In early May 2022, cases of monkeypox with no direct link to travel to Central or West Africa—where the virus is present—or to people returning from such trips were reported in Europe and around the world. Since then, the outbreak has spread to a growing number of countries, and the disease is subject to enhanced surveillance in both France and Europe. Today, the Agency is updating its surveillance efforts and will soon release new indicators.

• More information on monkeypox (disease description, transmission, symptoms...)

Epidemiological surveillance that adapts to evolving knowledge and diagnostic practices

Surveillance in France and internationally initially relied on case confirmation through a biological test (PCR). As the outbreak progressed and knowledge of case symptoms grew, clinicians no longer routinely relied on laboratory testing for clinically suggestive cases where exposure to risk or contact with a PCR-confirmed case was documented.

To better interpret epidemiological trends, the Agency is adapting surveillance to cover all cases and no longer limit it to biologically confirmed cases alone. This change allows for a more accurate description of the situation on the ground, quantifies the impact of the outbreak, and accounts for changes in diagnostic practices by clinicians.

As a reminder, Monkeypox virus infections (whether cases are biologically confirmed or clinically suggestive with risk exposure) must be subject to mandatory reporting (Orthopoxvirus form, including smallpox) to enable the transmission of information to the Regional Health Agency, and subsequently to Santé publique France, as part of surveillance efforts.

To date, only biologically confirmed cases must be reported at the European level.

The new indicators are expected to be published next week following a necessary verification period to ensure their robustness and reliability.

Information and Prevention Initiatives

Given what has been observed in Europe regarding the disease, targeted communication was quickly implemented for men who have sex with men (MSM). The website sexosafe.fr, dedicated to the sexual health of MSM, is regularly updated with a summary of current knowledge on the subject and prevention measures. Poster, radio, and digital campaigns provide information to the public, complementing on-the-ground efforts. Since June 17, the digital campaign has generated nearly 689,463 clicks on banners and over 599,065 visits to the Sexosafe website.

All information on vaccination is updated weekly on the page for the general public and the page for healthcare professionals (accessible without a login) on the vaccination-info-service website.

Prevention efforts are continuously adapted to the evolving situation and the current state of knowledge.

• Access the documents

To make information more accessible to vulnerable people in precarious situations, a visual resource—translated into 6 languages and developed with professionals who work with these individuals—is available on Santé Publique France.

• Monkeypox Dossier (publicly accessible section)

The MOBCO Newsletter No. 7, developed in collaboration with frontline workers, compiles a series of questions and answers on the topic of monkeypox. It is intended for professionals or volunteers in contact with people in precarious situations.

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In France, ongoing surveillance of monkeypox through the mandatory reporting system has been strengthened, and information and alert messages are being sent to healthcare professionals. Discussions are also continuing with other European countries, the WHO, and the ECDC.

Preventive Vaccination Against Monkeypox

In response to the spread of the Monkeypox virus, the High Authority for Health, following a referral from the Directorate General of Health, recommended in its opinion dated July 7, 2022, that preventive vaccination be offered to groups most at risk of exposure to the virus.

Regarding the rollout of the vaccination, 103,000 doses of third-generation vaccine had been delivered by the Agency to the regions as of August 18, 2022.

Since July 11, 2022, in addition to individuals who have had high-risk contact with an infected person, individuals meeting the criteria established by the HAS may schedule an appointment to be vaccinated throughout the country:

• men who have sex with men and report having multiple sexual partners

• transgender individuals reporting multiple sexual partners

• sex workers

• professionals working in venues where sexual services are provided

Vaccination may also be considered on a case-by-case basis for healthcare professionals who care for infected individuals.

To learn more about vaccination and access to vaccination sites:

• Monkeypox Information Sheet

• Monkeypox, sexosafe.fr website

• Monkeypox, vaccination-info-service.fr website

• Monkeypox, advice and care in the Île-de-France region, website of the IDF Regional Health Agency