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Q: How concerned should I be about Monkeypox?

Infectious Diseases

A: For most people, the current risk of contracting Monkeypox is very low. Fears of back to school Monkeypox outbreaks are likely overblown.

(NOTE: this assessment of risk based on current data—as always, we will update as the situation develops).

In the current outbreak outside of endemic areas in Africa, almost all cases of Monkeypox have been in men. Evidence continues to suggest community transmission with a disproportionate incidence among gay, bisexual and other men who have sex with men (GBMSM). This does NOT mean that this a disease only of GBMSM (or sexual contact), simply that this initial spread has taken off in that group due to the nature of the social networks and close contact. If you are a GBMSM who has multiple or anonymous sex partners, your risk is higher and you should seek out vaccination where available and be aware of the signs and symptoms of infection.

One bit of good news is that Monkeypox is not as transmissible as SARS-CoV-2. Close skin to skin contact is generally needed for transmission, and this can more easily happen during sexual contact. The current outbreak is heavily concentrated in densely connected sexual networks of men who have sex with men. While transmission could easily happen outside these networks, sustained transmission is harder than with respiratory viruses and (hopefully) more feasible to contain.

Quick Recap:

So far this year, over 14,000 Monkeypox cases have been detected in 70 countries. The WHO recently declared Monkeypox a “public health emergency of international concern.”

Despite the name, Monkeypox is not related to chickenpox and does not come from monkeys. It *is* in the same family of viruses as smallpox, but luckily much less dangerous.

The median incubation period (time between exposure and symptoms) is around 9 days. Symptoms can include typical viral symptoms such as headaches, muscle aches, and fatigue. A rash of pimple-like or pus-filled blisters can appear at all sites on the body, including face, feet, hands, genitals and inside the mouth. Something to be aware of with this outbreak is that doctors are sometimes seeing only a single lesion near the genitals that could be mistaken for a symptom of sexually transmitted diseases such as herpes or syphilis. People with monkeypox are infectious until all their lesions heal, which can take several weeks.

Theoretically, Monkeypox can be transmitted to anyone through contact with body fluids, monkeypox lesions, or shared clothing/bedding, but epidemiological data shows current transmission is largely via intimate close contact.

Has Monkeypox suddenly become more transmissible? Probably not. The genetic make-up of the virus doesn’t look different from samples identified in the years past. The highly connected & dense network of those spreading the disease can help explain this sudden sustained growth. This also means that transmission outside of GBMSM networks may be more likely to be self-limiting without as much onward transmission (but that is TBD).

More good news is that we already have effective vaccines for Monkeypox, but supplies are currently limited (but being ramped up). Cities such as New York and London are offering vaccines where possible to exposed or individuals at high risk:

New York

London

As we learned the hard way with SARS-CoV-2, predictions–especially about the future–are hard. It’s possible we’ll learn about wider transmission as testing increases that will change our risk assessments. But the epidemiology of Monkeypox is very different from SARS-CoV-2, and thus our public health efforts will need to be different as well. While we must remain mindful of not stigmatizing specific groups, it’s important to also be clear about who is most at risk. Being aware of risk means people can take actions to protect themselves and resources for prevention can be effectively targeted.

Stay safe, stay well!

Love,
Those Nerdy Girls

“You are being misled about monkeypox” (Opinion)

Links:

“Monkeypox is a public health emergency. Here’s what you need to know about the virus.”

Helpful Twitter thread on the Epidemiology of Monkeypox from Dr. Muge Cevik

“Demand for Monkeypox Vaccine Exceeds Supply, C.D.C. Says”:

Monkeypox data, UK

Link to Original FB Post