On 23 July 2022, the World Health Organization (WHO) declared the escalating global mpox (previously named monkeypox) outbreak a Public Health Emergency of International Concern (PHEIC). This is the highest level of alert the WHO can issue and underlines the organization’s concerns about the rapid spread of the disease.

At the time of writing the mpox disease has not been reported to cause any particular challenges for Gard’s Members and clients. However, cases of mpox have now been reported from 110 member states across all six WHO Regions. We therefore encourage ship operators to stay alert to the situation and follow the evolution of the outbreak and the areas affected by mpox at a given time.

It is also critical to keep ship personnel informed about mpox through risk communication, e.g., by displaying posters, videos, and message boards. Promotion of personal protective measures and risk-reducing behavior is important, particularly before shoreside visits. Key messages should include information about:

• Symptoms: Mpox presents with fever, headache, muscle aches, exhaustion and an extensive characteristic rash that looks like pimples or blisters. The febrile stage is followed by the skin eruption stage, lasting for 2 to 4 weeks. Lesions evolve from macules (lesions with a flat base) to papules (raised firm painful lesions) to vesicles (filled with clear fluid) to pustules (filled with pus), followed by scabs or crusts. 
• Transmission: Mpox spreads in different ways. The virus can spread from person-to-person through:
• direct contact with the infectious rash, scabs, or body fluids,
• respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing or sex, and
• touching items (such as clothing or linens) that previously touched the infectious rash or body fluids.

It is also possible for people to get mpox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

• Prevention: Personal hygiene is paramount. Self-protection steps include avoiding skin-to-skin or face-to-face contact with anyone with symptoms, practicing safer sex, cleaning hands with water and soap or alcohol-based hand rub, and respiratory etiquette.
• Reporting: Any rash-like illness should be immediately reported to a medic, including information about all recent travel, sexual history, and smallpox immunization history. The ill person should remain isolated.

General information and advice

For the latest official information and advice related to the mpox outbreak, we recommend consulting the following organizations’ websites dedicated to the disease:

• International Maritime Organization (IMO)
• World Health Organization (WHO)
• US Centers for Disease Control and Prevention (CDC)
• European Centre for Disease Prevention and Control (ECDC)

The WHO has also aunched a global epidemiological report titled “ 2022 Mpox Outbreak: Global Trends” that is updated regularly, and the geographic distribution of cases can be viewed using the WHO Health Emergency Dashboard. These two data products complement the Situation Reports, which is produced every two weeks and provides a more comprehensive update of the mpox outbreak beyond the epidemiological information.

In addition, the Mariners Medico Guide app includes up to date medical information and support. This international guide is designed by doctors specialised in maritime medicine as an assessment tool specifically for seafarers while at sea. It is possible to search by symptoms as well as condition, and it is written in easy-to-follow language and steps. It can be downloaded for free for desktop as well as Apple and android mobile devices. Once downloaded, the medical guide is available without internet access. The Mariners Medico Guide includes contact details and links to shore based telemedical assistance and is accessible to all seafarers.