What Is Monkeypox?

A virus jumps from animals to humans and then starts spreading between humans in areas of the world where that has never happened. That sounds like another COVID scenario, but Monkeypox is not COVID.

monkeypox and dna

Monkeypox is usually spread from person to person through close contact with body fluids or large respiratory droplets.

© Uma Shankar sharma | Getty Images

Monkeypox was first diagnosed in humans around 1970 in Central Africa. Early cases were spread from infected monkeys, squirrels, or rodents when humans ate infected meat or handled infected animals. Over time, the virus became able to jump from human to human. For about 50 years, monkeypox only occurred in Africa or in people who recently traveled from Africa. However, when the virus began to turn up in Europe and America and to spread from person to person, the COVID-weary world took notice.

Is Monkeypox Deadly?

Monkeypox can be a very severe disease. It is in the same viral family as smallpox, which ravaged the word for centuries killing about 30 percent of people it infected until it was finally stamped out by the smallpox vaccine in the 1970s. Monkeypox can cause a severe infection, especially in pregnant women and children. In Central Africa about 10 percent of people infected with the virus may die, making it more lethal than COVID.

Monkeypox is usually spread from person to person through close contact with body fluids or large respiratory droplets. Kissing, sex, and other intimate contact is the usual way the virus travels, but it can spread through coughing and sneezing. If that becomes the main mode of transmission, monkeypox could start to spread more rapidly. Like COVID, a person can have early monkeypox without symptoms and still spread the virus. Finally, there is no medication approved to treat monkeypox and no vaccine has been developed specifically for monkeypox. So, why are the infectious disease experts not panicking?

No Reason to Panic

COVID also jumped from animals to people, but it was a new disease for people. There had never been a COVID vaccine, so nobody had any resistance to the infection. COVID spread quickly because it was unknown and was spreading from person to person before people knew they were sick. COVID also started out with the ability to spread through small respiratory droplets over some distance, like a cold or flu virus. You did not have to be in very close contact.

Because monkeypox has been around in Africa for many years, infectious disease doctors already know that the smallpox vaccine is about 85 percent effective against monkeypox. For people who had a smallpox vaccine before 1970, that rate is probably significantly lower, but still somewhat protective. They also know that antiviral drugs may reduce symptoms and shorten the disease, even though they have never been approved to treat monkeypox. The smallpox vaccine given soon after a person is in contact with monkeypox may prevent or reduce the infection. Unlike COVID, research scientists do not have to develop a new vaccine from scratch or try untested medications.

Finally, we have been lucky with the type of monkeypox that has been spreading. There are two types of monkeypox, called clades. The Central African clade is the most dangerous. The other clade is from West Africa. It has only been lethal in about one percent of cases in Africa, and it is the one spreading outside Africa. So far, the death rate from the West African clade outside Africa is much less than one percent, probably because of better medical care in Europe and America than in rural Africa.

Monkeypox Treatment

Symptoms of monkeypox are similar to a cold or the flu at first. They may start anywhere between 5 to 21 days after the virus gets into your system. Early symptoms are fever, chills, headache, muscle aches, and fatigue. Unlike COVID or the flu, monkeypox  may cause swollen lymph nodes. A rash that follows the other symptoms is another important sign leading to diagnosis. It may appear on the face or extremities and starts as red bumps, called lesions. The bumps then fill with fluid, rupture and crust over.

The virus is found by taking a sample of fluid from a draining lesion. There is also a blood test that can find viral DNA. Treatment with the smallpox vaccine before symptoms start may prevent or shorten the infection. Antiviral drugs may help and the symptoms can be treated with pain and fever relievers. In most cases, the infection clears up within 2 to 4 weeks.

Monkeypox Smallpox Vaccine

There is no vaccine for monkeypox but the smallpox vaccine is approved for prevention of monkeypox, and that vaccine is available. The vaccine is not recommended for prevention in the general population yet. It is only recommended for researchers and health care persons who have known contact with the virus.

Monkeypox is still a very rare disease. Time will tell if it reaches the level of a global pandemic requiring vaccinations for the general public like COVID or flu. The best way to prevent monkeypox is to continue taking the same precautions as you would for COVID or flu. Wash your hands frequently, avoid close contact with people who have flu-like symptoms or a rash, and wear a mask if you are exposed to crowds of people.

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Chris Iliades, MD

Dr. Chris Iliades is board-certified in Ear, Nose and Throat and Head and Neck Surgery from the American Board of Otolaryngology and Head and Neck Surgery. He holds a medical … Read More

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