Michael Hunter, MD on Medika Life

Monkeypox: What You Need to Know

Curiouser and curiouser!” Cried Alice (she was so much surprised, that for the moment she quite forgot how to speak good English).” ― Lewis Carroll, Alice’s Adventures in Wonderland / Through the Looking-Glass

MONKEYPOX HAS ARRIVED AT THE SHORES of the United States. A gentleman has been hospitalized in Massachusetts following recent travel to Canada. Monkeypox is not confined to the USA: More than 100 suspected or confirmed cases of monkeypox have been reported in 12 nations, including the United States.

The World Health Organization (WHO) offers that confirmed cases have been identified in Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, the United Kingdom, and the United States — which had between one and five confirmed monkeypox cases mid-May 2022.

Everybody should be concerned,” offers US President Biden. But how concerned should you and I be? While monkeypox is only occasionally fatal, are we on the verge of another pandemic? Today we explore what you should know about this uncommon illness.

What is monkeypox?

Monkeypox is a virus endemic in parts of West and Central Africa. The condition is a less virulent form of smallpox.

The name “monkeypox” comes from the first documented cases of the illness in animals in 1958, when two outbreaks occurred in monkeys kept for research. However, the virus did not jump from monkeys to humans, nor are monkeys significant carriers of the disease.

Photo by Glen Hooper on Unsplash

The monkeypox virus belongs to a family of viruses: cowpox, smallpox, and vaccinia.

Monkeypox virus causes the condition, with the virus a subset of the Poxviridae family of viruses called Orthopoxvirus. This subset includes smallpox, vaccinia, and cowpox viruses. Scientists suspect that African rodents play a role in transmission, but the natural reservoir of monkeypox is not clear.

Monkeypox transmission and symptoms

Contacting an infected individual or animal (or contaminated surfaces) can lead to virus transmission.

Most commonly, the monkeyvirus enters the body through broken skin, mucous membranes of the eyes, nose, or mouth, or through inhalation. Contaminated clothing can be a vector, too. How and where infections are happening remains under investigation.

Monkeypox creates a rash that starts with flat red marks that become raised and filled with pus. Infected people may also have a fever and body aches. Monkeypox can also cause lymph nodes to swell (in contradistinction, smallpox does not). Other initial symptoms may include:

  • Fever or chills
  • Headache
  • Muscle aches or backache
  • Exhaustion

Symptoms usually appear in six to 13 days but can take as long as three weeks after exposure to become noticeable and last for two to four weeks.

Often, the rash develops within one to three days of the fever, with the skin changes beginning on the face and then spreading to other body parts. The skin lesions can begin as flat (macules), become raised (papules), and then transition to vesicles (a thin-walled sac filled with a fluid, usually clear and small).

If progression continues, pustules may form and finally transition to scabs. The overall course is usually around two to four weeks. In Africa, monkeypox is fatal in as many as 10 percent of those who get the disease.

Monkeypox risk reduction and management

The United States Centers for Disease Control (CDC) volunteers these risk reduction strategies:

  • Avoid contact with animals that may have the virus (including sick or dead animals in endemic areas).
  • Avoid contact with any materials (such as bedding) that have been in contact with a sick animal.
  • Isolate infected patients from others who could be at risk for infection.
  • Practice good hand hygiene after contact with infected animals or humans. For example, wash your hands with soap and water or use an alcohol-based hand sanitizer.
  • Use personal protective equipment (PPE) when caring for patients.
Photo by Ed Us on Unsplash

An attenuated live virus vaccine for monkeypox is JYNNEOSTM (Imvamune or Imvanex).

The CDC explains there is no proven, safe treatment for monkeypox virus infection. Smallpox vaccine, antivirals, and vaccinia immune globulin (VIG) are options to control a monkeypox outbreak in the United States. Learn more about treatment here:Monkeypox TreatmentClinician Treatment. Monkeypox is a viral disease that occurs mainly in central and western Africa. It is called…www.cdc.gov.

If you have a new skin rash or are concerned about monkeypox, the US Centers for Disease Control (CDC) urges people to contact their health care provider. The agency has asked doctors to be on the alert for signs of the telltale rash and says potential monkeypox cases should be isolated and flagged to them.

Am I worried? Not particularly, but I will be on guard until we get more clarity on the scope of the problem. It is challenging to estimate how big a problem monkeypox will become. For now, be aware but know that the risk posed by monkeypox is currently remarkably low.

The likelihood of transmission during sexual contact is high. Still, the risk of transmission from other forms of close contact is low, the European Center for Disease Prevention and Control explains.

Fortunately, symptoms are usually mild, but in Nigeria, 3.3 percent died (with the most vulnerable including children, young adults, and immunocompromised people. Thank you for joining me today.


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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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