Mpox can be passed on from person to person through:

• any close physical contact with mpox blisters or scabs (including during sexual contact, kissing, cuddling or holding hands)
• touching clothing, bedding or towels used by someone with mpox
• the coughs or sneezes of a person with mpox when they're close to you

In parts of central and east Africa, mpox can also be caught from infected rodents (such as rats, mice and squirrels) if:

• you're bitten
• you touch their fur, skin, blood, body fluids, spots, blisters or scabs
• you eat their meat and it has not been cooked thoroughly

If you get infected with mpox, it usually takes between 5 and 21 days for the first symptoms to appear.

The first symptoms of mpox include:

• a high temperature (fever)
• a headache
• muscle aches
• backache
• swollen glands
• shivering (chills)
• exhaustion
• joint pain

A rash usually appears 1 to 5 days after the first symptoms. It can be on any part of the body, including the palms of the hands, soles of the feet, mouth, genitals and anus.

You may also have anal pain or bleeding from your bottom.

The rash is sometimes confused with chickenpox. It starts as raised spots, which turn into sores (ulcers) or small blisters filled with fluid. The blisters eventually form scabs which later fall off.

The symptoms usually clear up in a few weeks. While you have symptoms, you can pass mpox on to other people.

Call NHS 111 if:

• you have a rash with blisters or sores (ulcers) and you've been to central or east Africa in the past 3 weeks
• you have a rash with blisters or sores (ulcers) and you've been in close contact (including sexual contact) with someone who has symptoms of mpox and they've been to central or east Africa in the past 3 weeks
• you have any other symptoms of mpox and you've been to central or east Africa in the past 3 weeks and had close contact with someone who had symptoms of mpox

Stay at home and avoid close contact with other people, including sharing towels or bedding, until you've been told what to do.

Tell the person you speak to about your recent travel history.

Call Embrace sexual health clinic if:

You have a rash with blisters or sores (ulcers) and have either:

• had 1 or more new sexual partners in the past 3 weeks
• had sex or sexual contact with someone who has symptoms of mpox but has not been to central or east Africa in the past 3 weeks

Stay at home and avoid close contact with other people, including sharing towels or bedding, until you've been told what to do.

Call the clinic before visiting. Tell the person you speak to if you've had close contact with someone who has or might have mpox.

Mpox is usually mild and can get better within a few weeks without treatment.

But if your symptoms are more severe and you become unwell, you will need treatment in hospital.

The risk of needing treatment in hospital is higher for:

• older people
• young children
• people with a condition or who are taking a medicine that affects their immune system

Because the infection can be passed on through close contact, it's important to isolate if you're told to do so.

Mpox is caused by an infection with the mpox virus. The mpox vaccine can give good protection against mpox.

Who can have the mpox vaccine

The NHS is offering the mpox vaccine to people who are at increased risk of catching mpox.

You may be able to have the mpox vaccine if:

• you're a man who has sex with other men and you have multiple partners, participate in group sex or attend sex-on-premises venues (staff at these venues may also be eligible)
• you've had contact with someone who has mpox

If you've had contact with someone who has mpox, the contact tracing team should contact you. They will check your risk of catching mpox and tell you if you need to have an mpox vaccine.

How the mpox vaccine is given

The mpox vaccine is given as an injection.

Most people will be offered 2 doses of the vaccine at least 1 month apart. Some people only need 1 dose of the mpox vaccine.

How to get the mpox vaccine

Embrace are able to provide Mpox vaccine action to all eligible patients. For more information or to book an appointment please call 01902 444 444 or call our Advice Line on 01902 481689 (Monday, Wednesday, Thursday, Friday 9am – 12pm and Tuesday 10am-12pm).

The healthcare professional at your appointment will check if you're eligible.

If you've been offered an mpox vaccine because you've had contact with someone who has mpox, you do not need to find an mpox vaccination site. The mpox contact tracing team should tell you where to get vaccinated.

Although mpox is rare, there are things you can do to reduce your chance of getting it and passing it on.

Do

• wash your hands with soap and water regularly or use an alcohol-based hand sanitiser

• look out for any possible symptoms of mpox for 3 weeks after returning from central or east Africa

• talk to sexual partners about their sexual health and any symptoms they may have

• be aware of the symptoms of mpox if you're sexually active, especially if you have new sexual partners

• take a break from sex and intimate contact if you have symptoms of mpox until you're seen by a doctor and are told you cannot pass it on

Don't

• do not share bedding or towels with people who may have mpox

• do not have close contact (within 1 metre) with people who may have mpox

• do not go near wild or stray animals, including animals that appear unwell or are dead, while travelling in central or east Africa

• do not eat or touch meat from wild animals while travelling in central or east Africa

Gonorrhoea, caused by the bacterium Neisseria gonorrhoeae, is one of the most common sexually transmitted infections (STI) in the UK. GBMSM who have sex with more partners are at increased risk of contracting it. Gonorrhoea infections can also increase the risk of getting other infections and untreated gonorrhoea infection can cause serious problems including infections in the testicles and eyes.

Bexsero is a vaccine that helps protect against Neisseria meningitidis group B (MenB) bacteria, which can cause meningitis (an infection of the lining of the brain and spinal cord) and septicaemia (blood poisoning). It has been used in the UK routine immunisation programme for babies since 2015 and has led to 75% reduction in MenB infections for vaccinated groups. Recent research has shown that the Bexsero vaccine may also offer some protection against gonorrhoea.

The meningococcus (Neissera meningitidis) and the bacteria that cause gonococcus (Neisseria gonorrhoeae) are closely related. While Bexsero is primarily designed to protect against meningococcal infections (meningitis and septicaemia), studies have shown that the vaccine can also provide some protection against gonorrhoea. This means that individuals who receive the Bexsero vaccine may have a reduced risk of contracting gonorrhoea compared to those who are not vaccinated.

You need 2 doses of the vaccine for protection. The second dose must be given at least 4 weeks after the first dose, but can be given after 3 months, 6 months or later, whenever you next attend the clinic. The vaccine is given by injection, usually in the upper arm.

It is common to get some swelling, redness or tenderness where you have the injection. You may also get a mild fever, nausea, headache or muscle aches but these symptoms should disappear after one or 2 days.

More serious side effects are rare. You can take over the counter pain medication such as paracetamol or ibuprofen to manage these symptoms if required.

It takes at least 2 weeks from your second dose for your body to produce enough antibodies to give you a good level of protection. The vaccine provides around 30 to 40% protection against gonorrhoea so you must continue to use condoms for protection against gonorrhoea and other sexually transmitted infections such as syphilis.

The vaccine will not completely stop you from getting gonorrhoea infection, but it will help reduce the chance of infection and passing it on to other partners.

Meningitis and septicaemia are rare but severe diseases that can kill or leave people with life changing disabilities and health problems. The vaccine protects against meningitis and septicaemia caused by the MenB bacteria but other bacteria can also cause meningitis and septicaemia so you should still be aware of the signs and symptoms. Further information is available on the NHS website.

Gonorrhoea symptoms:

• many infections may be asymptomatic
• can include thick yellow discharge from the penis
• pain on urination

If you are concerned about gonorrhoea infection, call our advice line on 01902 481689 (Monday, Wednesday, Thursday, Friday 9am – 12pm and Tuesday 10am-12pm), or call 01902 444444 to book an appointment. You can also text a sexual health nurse for confidential advice on 07480 635 548.

Do not forget your MenB vaccine record card. You will need a second dose at least 4 weeks after the first dose to give you the best protection from gonorrhoea.

For more information on gonorrhoea please visit:

• Gonorrhoea symptoms from the NHS website
• Gonorrhoea symptoms from the Terrence Higgins Trust website
• Information on gonorrhoea and meningitis from the NHS website
• Meningitis Research Foundation free helpline 0808 800 3344
• Meningitis Now 24 hour helpline 0808 801 0388

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