Monkeypox Cases: Update as of June 9, 2022

Update as of June 9, 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 in France

As of June 9, 2022, at 2:00 p.m., 91 confirmed cases of monkeypox have been reported in France: 64 in Île-de-France, 10 in Occitanie, 8 in Auvergne-Rhône-Alpes, 2 in Normandy, 2 in Hauts-de-France, 1 in Centre-Val de Loire, 1 in PACA, 1 in Bourgogne-Franche-Comté, and 2 in Nouvelle-Aquitaine.

Of the 91 confirmed cases as of June 9, 2022, at 2:00 p.m., 85 have been investigated, one refused investigation, one remains unreachable, and 4 are currently under investigation. All investigated cases are men, aged between 20 and 63 (median age: 35). Among the investigated cases, 4 are immunocompromised; two were hospitalized but are no longer so as of today; none have died.

To date, as in other European countries, these cases have occurred predominantly, though not exclusively, among men who have sex with men (MSM), with no direct link to individuals returning from endemic areas. The majority of cases report having multiple sexual partners.

Most of the investigated cases report being unable to identify the person who infected them.

Finally, 4 of the investigated cases are secondary cases who were unvaccinated.

Among the investigated cases, 39 had traveled, stayed, or worked abroad before the onset of their symptoms, some of them in several different countries: 18 trips were reported to Spain, 6 to Belgium, 5 to Germany, 1 to Portugal, 1 to the United Kingdom, 1 to the Netherlands, 1 to Morocco, 1 to India, 2 to Switzerland, 1 to the United States, 2 to Mali, and 1 to Colombia. These trips do not necessarily constitute the source of infection.

The next update on this situation will be released on Tuesday, June 14.

Given what has been observed regarding the disease in Europe, targeted communication was quickly implemented for men who have sex with men (MSM). The messages highlight transmission routes, symptoms, and what to do if symptoms appear. They are currently being shared digitally on the Sexosafe website dedicated to MSM and via social media. At the same time, on the ground, posters, flyers, and advice sheets have been distributed through community organizations, Regional Health Agencies (ARS), and Sexosafe teams working in the field. Prevention efforts will be adapted as the situation evolves.

  • Access the documents:

    • Monkeypox Info - Poster

    • Monkeypox Info - 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 a warning 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 ongoing 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.

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