Monkeypox Cases: Update as of October 4, 2022

Update as of October 4, 2022, following reports of monkeypox cases in France and around the world. The next update will be released on October 11.

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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 disease has been subject to enhanced surveillance in France and across Europe, based on mandatory reporting, for which the form has been specifically updated.

Situation Update in France

As of 12:00 p.m. on October 4, 2022, 4,043 confirmed cases of Monkeypox infection had been reported in France, representing 44 additional cases since the September 27 update.

The distribution of confirmed cases by region of residence (or by region of reporting when the region of residence is unknown) is shown in Figure 1. The Île-de-France region has the highest number of cases (2,467, or 61.0%), followed by Occitanie (312 cases), Provence-Alpes-Côte d’Azur (273 cases), and Auvergne-Rhône-Alpes (267 cases); 21 cases reside abroad.

The vast majority of confirmed adult cases recorded to date are male, and 98 cases among those over 15 years of age (2.4%) are female. The proportion of female cases has increased over the past few weeks, reaching 13.6% in Week 36; it then stabilized at 10.1% of confirmed cases reported in Week 37 and 9.1% in Week 38, and decreased in Week 39 to 5.9% (unconsolidated data). The number of confirmed cases reported in women remains low (with a maximum of 16 cases reported in week 36), against a backdrop of a decline in the total number of confirmed cases over the past several weeks.

Ten (0.25%) children under 15 years of age were reported as confirmed cases. Confirmed adult cases have a median age of 36 years; 25% of adult cases are under 29 years of age, and 25% are between 43 and 81 years of age.

Among the 10 children under 15 years of age, 8 were under 6 years old, and the male-to-female ratio among these children was 1 (5 boys and 5 girls). Household transmission was strongly suspected in 4 of them (contact with a confirmed parent), one pediatric case had contact with a confirmed case (reported but not specified), and for the remaining 5 cases, the source of infection was unknown. All cases resided in the Île-de-France region except for two in the Grand-Est region.

Among the confirmed cases for which information is available, 90 (2.2%) were hospitalized due to their Monkeypox infection; this proportion has remained stable over time.

No deaths have been reported to date.

The distribution of cases by date of symptom onset (when known) is shown in Figure 2. The date of symptom onset for these cases ranges from May 7 to October 3, 2022. Due to reporting delays, data from the most recent weeks have not yet been consolidated. The reports received do not always mention the date of symptom onset. As an alternative to this information, the distribution of cases by date of reporting is shown in Figure 3.

These updated data show that the peak in infections occurred in late June/early July and that the number of confirmed cases has declined since then. However, caution is warranted, as improved knowledge about the disease may lead to reduced healthcare-seeking behavior among better-informed populations. Several other countries, particularly in Europe, are observing similar trends in the number of new cases reported over the past 3 months.

Figure 1. Biologically confirmed cases of monkeypox (n=4,022 cases) by region of residence (or by region of reporting when the region of residence is unknown), France, May–October 2022 (data as of October 4, 2022 – 12:00 p.m.)

Figure 1. Cas confirmés biologiquement de variole du singe (n=4 022 cas) par région de résidence (ou par région de signalement lorsque la région de résidence est inconnue), France, mai-octobre 2022 (données au 04/10/2022 – 12h00)

Figure 2. Biologically confirmed cases of monkeypox (n=2,965 cases, number of missing data points: 1,078) by week of symptom onset, France, May–October 2022 (data as of October 4, 2022 – 12:00 p.m.).

Figure 2. Cas confirmés biologiquement de variole du singe (n=2 965 cas, nombre de données manquantes : 1 078) par semaine de début des symptômes, France, mai-octobre 2022 (données au 04/10/2022 – 12h00).
The data for the past few weeks (in light blue) is not yet fully finalized.

Figure 3. Biologically confirmed cases of monkeypox (n = 4,043 cases) by week of reporting, France, May–October 2022 (data as of October 4, 2022 – 12:00 p.m.).

Figure 3. Cas confirmés biologiquement de variole du singe (n= 4 043 cas) par semaine de signalement, France, mai-octobre 2022 (données au 04/10/2022 – 12h00).
The data for the past week (in light blue) is not yet fully consolidated. The dip in reported cases observed in week 28 (July 11–17) can be attributed to the July 14 holiday.

Preventive Vaccination Against Monkeypox

In response to the spread of the Monkeypox virus, the High Authority for Health, following a request from the Directorate General for 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, as of October 4, 2022, 164,920 doses of the third-generation vaccine had been delivered by the Agency to the regions.

As of October 2, 2022, the total number of doses administered was 112,777 (source: Ministry of Health and Prevention).

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, 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 initiatives. From June 17 to September 30, the digital campaign generated nearly 958,788 clicks on banners and over 884,071 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.

To facilitate access to information for vulnerable people in precarious situations, a visual tool—translated into 8 languages and developed in collaboration with professionals working with these individuals—is available on Santé publique France:

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.

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

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 supporting prevention messages and protective measures, providing information on symptoms, treatments, and vaccination, and offering advice and referrals to care services.

Since the hotline opened in mid-July, 7,888 calls have been handled by the Monkeypox Info Service.

  • 115 calls were handled in week 39 (compared to 136 the previous week).

The decline in the number of calls to the Monkeypox Info Service continues this week. Callers are younger, with a median age of 36 (vs. 41 in week 38).

The proportion of calls from Île-de-France is on the rise (57% vs. 46% in week 38), as are those from Occitanie (9% vs. 5%).

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