Mpox symptoms in Ireland: what to do about a new rash

Mpox (the illness formerly called monkeypox) is a viral infection that spreads mainly through close, prolonged, skin-to-skin contact — including sexual contact — and sometimes through contaminated bedding, towels or clothing. It is uncommon in Ireland. Chickenpox, shingles, cold sores, hand-foot-and-mouth and a handful of bacterial infections are all far more likely explanations for a new rash. That said, mpox is one of the few rashes where what you do in the first hour genuinely matters.

What mpox actually looks and feels like

Irish public health guidance (HPSC) describes two broad presentations, and people can have either or both.

Swollen glands are the detail doctors pay attention to, because chickenpox usually does not cause them and mpox often does. It is a clue, not a diagnosis — only a PCR swab of a lesion can confirm or rule out the virus.

The 21-day question you will be asked

Symptoms alone are not enough. Clinicians pair them with exposure in the 21 days before your symptoms started. Expect to be asked, without judgement and in confidence, about:

• Close, skin-to-skin, intimate or sexual contact with anyone who had a rash or a confirmed or suspected case of mpox
• Any change in sexual partners in that three-week window, whatever your sexual practice
• Travel to a country where mpox is currently circulating (transiting an airport without leaving it does not count)
• Sharing a bed, towels, clothing or bedding with someone who was unwell with a rash
• Contact with an infected animal or with bushmeat

You can still be tested with no identified exposure at all. Where a compatible rash has no obvious risk factor and no better explanation, Irish guidance says the case should still be discussed with specialist services rather than dismissed.

Clade I and clade II — what the news means for you

There are two families of the virus. Clade II drove the global outbreak from 2022 and is generally milder. Clade I is associated with parts of central and east Africa and prompts a more cautious approach, so travel history matters more for it. The clade changes the public health response; it does not change what you personally should do first, which is the same in both cases — phone ahead and isolate pending advice.

What almost certainly is not mpox

Before anyone reaches for a swab, these common conditions are considered first, because they explain the overwhelming majority of rashes:

• Chickenpox or shingles (varicella zoster) — shingles typically stays in one band on one side of the body
• Cold sores and genital herpes (herpes simplex)
• Hand, foot and mouth disease (enterovirus), especially in young children
• Impetigo, cellulitis, folliculitis and other staph or strep skin infections
• Syphilis, which can produce anal and genital sores and a body rash
• Eczema flares, allergic reactions and insect bites

Step by step: what to do today

1. Do not travel to a waiting room unannounced. Phone your GP, the out-of-hours co-op, a sexual health clinic, or book a remote GP consultation.
2. Cover the lesions with clothing or a light dressing and wear a face covering if you must be around others.
3. Take clear, well-lit photographs of the rash — they help enormously on a video call.
4. Stay at home and avoid close physical contact, sharing a bed, and sharing towels or bedding, until you have been advised.
5. Write down when symptoms started and any relevant contacts in the previous 21 days.
6. If you are advised you need testing, your clinician arranges it with infectious diseases or clinical microbiology — you do not have to organise it yourself.
7. If you are unwell with a high fever, severe pain, difficulty swallowing or extensive lesions, say so on the call so you are assessed urgently.

How a video consultation helps here

Assessment of a possible mpox case is one of the situations where Irish guidance explicitly supports remote review. A clinician can see the rash on camera, take the exposure history, judge how well you are, and either reassure you with a far more likely diagnosis or escalate to the specialist services that arrange swabbing — all without you sitting in a room with other patients.

At NOVAGP.IE, a €39 consultation with an Irish-registered GP is available seven days a week at one fixed fee, with no evening, weekend or bank holiday surcharge. If the picture points to shingles, herpes or a bacterial skin infection, treatment can usually start the same day by Healthmail to your pharmacy. If it points towards mpox, we say so plainly and connect you to the right pathway.

Testing, isolation and how long it lasts

Diagnosis is by PCR on a swab taken from a lesion, arranged through infectious diseases or clinical microbiology. While you wait for assessment and results, the advice is to self-isolate at home. If your home situation makes that impossible, there is a national isolation facility and your clinician can raise a referral.

Where mpox is confirmed, the infectious period runs from the first symptoms until every scab has fallen off and fresh skin has formed underneath. That is typically two to four weeks. Public health will contact anyone who needs to know, and household contacts are given specific advice — you are not expected to do that work yourself.

Call 112 or 999, or go to an emergency department, if

• You are struggling to breathe or becoming drowsy or confused
• You cannot swallow fluids because of mouth or throat lesions
• You have severe, uncontrolled pain, particularly rectal pain
• There is spreading redness, swelling and heat around lesions with a high fever (possible secondary bacterial infection)
• You have eye pain, light sensitivity or changes in vision with lesions near the eye

Prevention and vaccination

Vaccination against mpox is offered in Ireland through public health and sexual health services to people at higher risk, and after some exposures. Eligibility is set nationally and changes as the epidemiology changes, so check the current HSE and HPSC position or ask at a sexual health clinic. Beyond vaccination, the practical measures are the ordinary ones: avoid close contact with anyone who has an unexplained rash, do not share bedding or towels while someone is unwell, and get any new anogenital sore checked rather than waiting it out.

Sources

• HPSC — Mpox (monkeypox) case definition, version 2.13
• HPSC — Mpox assessment and testing pathway for primary care settings
• HSE — Mpox: symptoms, testing and vaccination

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