Monkeypox–What Is It?

February 24, 2023

Is monkeypox dangerous?

Monkeypox has been in the news recently, and rightly so. Since spring of 2022, it has been reported far from its usual environment in Africa, spreading to the United Kingdom, Europe, Israel, Australia, and North America. In the United States it has been reported in all 50 states.

So, what is this virus, and how concerned should we be? First, unlike its relative, smallpox, which was fatal in about 30% of cases before being eradicated in the 1970’s, monkeypox is fatal in 1% to 10% of cases. As a DNA virus, it is unlikely to undergo radical changes, so unique mutants with immunity to our vaccines are unlikely.

How is monkeypox spread?

Monkeypox is contagious, usually from direct skin contact with the lesions. Although droplets from the nose and mouth carry the virus of monkeypox, it is not usually spread by this route. Touching a patient’s clothes or bedding is another unlikely but possible method of transmission. It is not transmitted venereally per se through semen or vaginal secretions, but it is commonly transmitted to a sexual partner due to skin-to-skin contact. People who are exposed can develop the disease in 5 to 21 days.

The signs and symptoms, according to the Centers for Disease Control and Prevention (CDC) include:

  • Fever
  • Headache
  • Muscle ache
  • Backache
  • Swollen lymph nodes (masses in neck, armpits, groin)
  • Chills
  • Extreme tiredness
  • Pus-filled red lesions appearing 1 to 3 days after fever, similar to the rash of chickenpox, but all pox at same stage

The illness typically lasts between 2 and 4 weeks

Prevention and Treatment of Monkeypox

So far no travel restrictions have been mandated, although the World Health Organization has expressed concern over possible outbreaks during superspreader events like summer festivals.

The US Government has a stockpile of smallpox vaccine, which can be made available to individuals who have been exposed to monkeypox. When given within four days of exposure, it can protect against monkeypox in about 85% of cases. When given after four days it can help alleviate signs and symptoms. ACAM200 is a vaccine licensed for prevention of smallpox in the United States, and JYNNEOS (Imvamune, Imvanex) is licensed for prevention of smallpox and specifically for monkeypox. It is recommended for high-risk individuals, like sex workers, and certain members of the LGBTQ community, particularly gay men who have multiple partners.

TPOXX (tecovirimat) is approved for treating smallpox, monkeypox, and cowpox, members of the same family of viruses. It is also used to treat a rash that can break out from smallpox vaccination.

If you have reason to believe that you or a family member might have monkeypox, see your family doctor or emergency room physician. A simple test called a PCR consists of swabbing one of the lesions and sending the swab to the lab for results.

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