Monkeypox: What you really need to know

Monkeypox virus cells

Monkeypox, a virus first discovered in 1958 among monkeys and first recorded in humans in 1970, is a rare disease. But beginning in May 2022, we’ve seen cases spreading in Europe and North America — continents that don’t typically see monkeypox.

The majority of monkeypox infections are reported in the Democratic Republic of the Congo, with several other central and western African countries also having seen cases in humans. According to the Centers for Disease Control and Prevention (CDC), cases that have occurred outside of Africa are typically linked to international travel or imported animals.

How is monkeypox transmitted? 

Monkeypox can be spread from person to person or between an infected animal and a person (through a bite or scratch, by handling wild game or through products made from infected animals). Monkeypox can also cross the placenta in pregnancy to a fetus.
When spread between humans, monkeypox is transmitted mostly through direct contact with body fluids, scabs or infectious sores. It might also spread through materials like clothing or sheets that have touched those body fluids or wounds. If there's long enough face-to-face contact, it can also be spread through respiratory secretions. While the CDC notes that it’s not yet known if monkeypox can spread through semen or vaginal fluids, monkeypox can spread during sex and other close contact between people.
According to the World Health Organization (WHO), most reported monkeypox cases recently have been among men who have sex with men. This does not account for all cases, though. Many of those patients, but not all, reported having multiple and sometimes anonymous sexual partners. However, monkeypox doesn’t tie itself to any particular group of people, and it can spread between people regardless of their gender, sexual orientation or race.

Has a monkeypox outbreak happened before in the United States?

In 2003, we saw an outbreak of monkeypox in the U.S. in six states: Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin. The outbreak involved 47 cases in humans, each associated with contact with pet prairie dogs that were believed to have been infected when they were housed near other imported, small mammals from Ghana.

In that 2003 monkeypox outbreak, a joint effort among the CDC, local health departments, the U.S. Department of Agriculture and the FDA helped contain the disease, ultimately by giving veterinarians and other health care providers plenty of guidance. They used extensive lab testing to confirm cases, and vaccines were available to those at risk. Today, there’s a restriction on imports of rodents from Africa to the United States to further prevent outbreaks like this.

How can monkeypox be contained this time?

For this outbreak in 2022, the spread is happening from person to person, mostly through direct or close contact — as opposed to being spread through exposure to imported animals. Because of this, some of those previous transmission prevention methods aren’t relevant.

We still need a combined effort, though, from the CDC, local health departments and health care providers to recognize new cases and take measures to contain that spread. As of 2 p.m. on June 16, 2022, the CDC has recorded 99 cases in 20 states and the District of Columbia.

One June 15, the WHO announced that an emergency committee would meet the following week to determine whether the current spread of monkeypox is enough of an international concern to be labeled a public health emergency. 

The WHO advised people with suspected or confirmed monkeypox to isolate until their symptoms go away, while working with their health care provider to get the support they need to recover. Close contacts of anyone with monkeypox symptoms are asked to self-monitor for 21 days for any signs of the disease, such as fever or a raised rash.

How worried should we be about monkeypox in the United States?

The public needs to be aware that this is occurring, so that they can recognize symptoms and notify their health care providers, who can then alert local health departments if needed.

The good news: While there's currently no proven, safe treatment for monkeypox, we have vaccines available if we see enough cases that they’re needed.

Monkeypox signs and symptoms to watch for

Monkeypox symptoms are similar to smallpox symptoms. It typically begins with fever, headache, muscle aches and backache, and exhaustion. With monkeypox, you’ll also experience swollen lymph nodes, which isn’t a typical smallpox symptom.

Within about one to three days after fever begins, someone with monkeypox develops a rash that often begins on the face and spreads to other parts of the body. Illness usually lasts two to four weeks.

If you develop those symptoms, you should contact your health care provider. For more information and updates on monkeypox spread in the United States and how to prevent spread, you can visit the CDC’s informative page on the virus.

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