Monkeypox Outbreak: Symptoms, Vaccines, and Treatments

On July 23, following months of rising case counts in numerous countries, the World Health Organization’s (WHO) director-general Tedros Adhanom Ghebreyesus declared monkeypox a global health emergency. That label is meant to prompt a coordinated global response, with the aim of getting the virus’ spread under control.

You may now be curious about the implications of the worldwide monkeypox epidemic for your health. “This is an infection that we need to be aware of,” says Dr. Roy Gulick, chief of infectious disease at Weill Cornell Medicine and NewYork-Presbyterian. “But people don’t need to be fearful of it.”

Here’s what to know.

How can you tell if your child has monkeypox

Smallpox virus is the same as monkeypox. Monkeypox symptoms are similar to those associated with smallpox, but they’re not as severe; the disease is rarely fatal. Someone infected with monkeypox can experience flu-like symptoms—such as fever, muscle aches, headaches, swollen lymph nodes, and chills—and a blister-like rash, according to the U.S. Centers for Disease Control and Prevention (CDC). While some people experience a broad rash, others only get small lesions and blemishes.

Is monkeypox still spreading in your area?

According to the WHO’s July 23 report, there have been more than 16,000 cases of monkeypox in 75 countries. Five deaths have been reported worldwide from the May outbreak.

The CDC reports that nearly 2900 of the 2,900 confirmed cases are from the U.S. New York has the most confirmed cases, at 900 as of July 22. California is the state with the highest incidence, 356.

The 1950s were the first time Monkeypox was identified. Before the current outbreak it was an endemic disease in central Africa and parts of west Africa. Its spread could be linked to animals being exposed to the virus. It is very unusual that the current outbreak has such a large scale and spreads from person to person. Although experts are still trying figure out the reason, possible causes include viral mutations and declining smallpox vaccination use.

What is the spread of monkeypox?

Human-to-human transmission mostly happens through close contact—either direct skin-to-skin contact with someone who has a monkeypox rash, or, less commonly, by touching items (such as clothing or bedding) that have come into contact with an infectious person’s sores or bodily fluids. The CDC states that a person can be considered to have an infectious condition until the rash is completely healed and their skin is healthy again. This process may take as long as four weeks.

Monkeypox is not a “traditional” sexually transmitted infection, Gulick says. While sex is a form of close contact, and thus a possible way for the virus to spread, monkeypox doesn’t only spread through sexual activity. Anyone who comes into contact with the monkeypox virus rash can transmit it. It can also be passed to the fetus by pregnant women.

Some cases, including that of a young boy in the Netherlands, have stumped doctors because they can’t find a clear source of spread. Such examples have raised concerns that the virus can occasionally spread by air—a theory the CDC has rejected. Monkeypox can sometimes spread through exposure to a sick person’s respiratory droplets, but the WHO says that usually requires sustained face-to-face contact. Gulick states that this form of transmission occurs most often if the person has open sores.

“This is not COVID,” Gulick says. “This is not a virus that is transmitted readily through the air. This isn’t the kind of thing you’d pick up by riding the bus.”

Are you at high risk for monkeypox?

A majority of U.S. cases have been identified in men who have sex. Study published in The 21 July. New England Journal of Medicine More than 500 cases of monkeypox were examined in 16 countries. The current epidemic was a result of this outbreak. 98% of cases involved gay men. 95% of cases could be traced back to sexual activity.

“There’s nothing specific about monkeypox that would make it more common in men who have sex with men,” Gulick says. “It’s just a virus that found its way into that community of individuals.” That doesn’t mean it can’t spread beyond that community—anyone can get monkeypox if they have close contact with an infectious person’s rash.

Who should be vaccinated against the monkeypox virus?

Two vaccines can be used to prevent monkeypox: ACAM2000 smallpox vaccination and Jynneos monkeypox/smallpox vaccine. Jynneos, which is given in two doses, is the preferred shot for widespread use because it carries a smaller chance of side effects, but the U.S. is still building up its stores of that product—which means, at least for now, demand exceeds supply.

Gulick recommends that people who have had monkeypox exposure should get vaccines. The vaccine is effective in preventing the disease if administered within 4 days. According to the CDC, it can be used within 2 weeks to lessen symptoms.

Public-health officials in hotspots such as New York City or Washington, D.C. have expanded vaccine eligibility to higher-risk people, including sex workers, and those who have had sex recently with multiple partners. To find out eligibility requirements and schedule requirements for your region, check with the local health department.

Are monkeypox treatments available?

The United States does not have a drug that is specifically designed to cure monkeypox. Doctors can prescribe antivirals kept in the Strategic National Stockpile to fight smallpox (the most common is called TPOXX) but it’s a labor-intensive process, Gulick says. Since the drug isn’t approved for use against monkeypox, it is considered investigational, and access is controlled by the CDC. To prescribe it, a doctor has to get informed consent from their patient and deal with “a lot of paperwork and requirements,” Gulick says.

Gulick says only certain high-risk monkeypox patients—including young children, pregnant people, immunocompromised individuals, and people with serious rashes—need antivirals. The majority of people feel better within a week and are able to manage their symptoms with anti-itch and painkillers.

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