Monkeypox Cases: Update as of July 12, 2022

Update as of July 12, 2022, following reports of monkeypox cases in France and around the world.

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Cases of monkeypox with no direct link to travel in Central or West Africa or to travelers returning from those regions have been reported in Europe and around the world; suspected cases are currently being evaluated in many countries, and the situation is therefore evolving very rapidly. In France, infections with this virus are subject to ongoing surveillance through the mandatory reporting system. Given the current alerts, surveillance of these infections has been stepped up by Santé publique France, and information and alert messages are being sent to healthcare professionals.

Monkeypox Cases: Update on the Situation in France

As of July 12, 2022, at 2:00 p.m., 912 cases have been confirmed: 569 in Île-de-France, 87 in Auvergne-Rhône-Alpes, 68 in Occitanie, 47 in Nouvelle-Aquitaine, 47 in Provence-Alpes-Côte d’Azur, 34 in Hauts-de-France, 18 in Grand Est, 13 in Normandy, 9 in Brittany, 8 in Centre-Val de Loire, 5 in Pays-de-la-Loire, 3 in Bourgogne-Franche-Comté, and 4 cases abroad.

As of July 11, 2022, at 12:00 PM, the distribution by region of residence of the 824 confirmed cases residing in France that were investigated is shown in Figure 1.

Figure 1. Confirmed cases of monkeypox (n=824), by region of residence, France, May–July 2022 (data as of 07/11/2022 – 12:00 PM)

Figure 1. Cas confirmés de variole du singe (n=824), par région de résidence, France, mai-juillet 2022 (données au 11/07/2022 – 12h00)

The description of the 828 confirmed cases that were investigated is provided below.

Among all confirmed cases, 5 adult females and 2 children were identified.
The adult cases are aged between 19 and 84 years (median age: 36 years).

The dates of symptom onset range from May 7, 2022, to July 7, 2022 (Figure 2). These cases were diagnosed a median of 6 days (ranging from 0 to 22 days) after symptom onset; therefore, data from the last week are not consolidated.

Among investigated cases, the median time to testing per surveillance week has decreased significantly since the start of the outbreak, from 13 days in Week 18 of 2022 (May 2–8) to 4 days in Week 26 of 2022 (June 27–July 3).

Figure 2. Confirmed cases of monkeypox (n=828), by date of symptom onset, France, May–July 2022 (data as of July 11, 2022 – 12:00 PM)

Chez les cas investigués, le délai médian de recours au test par semaine de dépistage est en nette diminution depuis le début de l’épidémie, passant de 13 jours en S18-2022 (2 au 8 mai) à 4 jours en S26-2022 (27 juin au 03 juillet).

Among the cases, 81% presented with a genital-anal rash, 73% with a rash on another part of the body, 78% with fever, 76% with lymphadenopathy, and 37% with a sore throat.

Among the cases, 40 are immunocompromised; 211 are HIV-positive (26%). Among cases not living with HIV, 403 are on PrEP (70%). No cases have died.

To date, in France, 97% of cases for which sexual orientation is reported have occurred among men who have sex with men (MSM). Among cases for which information is available, 75% report having had at least two sexual partners in the three weeks prior to the onset of symptoms.

Most cases report being unable to identify the person who infected them; 153 are secondary cases, meaning they reported having been in contact with a monkeypox case within three weeks prior to the onset of symptoms.

The next update to this report will be on Wednesday, July 20, 2022.

Information and Prevention Initiatives

Given what has been observed in Europe regarding the disease, targeted communication was quickly implemented for MSM. The website sexosafe.fr, dedicated to the sexual health of MSM, was updated with a summary of current knowledge on the subject and prevention measures. Messages reminding people of the symptoms and what to do if symptoms appear were shared through a digital campaign. Since June 17, the digital campaign has generated nearly 307,173 clicks on banners and over 246,484 visits to the Sexosafe website. This initiative was supplemented by a poster campaign in social gathering places, with nearly 1,350 display locations. At the same time, posters, flyers, and fact sheets were distributed through community organizations, Regional Health Agencies (ARS), and Sexosafe teams on the ground, during Pride parades, and in MSM social spaces. To date, 1,636 posters and 67,050 flyers have been ordered.

In the coming days, messages will be broadcast on community radio stations. Regarding preventive vaccination, field-ready tools will also be made available, following the publication of the Haute Autorité de Santé’s advisory on July 7.

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

  • Access the documents:

    • Monkeypox Information | Poster

    • Monkeypox Information | Flyer

Given the usual absence of monkeypox in Europe and the lack of reported links between identified cases and a risk area, the current European context constitutes an alert and suggests local transmission in Europe. This is why, 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.

Monkeypox Info Service: A Helpline to Answer Questions About Monkeypox

Since Wednesday, July 13, a helpline has been available to answer questions about monkeypox. Funded by Santé publique France and operated by SIS Association (Sexualité info service Association), the “Monkeypox Info Service” hotline is available daily from 8 a.m. to 11 p.m. at the toll-free number 0 801 90 80 69 (free calls and services; anonymous and confidential) This service is responsible for promoting prevention messages and protective measures, providing information on symptoms, treatments, and vaccination, and offering advice and referrals to care services.

What is monkeypox?

Monkeypox is an infectious disease caused by an Orthopoxvirus. This zoonotic disease is usually transmitted to humans in the forested areas of Central and West Africa by wild rodents or primates, but human-to-human transmission is also possible, particularly within households or in healthcare settings.

How is it transmitted?

The monkeypox virus can be transmitted through direct contact with the skin lesions or mucous membranes of an infected person, as well as through droplets (saliva, sneezing, spittle, etc.). Sexual intercourse, with or without penetration, creates conditions conducive to transmission, and having multiple partners increases the risk of exposure to the virus.

Transmission can also occur through contact with the patient’s environment (bedding, clothing, dishes, bath linens, etc.). It is therefore important for patients to remain in isolation for the entire duration of the illness (until the last scabs have fallen off, usually 3 weeks).

In Central or West Africa, humans can also become infected through contact with animals—wild or captive, dead or alive—such as rodents or monkeys.

Infection with the monkeypox virus is not classified as an STI, but direct contact with broken skin during sexual intercourse facilitates transmission.

What are the symptoms?

Infection with the monkeypox virus can cause a vesicular rash, consisting of fluid-filled blisters that dry out, form scabs, and eventually heal. Itching may occur. The blisters tend to concentrate on the face, the anogenital area, the palms of the hands, and the soles of the feet, though they may also appear on the trunk and limbs. The mucous membranes are also affected, particularly in the mouth and genital region. This rash may be accompanied by fever, headache, body aches, and fatigue. Lymph nodes may be swollen and tender under the jaw, in the neck, or in the groin. Sore throat has also been reported.

The incubation period for the disease can range from 5 to 21 days. The fever phase lasts about 1 to 3 days. The disease usually resolves spontaneously after 2 to 3 weeks, but sometimes takes up to 4 weeks.

Is monkeypox serious?

The disease is more severe in children and in immunocompromised individuals. It can lead to complications such as secondary infections of the skin lesions or respiratory, digestive, ophthalmological, or neurological complications.

In Europe, and particularly in France, no deaths have been reported.

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