Risk of monkeypox becoming endemic in Europe: ECDC assessment

Simon Collins, HIV i-Base

On 23 May 2022, the most comprehensive public report on the recent international cases of monkeypox virus (MPV) includes an important caution that MPV could become endemic in European countries. [1]

This assessment from the European Centre for Disease Control (ECDC) says that future risks depend on how effectively further transmission is prevented, and that this currently involves asking close contacts to isolate for three weeks until MPV can be ruled out.

Although MPV is reported as being difficult to transmit, there is only a short window period to establish control, given the extent of the current networks is unknown.

It also depends on MPV not being transmitted into other animal species.

ECDC in partnership with EACS also hosted two informal webinars on MPV on 24 and 31 May 2022. Slide sets from these are posted below. [4]


These implications are difficult coming at a time of reduced concern over COVID-19, but are essential to take seriously.

Unfortunately, further cases are likely to continue to rise given that transmission might be possible for several weeks. This might include a period before lesions occur. Effective prevention will also depend on contact tracing.

MPV is not currently classed as a sexually transmitted infection but because genital sores are a symptom, infections have been reported by sexual health clinics. STI clinics stress the importance of not using drop-in services (as staff would then need to isolate) but to phone first for advice or to call 111.

The ECDC document also reports a caution for people with reduced immunity, including older people living with HIV, and that any additional risk might be largely mitigated by effective ART.

BHIVA also produced a rapid statement, that will be updated as information changes. [2]

i-Base has published a non-technical factsheet on monkeypox that will be updated as needed. [3]

Slides from two EACS/ECDC webinars on 24 and 31 May 2022 are online. [4, 5]


  1. European Centre for Disease Prevention and Control (ECDC). Monkeypox multi-country outbreak: rapid assessment report. (23 May 2022). page) (PDF)
  2. Monkeypox cases in the UK: BHIVA statement. HTB (18 May 2022).
  3. i-Base. Monkeypox: Q&A and update. (25 May2022).
  4. EACS/ECDC. Informal webinar given on 24 May 2022.
    Monkeypox EACS/ECDC webinar 1 (PDF)
  5. EASC/ECDC. Informal webinar given on 31 May 2022.
    Monkeypox_EACS/ECDC_webinar 2 (PDF)

This report was first published on 23 May 2022.

Links to other websites are current at date of posting but not maintained.