 2022), for many the rash began around the genitals and in the buttock and rectal region. The rash can also begin on the face or in the mouth and can spread to the rest of the body and may then resemble chickenpox. Some also have rashes in the palms and soles of the feet. The rash can also be sparse, with just a few small blisters or sores, and may resemble herpes.

The disease course normally lasts 2 to 4 weeks. You are contagious from the start of symptoms until the scabs fall off and new skin has formed underneath (approximately 3 weeks).

Vaccine

There is a vaccine against smallpox that can provide protection against monkeypox. This is now approved in Europe for use against monkeypox. For the time being, we recommend this vaccine for preventive use only after an exposure to monkeypox (Post-exposure vaccination) to prevent disease or reduce its severity.

Do you suspect you may be infected?

Are you living in Norway and suspect that you might be infected? Call your doctor to arrange an appointment. Are you a tourist in Norway? Call the out-of-hours medical service on 116 117. Staying in Oslo? Call +47 21 80 21 82 (Koronatelefonen). Testing for monkeypox is free of charge.

History

10.08.2022: New paragraph: Preventive measures at home; Updated recommendations for vaccination.