Monkeypox Cases: Update as of July 7, 2022

Update as of July 7, 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 7, 2022, at 12:00 p.m., 721 cases have been confirmed: 473 in Île-de-France, 70 in Auvergne-Rhône-Alpes, 52 in Occitanie, 33 in Nouvelle-Aquitaine, 29 in Hauts-de-France, 28 in Provence-Alpes-Côte d’Azur, 11 in Normandy, 10 in Grand Est, 6 in Brittany, 4 in Pays-de-la-Loire, 3 in Bourgogne-Franche-Comté, and 2 in Centre-Val de Loire.

As of July 6, 2022, at 12:00 PM, the distribution by region of residence of the 652 confirmed cases residing in France that were investigated is shown in Figure 1. Additionally, 4 further cases reside abroad.

Figure 1. Confirmed cases of monkeypox (n=652), by region of residence, France, May–July 2022 (data as of July 6, 2022 – 12:00 PM)

Figure 1. Cas confirmés de variole du singe (n=652), par région de résidence, France, mai-juillet 2022 (données au 06/07/2022 – 12h00)

Among these cases, one new pediatric case in a child under 10 years of age and one new case in a woman have been reported. In total, 2 children and 4 women have thus been identified to date among all cases infected with the monkeypox virus since May 7, 2022, the date of the first case detected in France.

Confirmed adult cases are aged between 19 and 71 (median age: 35).

The dates of symptom onset range from May 7, 2022, to July 1, 2022 (Figure 2). These cases were diagnosed a median of 6 days (ranging from 0 to 22 days) after symptom onset; consequently, data from the last week have not been consolidated.
Among the investigated cases, the median time to testing per surveillance week has been decreasing since the start of the outbreak, from 13 days in Week 18 of 2022 (May 2–8) to 5 days in Week 25 of 2022 (June 20–26).

Figure 2. Confirmed cases of monkeypox (n=656), by date of symptom onset, France, May–July 2022 (data as of 07/06/2022 – 12:00 PM)

Figure 2. Cas confirmés de variole du singe (n=656), par date de début des symptômes, France, mai-juillet 2022 (données au 06/07/2022 – 12h00)

Among the investigated cases, 81% presented with a genito-anal rash, 74% with a rash on another part of the body, 79% with fever, and 75% with lymphadenopathy.

Among the investigated cases, 34 are immunocompromised; 174 are HIV-positive (27%). Among cases not infected with HIV, 314 are on PrEP (69%). No cases have died.

To date, in France, 98% 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% reported having had at least two sexual partners in the three weeks prior to symptom onset.

Most of the investigated cases report being unable to identify the person who may have infected them; 118 are secondary cases, meaning they reported having been in contact with a monkeypox case within the three weeks prior to the onset of symptoms.
The next update to this report will be on Wednesday, July 13, 2022.

Information and Prevention Efforts

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 220,817 clicks on banners and over 204,999 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, 1,626 posters and 62,850 flyers have been ordered.

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 high-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.

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 towels, 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.

See previous updates

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