Following the World Health Organisation’s announcement that the monkeypox outbreak should be considered a global health emergency, there has been an explosion of media attention and discussion around the subject. Considering the past couple of years we’ve all just lived through, it’s understandable that this development has caused widespread anxiety and even panic  You might be wondering if you’re at risk personally, when you can get the vaccine and whether you should change your behaviour in the meantime. Dazed spoke with Will Nutland, an HIV researcher and the founder of sexual health organisations Prepster and The Love Tank, to answer some questions you might have had about monkeypox.

WHAT SYMPTOMS SHOULD I BE LOOKING OUT FOR?

The early symptoms of monkeypox can include a high temperature, headache, muscle aches, backaches, swollen glands and exhaustion. What differentiates it from COVID – or any generic flu-like illness – is that a rash usually appears within one to five days of the first symptoms. This often begins on the face before spreading to other parts of the body, according to the NHS, starting as raised spots which turn into blisters. 

If you do notice any unusual symptoms and are worried you might have monkeypox, then you should call up your local sexual health clinic who will be able to advise. If you’re not a member of the most impacted demographics (most notably, men who have sex with men), then don’t jump to conclusions, because whatever rash or lesion you’re experiencing could easily be any number of things. This is also true if you are a man who has sex with men. In either case, seeking medical guidance is key.

HOW WORRIED SHOULD I BE?

It depends. If you’re straight, you should still be aware of monkeypox and on the lookout for symptoms, but you’re not at high risk of exposure right now. The data, both in London and the rest of the UK, is very clear that the vast majority of cases are occurring within networks of men who have sex with men. “It’s not useful to peddle conspiracy theories that there are a whole bunch of other people who have undiagnosed monkeypox,” Nutland tells Dazed. “If that were the case, we would be seeing scores of people rocking up at A&E and sexual health clinics with unusual lesions, and we’re not... We might see changing patterns of transmission in future but right now that’s not happening.” 

If you’re a MSM, and particularly if you’re sexually active, then it’s worth being a bit more mindful of the risk – but there’s still no need to panic. Vaccine capacity is increasing and you should be able to get one soon. More broadly, while it’s impossible to say for sure, there appears to be a consensus among scientists that monkeypox is unlikely to lead to a full-scale COVID-style pandemic. But that shouldn’t make tackling the problem any less urgent.

HOW CAN I GET THE VACCINE?

If you’re not a member of the most affected demographics, then you are unlikely to be offered a vaccine for now. “If you are pushing yourself to the front of the queue, you’d be stopping someone else who needs the vaccine from getting it,” says Nutland.

If you are a member of the most impacted groups, you have a few different options. Because there is a scarcity of the vaccine – and a huge amount of pressure on already overburdened sexual health services – the official line at the moment is that you should wait for your clinic to contact you to arrange an appointment. However, there are also drop-in clinics where people who haven’t been called up yet can queue up to get the vaccine, including Guy’s Hospital in London

It’s also worth keeping an eye out on social media for clinics announcing that they have capacity. Towards the end of the day, they might have some cancelled appointments and a small handful of vaccines available – information which they will spread through various networks. Keeping an eye on Twitter for last-minute appointments would be a good shout. 

I’M GAY BUT I’M IN A MONOGAMOUS RELATIONSHIP. DO I STILL NEED THE VACCINE?

This is a trickier one. The data is showing that monkeypox is being diagnosed among men who are part of key sexual networks. If you are in a truly monogamous relationship (people are often mistaken on that front) then you are not currently a priority for the vaccination. “Right now it’s being transmitted in networks of people who are generally sexually active with larger numbers of partners,” Nutland says. That’s not to say that the policy will change over time or that you will never be offered the vaccination, but the chances of you being exposed to monkeypox other than sexually are currently fairly low. 

Then again, given that monogamy is famously porous – and that it's hardly unheard of to contract an STI in such a relationship – if you want to queue up for a drop-in clinic then it might not be a bad idea. 

SHOULD I STOP HAVING SEX OR LIMIT SEXUAL PARTNERS?

This is something you’re going to have to decide for yourself. The key thing to acknowledge is that everyone has different perceptions of risk, depending on their circumstances, and it’s unrealistic to expect a universal standard to be applied. But one thing’s clear: demanding outright that people stop having sex is a bad idea. “We know from COVID, we know from the whole history of sexual and reproductive health, including HIV, that abstinence approaches don’t work,” says Nutland. “We saw very clearly during COVID that telling people not to have sex for a block of time isn’t sustainable.”

Some other experts are arguing that because you can’t always see the symptoms of monkeypox, or people might not recognise them, a harm reduction response is more appropriate. This could involve refraining from hook-ups or not having sex. It might include reducing the number of partners or not going to particular settings, such as saunas or backrooms, but still having occasional hook-ups. No one is prescribing this, but these measures are worth considering if you’re concerned about your own levels of risk. “What I’ve been encouraging people to do is: if we are still going to have sex, then we should be on the lookout for symptoms and, if we find them, then hold off until we’ve had them checked out,” says Nutland.

WHAT CAN I DO TO HELP THE BROADER EFFORT?

The biggest problem in the response to monkeypox is that sexual health services are chronically underfunded. Having been afforded no additional resources or staff, they are struggling to have the capacity necessary to handle a fresh outbreak, and this is having a knock-on effect on other vital services they provide, such as HIV care and long-acting contraception. If you want to do something to help tackle this, Nutland suggests writing to your MP and demanding ongoing investment in sexual health services. “We need services and systems in place which are properly invested in and sustainable. Otherwise, when - not if - the next outbreak happens, it will further reveal cracks in the system and the same thing will happen again.”