Scientists at the U.S. Centers for Disease Control and Prevention (CDC) are tracking reported cases of monkeypox in many countries, including the United States, that don’t normally have monkeypox.As of June 10, 2022, CDC reported 1,472 confirmed cases of monkeypox in 33 non-endemic countries. The list includes (in order of most to least cases): United Kingdom, Spain, Portugal, Germany, Canada, France, Netherlands, United States, Italy, Belgium, Switzerland, United Arab Emirates, Ireland, Australia, Czech Republic, Slovenia, Sweden, Denmark, Israel , Finland, Argentina, Iceland, Latvia, Norway, Austria, Brazil, Gibraltar, Greece, Hungary, Malta, Mexico, Morocco and Poland.
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This new monkeypox outbreak has made headlines for the rare, transmissible virus linked to smallpox. The global investigation into the 2022 outbreak — which is different from previous monkeypox clusters — is still in its early stages, and public health teams are learning more every day as the number of cases mounts.
Emily Landon specializes in infectious diseases and serves as Executive Medical Director of Infection Prevention and Control at the University of Chicago Medicine. She wrote:
“It’s important to know that the risk of acquiring monkeypox through casual contact is currently extremely low. And our best COVID-19 safety practices, such as wearing masks and washing hands regularly, will be invaluable tools in helping us prevent monkeypox.
Likewise, anyone who has been exposed to monkeypox or who thinks they may have symptoms must immediately isolate and notify public health.
This situation is rapidly evolving and our information is based on our understanding of this outbreak at the time of this post. We may know more in the coming weeks and months. But for now, we think you should know about monkeypox and how you can stay safe. “
What is monkeypox?
Monkeypox is a zoonotic infection, which means it starts in animals and is passed to humans. It is endemic in Africa and spreads when someone has close contact with another monkeypox patient or a rodent that carries the disease. Contrary to its name, monkeys are not a common host of monkeypox. In fact, the virus is most often traced to rodents. It belongs to the same family as other poxviruses, including smallpox (called the Orthopoxviridae), and was first discovered in humans in 1970.
What does monkeypox look like? Are there other symptoms?
Monkeypox rashes start as red spots that develop over time into pus-filled blister-like lesions that eventually crust over. It usually appears on the face or extremities such as hands, legs and feet. The lesions are generally all the same size and develop at the same rate. In the latest round of cases, many patients had the rashes only on the genitals or anus, meaning these symptoms could be mistaken for sexually transmitted infections, or STIs.
Sometimes people with monkeypox feel like they have a cold or the flu a few days before the rash develops. These symptoms include headache, fever, muscle and body aches, and fatigue. They may also have swollen lymph nodes.
How is monkeypox spread?
Monkeypox is spread by direct skin-to-skin contact with monkeypox lesions or the fluid within them. The virus can also be spread by inhalation or direct contact with infected respiratory droplets. There have been some cases where monkeypox was spread through surfaces contaminated with respiratory droplets or fluids within skin lesions. (This is another reason to continue wearing masks during the COVID-19 pandemic, and why regular handwashing and cleaning of high-touch surfaces should continue).
Time from exposure to onset?
After a person is exposed to monkeypox, it can take anywhere from 5 to 21 days to develop the disease. That’s a long time, making it especially difficult to do contact tracing. The good news is. The long incubation period means people can be given a treatment or vaccine that, if caught early enough, can help them not get sick. People who think they may have been exposed to monkeypox must contact their doctor or health department immediately. The entire course of the disease lasts approximately 2 to 4 weeks.
How dangerous is monkeypox?
The outbreak involved the so-called West African clade, which was less severe, with a mortality rate of about 1%. But many of these cases have occurred in countries without many medical resources, meaning people may have worse outcomes than those in other parts of the world. No one has died from monkeypox in the United States in previous outbreaks.
How is monkeypox treated?
Since monkeypox and smallpox are related, a smallpox vaccine can be used to prevent disease, even after someone has been exposed. It has about 85% protection against monkeypox. (However, someone’s immunity weakens with age.) There’s also a new vaccine available, but it’s in short supply. Antiviral drugs, such as cidofovir or tecavivir, can be used to treat severe cases. Some people can also be treated with immunoglobulin antibodies if other kinds of treatment are not available. Most people don’t need any treatment and can overcome the infection on their own.
Who is most at risk of contracting monkeypox?
Unlike previous outbreaks, some of the people currently infected with monkeypox are men who are identified as having had sexual contact with men and who reported new partners in the last month. However, cases were not limited to one gender or sexual orientation, and there have been reports of household contacts being infected. This makes diagnosing monkeypox challenging because doctors may mistake the skin lesions for a more common infection. There are good reasons to believe that other cases may not have been diagnosed.