The Travel Health and Vaccine Specialists

Monkeypox in Africa

Level 1

Practise usual precautions

Updated: May 31, 2019


  • Situation update.

Original publication date: October 24, 2018

Current situation

Nigeria has been experiencing an outbreak of monkeypox since September 2017. Since the beginning of the outbreak, confirmed cases have been reported in the following states: Abia, Akwa Ibom, Anambra, Bayelsa, Benue, Cross River, Delta, Edo, Ekiti, Enugu, Federal Capital Territory, Imo, Lagos, Nasarawa, Oyo, Plateau, and Rivers. Suspected cases have been reported in 26 states.

In September 2018, 2 unrelated cases of monkeypox were reported in the United Kingdom in travellers arriving from Nigeria. A health care worker caring for one of these cases also developed monkeypox. In addition, Israel and Singapore have reported 1 case in travellers arriving from Nigeria.

The Democratic Republic of the Congo is also currently reporting an outbreak of Monkeypox. The most affected provinces are Sankuru, Tshuapa, and Ecuador.

For the most current case counts, please see the World Health Organization’s regional office for Africa weekly bulletin on outbreaks.

About monkeypox

Monkeypox is a disease that is caused by a virus. It is mainly spread to people through direct contact with infected animals (mainly African rodents and monkeys), by bite, scratch, or contact with their body fluids. Monkeypox is usually a self-limited disease and does not frequently result in death.

This disease usually occurs in Central and West Africa.

Monkeypox does not spread easily between people. Although uncommon, it is possible for monkeypox to be spread from an infected person to other people through direct contact with:

  • skin lesions or scabs (which resemble chickenpox)
  • contaminated clothing or linens
  • respiratory droplets (for example: coughs and sneezes)

Monkeypox can also be spread from an infected pregnant woman to her developing fetus.

There is currently no specific licensed vaccine or treatment to prevent or treat monkeypox.

Symptoms of monkeypox occur in two stages, and can begin 5 to 21 days after exposure.

In the first stage, symptoms include:

  • swelling of the lymph nodes
  • fever
  • intense headache
  • back pain
  • muscle pain
  • lack of energy

In the second stage, symptoms include:

  • appearance of a rash

This rash is similar in appearance to chickenpox and often begins on the face before spreading to other parts of the body. Symptoms usually last between 14 and 21 days.


Consult a health care professional or visit a travel health clinic at least 6 weeks before you travel. During travel:

  • Avoid contact with animals, specifically African rodents and monkeys, and materials contaminated with their body fluids.
  • Protect yourself from the spread of germs.
    • Avoid close contact with people who are, or appear to be, sick.
    • Wash your hands frequently with soap and water.
    • Keep your hands away from your face.
    • Do not share eating or drinking utensils.
    • Clean surfaces that are frequently touched (e.g.: doorknobs or counters).
  • Eat and drink safely abroad.
    • Avoid handling raw or undercooked meat.
    • Only eat foods that are well cooked and served hot.
  • Monitor your health
    • If you develop symptoms that could be due to monkeypox when you are travelling, see a health care professional. Tell them where you have been travelling or living.
    • If you have symptoms that could be due to monkeypox during the flight, tell the flight attendant before you land or the border services officer as you enter the country. They will notify a quarantine officer who can assess your symptoms.
    • If you develop symptoms that could be due to monkeypox after you return to Canada, see a health care professional. Tell them where you have been travelling or living.

Health care professionals caring for returning travellers may be at risk of exposure.

  • Health care professionals should follow strict infection prevention and control measures when caring for patients with suspected or confirmed monkeypox virus infection.
  • The smallpox vaccine has been shown to be effective in preventing monkeypox infection in exposed individuals. The smallpox vaccine is not available to the general public, following global smallpox eradication in 1980, but has been used as a control measure in outbreaks.

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