FAQ: What should you know about monkeypox?

Although monkeypox continues to spread globally and in Europe, there have been no new cases reported in Estonia since 2022. However, the risk of introducing the disease still exists.

The symptoms of monkeypox are similar to those of smallpox, but milder: they include a fever, severe headache, muscle aches, backache, a swelling of the lymph nodes and fatigue as the initial symptoms. The characteristic skin rash usually appears 1 to 3 days after the onset of fever. 

Healthcare professionals are prepared to take samples for testing if monkeypox is suspected, with the samples sent to the Communicable Diseases Laboratory of the Health Board for analysis. Also, read the interview on how the sample analysis is conducted. More detailed information about monkeypox is available on the same page.

• Who is vaccinated against monkeypox in Estonia?

In Estonia, vaccination recommendations have been provided by the expert committee on immunoprophylaxis, and according to these, risk groups may be vaccinated both before and after exposure.

Before exposure, individuals over 18 years of age who may come into close contact with a confirmed or probable monkeypox case during the infectious period (eg, due to sexual behaviour, travel, work, etc) are vaccinated.

After exposure, individuals over 18 years of age who have been in close contact with a confirmed or probable monkeypox case during the infectious period and individuals who worked with an infectious patient or infectious material without using personal protective equipment are vaccinated.

Vaccination is provided to individuals in risk groups, and the need for vaccination for each person is determined by a healthcare professional.

• When was the last case of monkeypox in Estonia?

The first case of monkeypox in Estonia was registered on 28 June 2022. The last case was registered on 4 September 2022.

A total of 11 cases were registered in Estonia in 2022. Given that the disease could potentially be introduced, it is an infection that Estonian doctors occasionally consider when making a diagnosis. However, since 2022, laboratory tests have not confirmed any new diagnoses, nd the symptoms have been caused by other pathogens.

• How much monkeypox vaccine is available in Estonia, and when is its expiration date?

In 2022, Estonia received 1,400 doses of the Jynneos monkeypox vaccine, which were donated by the EU. Of these, 800 doses were transferred to the Health Insurance Fund’s storage, and the remaining 600 doses were distributed among hospitals with the necessary storage conditions.

There are 780 doses of the monkeypox vaccine in the Health Insurance Fund’s storage. There has been no need for disposals, as the current batch of vaccines is still within its expiration date. The stock levels in hospitals are not visible to the Health Insurance Fund. The current vaccine stock expires in May 2025.

If the need arises, it is possible to get vaccinated, for example, at the North Estonia Medical Centre (PERH), Tartu University Hospital (TÜK), Pärnu Hospital and Ida-Viru Central Hospital (IVKH). 

• What is the situation with monkeypox infections in Europe?

During the outbreak in Europe in 2022 (Clade 2), a total of 25,693 cases were identified. The highest number of cases was reported in July 2022, during the 28th week, when 2,588 cases were registered. 

In 2024, a total of 98 cases of the Clade 2 variant of monkeypox were registered across nine countries (as of July). Sweden reported the first case of the more dangerous Clade 1 strain of monkeypox in the European Union on 15 August 2024.

In its risk assessment published on 16 August 2024, the European Centre for Disease Prevention and Control (ECDC) stated that it is highly likely that more cases of monkeypox, caused by the more dangerous Clade 1 virus spreading in Africa, will reach the European Union and the European Economic Area. However, the likelihood of its sustained spread in Europe is very low, provided that imported cases are diagnosed quickly and control measures, such as isolation of infected individuals and tracing of their close contacts, are implemented.