Monkeypox Forum With Dr Vincent Cornelisse

Full Forum Video With Dr Cornelisse

Summary Video By Dr George

Important Topics Covered:

Transmission of Monkeypox

  • Monkeypox (MPX) virus can be found in bodily fluids as well as lesions in the skin. The virus is easily absorbed in mucosal linings such as the mouth, anus, and genitals.
  • Lesions can transmit the virus to mucosal linings and broken skin
  • Condoms may not prevent infection but can reduce the risk of internal anal lesions and perhaps urethral lesions which can be very painful.
  • MPX virus can last for up to 12 weeks in semen.
  • Bedding/towels used by an infected person can be sanitized with soap and UV light such as sunlight. The risk of transmission from bed sheets is must less than the sex you have in the bed.
  • It may be worth considering “sex bubbles” as was suggested during the early COVID outbreak.

Incubation & symptoms.

  • MPX incubation can be from 3-4 days up tp 21 days.

  • Initial symptom include:

    • flu-like illness
    • raised lymph nodes (golf ball size & painful)
    • There can be an early rash on the arms/legs/face
  • MPX lesions - dots, blisters, pustules, scabs, and ulcers can be found anywhere on the body but can also be in the mouth, genitals, and inside the anus. They are noted to be more painful than they look (10/10 painful in some cases)

  • Asymptomatic transmission: (Belgium & France data) 1-5% of people can have an infection without symptoms. It’s quite rare but it can happen.

  • Infectious bodily fluids ie semen inside a person you later have sex with can be considered an infection risk (orgies, multiple sex partners)

  • Oral sex is still considered risky - 95% of people with oral MPX reported having given oral sex.

  • Massage / physiotherapy risk is direct exposure to lesions to non-intact skin. Visual inspection has a role in prevention. Non-sexual massage is not considered a risk if there are no lesions and the skin on both parties is intact.


  • The vaccine is live but can’t reproduce so can’t lead to infection or transmission
  • 30% protective antibodies @ 2 weeks, 60% @ 4 Weeks
  • HIV + people have a slower response but get to similar levels of protection 2 weeks after the 2nd injection.
  • Post immunization there can be fatigue for 1-2 days & the injection site can have a lump and be sore for a week or so.
  • Myocarditis risk is unlikely (if a person had cardiac issues with the covid vaccine - when recovered they would be considered safe to have the MPX vaccine.
  • Intradermal injection gives a similar immune response to subcutaneous vaccination.
  • 1 shot may not prevent infection but will make infection must less severe
  • Previous smallpox vaccine (Look for the scar on the shoulder, foot or scapula) - single dose should be enough to bring protection
  • If you have had monkeypox you will most likely not need the vaccination. Data is in the early stages however we are not aware of people getting MPX twice.
  • Natural MPX infection is a much higher viral load than the vaccine therefore would most likely provide immunity for life. They do not need to get the MPX vaccine.
  • It is likely that if people have had monkeypox they wouldn’t be able to get it again and transmit it in the future.
  • VIC - seeing local transmission - partner notification is going to be important. Look after each other, keep in contact with sexual partners with a diary or similar.
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Dr George Forgan-Smith