Smallpox B (Mpox)

Smallpox B (Mpox), formerly known as monkeypox, is a rare viral infectious disease caused by the monkeypox virus and transmitted primarily from rodents to humans, and then from person to person, mainly through contact with skin lesions.

Our missions

  • Epidemiological surveillance and case investigation, particularly of clusters

  • Contributing to research efforts to advance scientific knowledge at the national and international levels

  • Participation in expert assessments of vaccination and care policies

  • Vaccine logistics (procurement, inventory management, and distribution)

  • Development and distribution of tools, and implementation of information and prevention campaigns targeting at-risk populations

What We Do

In this article

Epidemiological Surveillance of Monkeypox (Mpox)

In France, monkeypox (Mpox) is monitored through the mandatory reporting system coordinated by Santé publique France, which centralizes and analyzes the data, as well as through the characterization of the monkeypox virus by the National Reference Center for Orthopoxviruses.

Rapid case reporting enables Santé publique France to track epidemic trends and case characteristics; it also allows regional health agencies (ARS) to implement the necessary measures to limit the spread of the virus: recommending isolation for cases, contact tracing to identify contacts, reminding the public of preventive measures, organizing vaccination for at-risk contacts, etc.

The Ministry of Health, Santé publique France, and the Center for Epidemiology and Public Health of the Armed Forces (CESPA) are closely monitoring the evolution of the epidemic at the international level.

To learn more about the international situation:

Mandatory Reporting

Mandatory reporting (DO) involves collecting as comprehensive information as possible regarding all cases of certain diseases known as “notifiable diseases” from laboratory technicians and physicians. Physicians and laboratory technicians who suspect or diagnose a notifiable disease must report it immediately and by any appropriate means (phone, fax, email) to the ARS physician in their area of practice.

The report allows the ARS physician to implement individual and collective preventive measures around the cases and, if necessary, to initiate investigations to identify the source of the infection and take action to reduce it.

Notification occurs after reporting and most often after confirmation of the diagnosis. Reporting physicians or laboratory technicians notify the ARS physician at their place of practice using a form specific to each disease. Notification enables the analysis and monitoring of the progression of these diseases within the population in order to better target local and national prevention efforts.

Case definition and recommended actions

Clinical signs suggestive of smallpox B (Mpox)
Suspected case A patient suspected of having a Monkeypox virus infection is a person presenting
with - a rash or one or more ulcerations of the genital, anal, or oral mucosa suggestive of Monkeypox (Mpox),
- occurring in isolation, or preceded or accompanied by a perceived or measured fever (>38°C), lymphadenopathy, or odynophagia.
Probable case

A probable case of Monkeypox virus infection is a person presenting
with - a rash or one or more genital, anal, or oral mucosal ulcers suggestive of smallpox B (Mpox),
- occurring in isolation, or preceded or accompanied by a perceived or measured fever (>38°C), lymphadenopathy, or odynophagia;

AND a high-risk contact (definition below) with a confirmed case in France or another country.
Confirmed case A confirmed case of Monkeypox virus infection is a person with
:- a positive result from a Monkeypox virus-specific qPCR or RT-PCR test, or a test specific to a clade or subclade of the Monkeypox virus; or
- a positive result from a generic qPCR test for the Orthopoxvirus genus, combined with a partial sequencing result specific to the Monkeypox virus.

Download - Document for healthcare professionals

Definition of at-risk contacts

At-risk contact

Any person who has had:

  • unprotected direct contact of any duration with the broken skin or body fluids of a symptomatic probable or confirmed case, including sexual intercourse (with or without a condom), medical or paramedical care, or personal hygiene procedures; OR

  • indirect physical contact through the sharing of toiletries or kitchen utensils, or textiles (clothing, bath linens, bedding) used by the symptomatic probable or confirmed case.

Contact person with negligible risk

  • any person who has had high-risk contact as described above while the contact person was wearing effective protective measures, with the exception of sexual intercourse, which always remains a risk. Effective protective measures against physical contact include, in particular, the use of impermeable gloves (latex, nitrile, rubber);

  • any other situation.

Downloads - Documents for reporting the disease

Surveillance partners

  • Regional Health Agencies: list and locations: http://www.ars.sante.fr

  • The National Reference Center (CNR) for Orthopoxviruses:

Armed Forces Biomedical Research Institute (IRBA)
1 Place Valérie André 91220 Bretigny/Orge
Email: irba-cnropv.accueil.fct@def.gouv.fr
Head: Dr. Olivier FERRARIS - Tel.: 06 03 87 58 59
Email: olivier.ferraris@intradef.gouv.fr
Website: https://irba.sante.defense.gouv.fr/cnr/#orthopoxvirus

To learn more about the missions of the National Reference Centers, click here.

Expertise linked to research and supporting decision-makers

Santé publique France maintains close ties with ANRS-MIE regarding scientific monitoring and to discuss priority research initiatives to be implemented. It also collaborates with modeling teams to explore various hypotheses, such as the relative impact of prevention measures among men who have sex with men in 2022.

Santé publique France contributes to the work of health expert bodies, notably by sharing its knowledge and data on the epidemiological situation related to mpox and on vaccination activities: the High Authority for Health (HAS), the High Council for Public Health (HCSP), etc.

Preventive measures against smallpox B (Mpox)

Communication that adapts to the dynamics of the outbreak and to scientific knowledge

Santé publique France informs the public about appropriate preventive measures to reduce the risk of Monkeypox infection through its website, media campaigns, and the distribution of specific resources in the field.

To raise public awareness about recognizing symptoms and the importance of vaccination, Santé publique France relies on:

  • on-the-ground stakeholders;

  • the sexosafe.fr website, dedicated to the sexual health of MSM;

  • the vaccination-info-service.fr website for healthcare professionals and the general public regarding vaccination;

  • the creation and distribution of posters and flyers;

  • information campaigns (digital, radio, etc.)

Mpox-info-service.fr: a helpline to answer questions about monkeypox

Funded by Santé publique France and operated by SIS Association, the “Mpox 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.

Support for Preventive Vaccination Against Smallpox B (Mpox)

In accordance with its mandate, Santé publique France contributes to the smallpox B (Mpox) vaccination strategy in several ways:

  • contributing to the development and adaptation of vaccination strategies;

  • assessing vaccination coverage, efficacy, and impact;

  • supplying vaccines—from procurement to distribution of vaccine doses—in coordination with the ANSM, as part of a logistics plan established with the Ministry of Health and in support of the overall vaccination strategy established by the Government;

  • providing information on vaccination.

Through the Pharmaceutical Agency, Santé publique France manages vaccine stocks on behalf of the State (orders, storage at its national platform and at its depots) and organizes vaccine deliveries to various facilities.

Santé publique France also offers two dedicated sections on the vaccination-info-service website: one for the general public and the other for healthcare professionals, to better support them in their practice.

To learn more about vaccination and access to vaccination sites: