This document is guidance only.
Who this guidance is for
This guidance is for people who have been diagnosed with a monkeypox infection and who have been advised to self-isolate at home. You may have been discharged from hospital to continue isolation at home, or you may be self-isolating at home without being admitted to hospital.
It is important to follow the advice in this guidance as much as you can. By self-isolating, you are protecting others and preventing the spread of infection.
Monkeypox is a rare disease that is caused by the monkeypox virus. Monkeypox is most commonly seen in central and west Africa but there has been a recent increase in cases in the UK as well as other parts of the world where it has not been seen before.
Monkeypox usually causes a mild illness that resolves without treatment and most people recover within a few weeks. However, severe illness can occur in some people. It is possible that young children, pregnant women and immunocompromised people are more at risk of becoming severely unwell than others.
Many cases of monkeypox across the world are suspected to be caused by contact with infected animals. Monkeypox can also spread between people but it does not spread easily.
Infection mainly spreads between people through direct (skin to skin) contact, including sexual contact, or close contact via particles containing the monkeypox virus. Infection can also be spread via contaminated objects such as linen and soft furnishings. The chances of catching the infection increases when there is close contact with an infected person who has monkeypox symptoms.
Monkeypox infection usually starts with symptoms such as fever, headache, muscle aches, backache, chills or exhaustion. This is followed by a rash a few days later that may start on the face, groin or hands, before spreading to the rest of the body. It starts as raised spots, which turn into small blisters filled with fluid (lesions). These blisters eventually form scabs which later fall off.
An individual with monkeypox is considered infectious from when their symptoms start, until their lesions have scabbed over, all the scabs have fallen off and a fresh layer of skin has formed underneath. This may take several weeks.
How to isolate safely at home if you have monkeypox infection
Isolate at home
If you have been diagnosed with monkeypox and you have been advised to self-isolate at home by your doctor, you should not go to work, school or public areas.
If you have a garden, it is fine to use it. As monkeypox spreads via close contact, to protect other members of your household you should keep at least 3 steps (1 metre) away from them even while you are in the garden.
You should only leave your home for essential purposes such as emergencies, urgent medical appointments, or for urgent health and wellbeing issues.
If you need to leave your home, make sure the rash on your body is completely covered for example by wearing long-sleeved top and full-length trousers. Wear a well-fitting surgical face mask or a double-layered face covering while you are outside your home.
Keep the time spent outside your home as short as possible and avoid all contact with objects such as furniture in public spaces. If you need to attend hospital you should walk, cycle or drive yourself there. If you do not have your own vehicle, public transport can be used but you should avoid busy periods, cover any lesions with cloth (for example using scarfs or bandages) and wear a face covering.
Ask friends or relatives to help with buying groceries, other essentials or collecting medication, or order them online. Friends, relatives and delivery drivers should leave items outside your home and should not come inside. They should not touch anything that you have touched.
Do not invite or allow social visitors, such as friends and family, to visit you at home.
Avoid close contact with people you live with
People who live in the same household as someone with monkeypox are at the highest risk of becoming infected themselves because they are most likely to have prolonged close contact. If you live with other people, they will have been advised to isolate at home and provided with public health advice.
You should limit close contact with others in your household and take the following steps to reduce the chance of passing your infection on to the people you live with:
- sleep in a separate room, if available, and do not share bedding. You may need to change your sleeping arrangements to accommodate this
- use a separate bathroom from the rest of your household, if available. If you do not have a separate bathroom, follow the cleaning instructions below
- make sure you use separate towels from other people in your home
- eat in a separate room. Ask the people you live with to bring your meals to you
- cover your mouth and nose with disposable tissues when you cough or sneeze and dispose of them in a bag. Place this bag in another bag and follow the instructions for disposing waste. Wash your hands thoroughly with soap and water for 20 seconds
- clean your hands frequently throughout the day by washing with soap and water for 20 seconds. Care should be taken if there are extensive or ulcerated hand lesions
If you need to spend time in the same room as someone in your household you should avoid physical contact and aim to keep at least 3 steps (1 metre) away from the other person. In addition wearing a well-fitting surgical face mask or double-layered face covering may provide some additional protection.
It is particularly important to avoid close contact with young children, pregnant women and immunosuppressed people as they may be at higher risk of serious illness. Use your own toothbrush, eating and drinking utensils, dishes, towels, washcloths and bed linen. Do not share food and drinks.
If you are no longer able to follow the advice in this section at any time during your self-isolation period you should speak to your doctor as it may be necessary for you to self-isolate in another location.
Cleaning, disinfection and waste disposal
You should handle your own used crockery and cutlery, and if you have one, use a dishwasher to clean and dry these items. If this is not possible, wash your own crockery and cutlery using your usual washing up liquid and warm water and leave them to air dry.
If you have lesions on your hands and you have no access to a dishwasher, wear single use disposable gloves or reusable washing up gloves while washing up. Any reusable gloves should not be shared and should be discarded at the end of your isolation period.
You should regularly clean surfaces that you touch frequently, such as door handles and light switches and use a damp cloth to prevent dust from accumulating on surfaces, especially in your bedroom. You can use your usual household cleaning products for this, such as detergents and bleach.
Personal waste (such as used tissues) and disposable cleaning cloths can be stored securely within disposable rubbish bags.
Vacuum cleaner waste, including disposable filters if your vacuum cleaner has one, should be carefully emptied into a disposable rubbish bag.
As an additional precaution, all disposable rubbish bags should be placed into a second disposable bag, tied securely, before being disposed of as usual with your domestic waste. You should not put any waste into recycling bins until you have ended your self-isolation.
You should do your own laundry. Keep your laundry items separate from the rest of the household’s laundry and wash them using your normal detergent, following manufacturer’s instructions. If possible use the highest temperature which the items can withstand, do not overload the washing machine (aim for half or two-thirds full) and avoid shorter ‘economy cycles’ (those which reduce water and save energy) until you have fully recovered.
When you are taking laundry to the washing machine it is important to avoid shaking the laundry, as this could spread virus particles into the air and onto surfaces in your home. If you are carrying laundry from one room to another you should consider placing dirty laundry in a large plastic bag (such as bin liner) or a container then taking it straight to the washing machine.
If you do not have a washing machine, you can handwash your laundry using warm water and your normal detergent. This might be more effective in a large sink or bathtub. It is important to clean all surfaces when you have finished. Take extra care if using bleach to clean these surfaces: always follow the manufacturer’s instruction for diluting disinfectants, protect your eyes, and thoroughly rinse the disinfectant off every surface, to prevent accidental contact with skin or eyes, once you have finished.
If you have had to travel in a car with a friend or relative, you should wear a well-fitting surgical face mask or double-layered face covering while in the car. Your friend or relative should wipe down all hard surfaces after the journey using a standard detergent or detergent wipes while wearing gloves and surgical face mask or face covering.
Waste should all be double bagged and disposed of as described above.
No cases of monkeypox have been reported in wild animals or pets in the UK but it is possible that pets could become infected or contaminated with the virus through close contact with an infected person and spread the virus to others.
If you have pets you should avoid close contact with them as much as you can and practice good hygiene:
Do not let pets sleep in the bed with you.
Wash your hands before and after handling pets or materials they have had contact with (such as collars, leads, feed and feeding bowls, litter trays, bedding and toys).
You will be contacted by Animal and Plant Health Agency (APHA) who will provide you with advice on how to manage your pets while you are isolating.
Until you hear from APHA, your pets should remain in the house with you but you may let them out for toileting purposes on a lead and maintaining 1 metre distance from other people and animals. Outside visits should be kept to an absolute minimum while you are isolating.
If your pet needs veterinary care while you are isolating at home, do not take your pet to your usual veterinary practice, but call them in advance to ask their advice. You may have to ask someone else to take your pet to the surgery for you.
If you need medical advice
You will have been provided with contact details of the medical team providing your care and they will be in contact with you regularly. You should call this team if you have any concerns. Seek prompt medical attention if your illness is worsening. In an emergency, dial 999 and inform the call handler or operator that you have monkeypox infection.
All non-urgent medical and dental appointments should be cancelled while you are isolating at home. If you are concerned or have been asked to attend in person within the period you are home isolating, discuss this with your medical contact first.
You should self-isolate at home until:
- you have not had a high temperature for at least 72 hours
- you have had no new lesions in the previous 48 hours
- all your lesions have scabbed over
- you have no lesions in your mouth
- any lesions on your face, arms and hands have scabbed over, all the scabs have fallen off and a fresh layer of skin has formed underneath
If you meet all of the points above, you may be able to stop self-isolating and you should contact the medical team for further advice.
You should continue to avoid close contact with young children, pregnant women and immunosuppressed people until the scabs on all your lesions have fallen off and a fresh layer of skin has formed underneath. This is because you may still be infectious until the scabs have fallen off.
After your self-isolation has ended you should cover any remaining lesions when leaving the house or having close contact with people in your household until all the scabs have fallen off and a fresh layer of skin has formed underneath.
Resuming sexual activity
Whilst you are self-isolating, you are advised to refrain from sexual activity to reduce the risk of you passing the infection on to your partner.
It is not known how long monkeypox virus remains present in semen and other genital excretions. If you wish to resume sexual activity after your self-isolation has ended, you should use a condom for 8 weeks after your rash has scabbed over and scabs have fallen off. This is a precaution to reduce the risk of spreading infection to your partner.
This guidance will be updated as further information is available.
Look after your wellbeing
Staying at home for a prolonged period can be difficult, frustrating and lonely for some people and you or other household members may feel low. It can be particularly challenging if you don’t have much space or access to a garden.
It is important to remember to take care of your mind as well as your body and to get support if you need it. Stay in touch with family and friends over the phone or on social media. There are also sources of support and information that can help.
The Every Mind Matters website has provides a lot of useful information.
You may be eligible for financial support if you are unable to work
Many people find it helpful to remind themselves why what they are doing is so important. By staying home, you are protecting others and preventing the spread of infection.