Full list of countries at risk of mpox outbreak as UK issues new travel advice

The Foreign Office has issued fresh travel advice in light of a public health emergency declared due to an outbreak of mpox.

The World Health Organisation (WHO) has flagged the rising number of mpox cases in Africa as a significant concern. Mpox is an infection caused by the mpox virus, which has two distinct strains.

Travel Health Pro, a subdivision of the Foreign Office, states that Clade 1 mpox is associated with a higher risk of severe illness or death compared to Clade 2. In May 2022, a global outbreak of Clade 2 mpox predominantly affected gay, bisexual and other men who have sex with men.

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Before 2024, Clade 1 mpox had only been reported in five central African countries, according to Travel Health Pro. However, recent cases in additional countries in central and east Africa mark the first known expansion of its geographical range, increasing the risk of spread beyond the region.

In an update on September 5, Travel Health Pro released a new list of countries affected by the concerning strain. The body stated: "In 2023, the Democratic Republic of Congo (DRC) reported its highest number of Clade 1 mpox suspected and confirmed cases on record. High case numbers have continued to be reported in 2024.", reports the Manchester Evening News.

"Since July 2024, confirmed cases of Clade 1 mpox have also been reported for the first time in Burundi, Kenya, Rwanda and Uganda with some having links to the DRC. Sweden and Thailand have reported confirmed cases of Clade 1 mpox in a traveller with links to countries involved in the current Clade 1 outbreak."

"No Clade 1 mpox cases have been reported in the UK to date."

Mpox, previously known as monkeypox, is an infectious disease caused by a virus. It can cause flu-like symptoms including fever, muscle aches, and a skin rash or pus-filled lesions that can last two to four weeks.

The affected countries

As of 22nd August 2024, the countries in central and east Africa where Clade I cases have been reported are:

• DRC

• Republic of the Congo

• Central African Republic

• Burundi

• Rwanda

• Uganda

• Kenya

• Cameroon

• Gabon

The countries where there may be a risk of Clade I mpox exposure (based on sharing a border with the DRC) currently include:

• Angola

• South Sudan

• Tanzania

• Zambia

Mpox symptoms and management

"Mpox is an infectious disease caused by the mpox virus," says the Travel Health Pro update. "Mpox can be transmitted when a person comes into close contact with an infected, human, animal or contaminated material."

"Person-to-person spread can occur through:".

"While more information is emerging, there is a potential risk of mpox spreading if you are close to an individual with mouth lesions of mpox when they are coughing or sneezing."

"The first symptoms of mpox include:".

"A rash or pus-filled lesions then usually appear 1 to 5 days after the first symptoms. The rash (spots, blisters or ulcers) often begins on the face, then spreads to other parts of the body."

"This can include the mouth, genitals and anus. The number of sores can range from one to several thousand."

Advice for travellers

The Foreign Commonwealth and Development Office (FCDO) advises checking whether it is safe to travel to your intended destination. This includes information on entry requirements, safety and security.

Travellers are advised to check the latest guidance on vaccination, malaria and other health risks, as well as consulting with a health professional to ensure they are fit to travel. Pregnant and immunosuppressed individuals should take particular care, as they are known to be at a higher risk of severe infection.

It's also recommended that travellers check their travel health insurance before departing.

Is there a vaccine?

"The UK does not currently recommend pre-travel vaccination for mpox. The JCVI continues to review latest data on the current Clade 1 mpox outbreak and will continue to update vaccination recommendations accordingly," says Travel Health Pro.

For further information about vaccinations recommended prior to travel, refer to the Green Book - Immunisation against infectious disease, adds the Foreign Office organisation.

How to reduce risk

Travel Health Pro has warned that Mpox can be transmitted through any form of close contact, including both sexual and non-sexual encounters.

The health advisory body suggests: "You can reduce your risk while travelling by taking sensible precautions to protect yourself from infection:".

For those seeking more information on the risks of Clade 2 mpox and sex, Travel Health Pro recommends referring to the public health advice for gay, bisexual and other men who have sex with men.

People living with HIV are advised to consult the British HIV Association (BHIVA) statement on the mpox (monkeypox) virus.

Upon returning to the UK, if you've recently travelled to any of the mpox affected countries and notice any new spots, blisters or ulcers, Travel Health Pro advises speaking to a member of port or border staff for guidance.

If symptoms develop within 21 days of returning to the UK after visiting an affected country, it's recommended to self-isolate at home and call NHS 111 for advice, making sure to inform them of your recent travel history.

Current advice on mpox can be found on the NHS website.