What you need to know now about monkeypox

Infectious Diseases

A multi-country outbreak of monkeypox is in progress and has affected over 100 people in Western Europe and other high-income countries so far.

Identified cases stretch across 12 countries where monkeypox is not usually found, and more cases are likely to be identified before the outbreak is resolved. Affected nations include 8 in Europe, the United States, Canada, Israel, and Australia.

Monkeypox virus is related to smallpox, but is less infectious and less severe. It is typically found in several countries in sub-Saharan Africa, but outside that area cases are quite rare.

In fact, leaders in countries where monkeypox has long been a part of life are calling the West’s newfound attention to this disease a double-standard. The disease has essentially been ignored by the West, including most of the research community, for 50 years. Until last week when people in Western nations started getting it, no one in the West seemed to care about monkeypox.

Clinical symptoms include fever, a bad headache, muscle aches, and back pain. These are followed about 5 days later by a rash. The rash has bumpy blisters that fill with fluid, often concentrated on the face, palms, and soles of feet. Symptoms usually begin with fever from 6 to 13 days after exposure. Symptoms last 2-4 weeks and often resolve without treatment.
However, given the outbreak, if you suspect you have monkeypox, you should contact your clinician, who will notify your local health department.

In the current outbreak, there is evidence of human-to-human transmission. WHO says that “Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.” Monkeypox is not a sexually transmitted disease. It spreads most commonly through skin-to-skin contact with the rash. However, like lots of viral diseases, infectious viral material *could* become airborne if it gets dried out and then kicked up into the air somehow. For example, this could happen if there was a lot of viral material on a sick person’s bedding and then someone shook the bedding out.

The smallpox vaccine is also effective against monkeypox because they are close cousins, but if you’re under age 50 you probably haven’t had it. Routine smallpox vaccination ended in the 1970’s after the disease was eradicated worldwide. Today, it is not routinely given outside groups who have high occupational risks–like people who work with infected animals. The United States stockpiles this vaccine in the event of a smallpox re-emergence and has released doses to high-risk contacts of infected people.

Many of the cases identified so far have been in men who have sex with men, but it’s worth noting that it is not a sexually transmitted infection. Transmission can happen during skin contact between any two people. Because of stigma around this population group and around sexual behavior in general, the situation is ripe for misinformation, hate speech, and further stigma.

Stigmatizing groups of people because of a disease can prevent people from seeking the care they need. It can also lead people outside the stigmatized group to feel they are immune when they are not.

Extensive efforts are now underway to trace the close contacts of all identified cases and identify additional cases. Lots of people in lots of countries are involved. WHO does expect that more cases will be identified before the outbreak is brought under control.

Monkeypox is not considered high-risk for becoming pandemic, but this outbreak isn’t over.

Here’s the latest from the WHO on the situation

WHO’s monkeypox info sheet

and their FAQ

Monkeypox vaccine stockpile release

Virologists in Africa say the West is using a double-standard for monkeypox

For a description of monkeypox we wrote last year, click here

For a thorough rundown of the current outbreak, please check out this recent update from Katelyn Jetelina at Your Local Epidemiologist

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