Monkeypox has been a popular subject as of late. This past week the World Health Organization has increased the global public health risk of monkeypox to moderate, but the individual risk of being exposed is still low for most people. It’s important to remember that though monkeypox has been with us for some time, with this renewed effort to look closely for it globally, we expect a lot of cases to show up over the next several weeks and months. Much like COVID, when we first hear about new cases, it is due to strong surveillance in countries and communities that have proactive and responsive public health programs.
This is not a virus that is likely to cause a pandemic, but it can cause localized outbreaks and it can cause severe disease and death, especially in those at higher risk, like children and those that are immunocompromised. This is also why so much care is being taken now to figure out how these new cases may change our thinking of where and how monkeypox has been spreading.
There is a lot of information out there, so let’s cut right to the facts and what you can share with your friends and family. So what is it that you should know about this virus and how it can affect you? Let’s dive in!
5 Things You Should Know About Monkeypox
1) It Does Not Come from Monkeys
- The natural hosts are actually rodents and squirrels. Rats, mice, prairie dogs are all examples of how this virus is often transmitted to humans. The virus is known to circulate in rodents endemic to parts of central and western Africa, and has spread to humans from prairie dogs in the U.S. Since we’re not its natural hosts, it does not spread very easily between humans, but we’re monitoring closely to make sure that the virus hasn’t evolved in a way to change that, or that it has taken hold in new animal hosts in the new regions where it is spreading. No evidence of either yet.
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With smallpox, the more severe cousin of monkeypox, and the first and only virus to be successfully eradicated (through an international vaccine effort!) humans were the main host, allowing it to spread much more easily among populations.
2) Infection is Usually Self-Resolving and Risk of Transmission is Still Low
- Most people’s risk of transmission is still low. Those at most risk are those who have been identified as contacts of any known cases. We expect to see a lot more cases appear as close monitoring and testing is now underway, but for now, most people’s risk of exposure is low, and can be prevented with a lot of the same safety measures we all take to prevent COVID-19.
- Most people who become infected will recover well. Though there is a risk of serious disease with monkeypox, the version that is currently circulating internationally is one that causes less severe disease and only rarely deaths. There is another version which can cause severe disease in about 10% of cases on average, which is why it is so important to monitor closely and isolate any known cases of this virus.
3) It’s Preventable
- While keeping yourself safe from this current surge of COVID-19 cases, you can also lower your risk of contracting most other viruses, including monkeypox. Wearing a high quality mask when around others outside of your own household, avoiding sick contacts and crowds/large gatherings (especially indoors), and diligent hand washing (at least 20 seconds!) are all ways to stay safe and healthy. Before meeting with friends and family it’s also important to have honest discussions about symptoms, including any rashes.
- There are vaccines and there are treatments, but some are in limited supply. This includes a newer vaccine approved in 2019 for monkeypox which has less side effects than the original smallpox vaccine. Those same vaccines can also be used as prophylaxis (protection) against infection when given to people who have been exposed. There is also an antiviral treatment available for those with more serious symptoms.
- You may already have some protection. If you were born or raised outside of the United States, you may have received a smallpox vaccine, which can provide up to 85% protection against monkeypox. Immunity does wane, which is why we are likely seeing a rise in cases now. As the world was at one point entirely vaccinated against smallpox in the successful effort to eradicate it, it was protected against monkeypox. Now most people have not been vaccinated, so monkeypox has the opportunity to spread.
4) Symptoms are Similar to the Flu or Chickenpox
- Symptoms can develop anytime around 5-21 days after exposure (this means that the quarantine period can be about 21 days). Normally, most people will develop flu-like symptoms of chills, body and muscle aches, fever, and swollen glands without any congestion or respiratory symptoms that come with the flu. This period of symptoms is called a “prodrome”. Some, but not all, people will go on to develop a rash. With this current group of cases, we are seeing more people without a fever and only light, localized rashes, likely due to transmission being mainly from direct contact with lesions.
- Though it is in an entirely different class of viruses from varicella, which causes chickenpox, the rash that appears after an initial few days of fever and body aches can look similar at first, including looking like flat red marks initially. If you or someone in your household develops these symptoms, make sure to isolate at home away from the household and contact your healthcare provider.
5) It is not a sexually transmitted disease
- Anyone can be exposed and become infected. But it is transmitted through close, prolonged contact. The virus is spread from lesions that appear on the skin or that are present in the throat which is why coughing can occur and it can be inhaled in droplets. This means that a person is contagious once the rash first appears until it has cleared, meaning the scabs have fallen from the skin. It can also be transmitted through infected objects (“fomites”), like bed linens. This is also why it can be transmitted with intimate contact, but also can be transmitted among family members, roommates and other close contact conditions.
- If you or someone in your household is experiencing any symptoms of a new rash or flu-like symptoms, especially in the summer, it’s important to stay home and reach out to a healthcare provider. There are several other diseases that can cause similar symptoms that can come from ticks and mosquitoes in the summer, so it’s important to be evaluated so the right diagnosis and treatment can be provided. To correctly diagnose monkeypox, a PCR test is usually performed (a swab of a lesion in this case).
References:
- Monkeypox. (n.d.). Retrieved June 2, 2022, from https://www.who.int/news-room/fact-sheets/detail/monkeypox
- IDSA Media Briefing: Monkeypox – What Experts Know. (n.d.). Retrieved June 2, 2022, from https://www.idsociety.org/multimedia/videos/idsa-media-briefing-monkeypox--what-experts-know/
- Monkeypox. (n.d.). Retrieved June 2, 2022, from https://www.who.int/news-room/questions-and-answers/item/monkeypox
- U.S. Monkeypox 2022: Situation Summary | Monkeypox | Poxvirus | CDC. (2022, June 2). https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html
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