In early May 2022, cases of monkey pox (Monkeypox) not directly linked to travel to Central or West Africa where the virus is present, or people returning from travel, were reported in Europe and the world. Since that date, the epidemic has affected a growing number of countries and the disease has been the subject, in France and in Europe, of heightened surveillance. Today, the Agency is developing monitoring and will soon produce new indicators.
Epidemiological surveillance that adapts to changes in knowledge and diagnostic practices
Surveillance was initially based in France and internationally on the confirmation of cases by biological examination (PCR). As the epidemic progressed and knowledge of the symptomatology of cases was accumulated, clinicians no longer systematically resorted to laboratory diagnosis for clinically suggestive cases for which a risky exposure or contact with a case confirmed (by PCR) was documented.
In order to better interpret epidemiological trends, the Agency is adapting surveillance to extend it to all cases and no longer be limited to biologically confirmed cases. This change makes it possible to better describe the reality on the ground, quantify the impact of the epidemic, and take into account changes in diagnostic practices by clinicians.
As a reminder, Monkeypox virus infections (whether the cases are biologically confirmed or clinically suggestive with risky exposure) must be the subject of a mandatory declaration (Orthopoxvirus sheet including smallpox) allowing the feedback of information to the Regional Health Agency, then Public Health France as part of surveillance.
To date, only biologically confirmed cases must be transmitted to the european level.
The new indicators should be published next week after a necessary verification period to ensure their robustness and reliability.
Update in France
As of August 18, 2022 at 12:00 p.m., 2,889 confirmed cases have been identified in France. The breakdown of cases by region of residence (or by reporting region when the region of residence is unknown) is as follows: 1,692 cases in Ile-de-France, 251 in Occitanie, 217 in Auvergne-Rhône-Alpes, 203 in Provence-Alpes-Côte d’Azur, 140 in Hauts-de-France, 113 in New Aquitaine, 76 in Grand Est, 58 in Pays-de-la-Loire, 32 in Normandy, 31 in Brittany, 29 in Burgundy- Franche-Comté, 27 in Centre-Val de Loire. For Martinique, Corsica, Guadeloupe and Saint-Martin, each of these regions had less than 5 cases. Twelve cases reside abroad.
All cases identified to date are adult males, except 34 adult females and 7 children. Adult cases have a median age of 36; 25% of adult cases are under 30 years old and 25% are 43 to 77 years old.
The distribution of cases according to the date of onset of symptoms (when this is known) is presented in figure 1. Given the reporting delays, the data for the last few weeks are not consolidated. The reports received do not always mention the date of onset of the symptoms. As an alternative to this information, the distribution of cases according to their date of reporting is presented in Figure 2.
The reporting low observed in week 28 (July 11 to 17) can be explained by the public holiday (July 14).
Figure 1. Confirmed cases of monkeypox (n=1,966 cases) by week of onset of symptoms, France, May-August 2022 (data as of 08/18/2022 – 12:00 p.m.)
The data for the last few weeks (in grey) are not fully consolidated.
Figure 2. Confirmed monkeypox cases (n=2,888 cases) by reporting week, France, May-August 2022 (data as of 08/18/2022 – 12:00 p.m.)
Data for the last week (in grey) are not fully consolidated.
Information and prevention actions
Given what has been observed in Europe on the disease, targeted communication was quickly implemented towards MSM people. The website sexosafe.fr, dedicated to the sexuality of MSM people, is regularly updated with a summary of knowledge on the subject and prevention measures. Poster, radio and digital campaigns provide information to people in addition to actions in the field. Since June 17, the digital campaign has generated nearly 689,463 clicks on the banners and more than 599,065 visits to the Sexosafe site.
All information on vaccination is updated weekly on the page intended for the General public and that intended for health professionals (accessible without login) of the site vaccination-info-service.
Prevention actions are continuously adapted to the evolution of the situation and the state of knowledge.
To facilitate access to information for vulnerable people in precarious situations, a pictorial tool, translated into 6 languages, developed with professionals working with these people is available on Sante Publique France.
The MOBCO newsletter n°7 compiled with actors in the field brings together a series of questions/answers on the subject of Monkeypox/monkey pox. It is aimed at professionals or volunteers in contact with people in precarious situations.
In France, long-term monitoring of monkeypox through the mandatory notification system is reinforced and information and alert messages are sent to health professionals. Exchanges are also continuing with other European countries, the WHO and the ECDC.
Monkeypox info service: a listening device to answer questions about monkeypox
Since Wednesday, July 13, a listening device has been open to answer questions raised by monkeypox. Subsidized by Public Health France and supported by SIS Association, the “Monkeypox info service” telephone line is accessible every day from 8 a.m. to 11 p.m., on the toll-free number 0 801 90 80 69 (free, anonymous and confidential call and services). This device is in charge of accompanying prevention messages and protective measures, of providing information on symptoms, treatments and vaccination, of advising and directing towards the care devices.
Since the opening of the line, 6,133 interviews were conducted on Monkeypox info service.
Preventive vaccination against monkeypox
Faced with the spread of the Monkeypox virus (monkey pox), the High Authority for Health, seized by the Directorate General for Health, recommended in its opinion the July 7, 2022 that preventive vaccination be offered to the groups most exposed to the virus.
Regarding the deployment of vaccination, 103,000 doses of 3rd generation vaccine were delivered by the Agency to the territories on 18/08/2022.
Since July 11, 2022, in addition to people who have had risky contact with a sick person, people falling within the indications retained by the HAS can make an appointment to be vaccinated throughout France:
- men who have sex with men reporting multiple sex partners
- trans people reporting multiple sex partners
- sex workers
- professionals working in places of sexual consumption
Vaccination can also be considered on a case-by-case basis for health professionals who have to take care of sick people.
For more information on vaccination and access to vaccination sites:
