Should you worry about mpox when travelling?

The spreading of any disease is unsettling. But when the World Health Organisation (WHO) announces an international emergency — as it did with mpox (formerly monkeypox) — in August, there’s a more urgent sense of concern.

A new, deadlier form of mpox was reported by scientists earlier this year. The WHO says there have been 18,000 suspected cases and 629 deaths in the Democratic Republic of the Congo — the worst affected country — this year. For travellers, that might bring back memories of Covid and two years of fraught rules, restrictions, masks, testing and quarantines. So here’s what you need to know.

What is mpox?

The viral zoonotic disease — meaning it can spread between animals and people — manifests with flu-like symptoms including fever, headache, muscle ache and fatigue, followed by a distinctive rash that progresses to blisters or sores. Human-to-human transmission occurs through close contact with infected individuals or contaminated materials. Although similar to smallpox, mpox is generally less severe and has a lower fatality rate. It’s primarily found in Africa but may spread to other areas. Vaccination and isolation are key to controlling outbreaks.

Which countries are affected?

As of August, suspected cases have been reported in 13 African countries: Burundi, Cameroon, the Central African Republic, the Republic of the Congo, the Democratic Republic of the Congo, Gabon, Ivory Coast, Kenya, Liberia, Nigeria, Rwanda, South Africa and Uganda. The Africa Centres for Disease Control and Prevention (CDC) has declared mpox a ‘public health emergency of continental security’. 

Has it spread in Europe?

Sweden reported the first imported case in August. The European Centre for Disease Prevention and Control (ECDC) has raised the risk of the deadlier Clade I strain from ‘very low’ to ‘low’.

“The emergence of a case on the European continent could spur rapid international spread of mpox,” Lawrence Gostin, a public health expert and professor at Georgetown Law in Washington, told Reuters. “A case in Sweden most likely means dozens of undetected cases in Europe.”

Dr Meera Chand, deputy director of the UK Health Security Agency, tempers that view: “The risk to the UK population is currently considered low. However, planning is underway to prepare for any cases that we might see in the UK.” 

Are travel restrictions likely?

China announced in August that, for the next six months, it will screen people entering the country from high-risk areas. And anyone travelling to Thailand from 42 ‘risk countries’ must register and undergo testing on arrival.

However, officials in Africa are lobbying against restrictions. “Don’t punish Africa,” said Jean Kaseya, head of the Africas CDC. “We need solidarity. We need you to provide appropriate support. This vaccine is expensive. I clearly request our partners to stop thinking about travel bans against Africa. That will bring us back to the unfair treatment from the Covid period and not help the world to move forward.”

Should I cancel my trip? 

Tour operators are likely to be lenient if you have a trip booked to the DRC. But, given the Foreign, Commonwealth and Development Office advises against all travel to only certain parts of the country, operators are under no obligation to refund you. There’s no need, at present, to cancel trips to other affected African countries. 

What precautions should I take?

Vaccination is an option. The ECDC says those visiting affected areas in Africa should consult healthcare professionals before travelling, to see if they are eligible for a jab. Those most at risk of contracting mpox include children under 15 years old, and adults who have multiple sexual partners.

Will travel insurance cover me?

The virus is an epidemic, so a good travel insurance policy — covering medical bills up to at least £2m in Europe and £5m worldwide — should cover you if you become ill abroad. However, the government-backed National Travel Health Network and Centre warns: ‘Travel to a mpox-affected area may affect travel health insurance options. Travellers should discuss their plans with their insurance provider before they go.’