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Monkeybox virus
Monkeybox virus
Monkeybox virus

Monkeypox

Monkeypox is an infection caused by a virus similar to the smallpox virus. It has been most common in some countries in Africa, but outbreaks can occur in other areas.

What You Need to Know

  • Monkeypox is spread by close contact and exposure to an infected person's respiratory droplets, skin lesions or other bodily fluids.
  • Monkeypox symptoms include swollen lymph nodes, fever, and a rash that may initially be mistaken for chickenpox or a sexually transmitted disease if in the genital or anal region.
  • The infection can be fatal, but it most often clears up on its own.
  • Monkeypox may be most severe in young children.
  • Vaccines can prevent monkeypox, but widespread vaccination is not likely to be necessary because cases are rare outside of outbreaks.
  • The infection is spreading, but because transmission requires close personal contact, a pandemic such as the one caused by SARS-CoV-2 (the coronavirus that causes COVID-19) is not expected.

What is monkeypox?

Monkeypox is an infection caused by a virus. The disease is endemic (it occurs among the general population) in some countries. Researchers and health professionals become concerned about monkeypox when cases and outbreaks occur. Paul Auwaerter, M.D., M.B.A., clinical director of the infectious diseases division at Johns Hopkins Medicine, provides an overview.

Monkeypox Symptoms

Monkeypox has a long incubation time. That means it can take four to 21 days to produce illness after someone has been exposed to the virus.

  • The symptoms start with a general, all-over feeling of being ill.
  • Fever and muscle aches develop with flu-like symptoms.
  • Lymph nodes become swollen.
  • A few days later, a blister-like rash appears that looks like chickenpox. This may begin on the face and spread elsewhere on the body, or if sexually acquired, may begin in the genital or anal areas.
  • The rash dries up a week or two later, and recovery continues.

Altogether, monkeypox lasts two to four weeks.

What causes monkeypox?

Monkeypox is caused by a virus related to the one that causes smallpox, but monkeypox disease is usually milder than smallpox. It is called monkeypox because it was first isolated in monkeys. However, rodents, not monkeys, are the primary carriers of the virus. The World Health Organization is renaming the illness because the name monkeypox is misleading. The disease may be more likely to affect people who have never been vaccinated against smallpox. The smallpox vaccination program ended in the U.S. in 1972.

In people, monkeypox is spread through contact with an infected person's rash or bodily fluids, including respiratory droplets. Close personal contact, sexual or not, can cause a person to become infected.

Monkeypox Diagnosis

A health care professional can identify monkeypox with a blood test or by looking under a microscope at a sample of fluid swabbed from the rash. Because the disease is rare, your doctor may need to rule out other, more common rash-producing illnesses such as chickenpox, measles or syphilis.

Are there different types of monkeypox?

Yes, there are two strains of monkeypox. The strain that is endemic in several countries in West Africa, which has been seen in outbreaks outside of Africa in 2022, is less severe than the strain that occurs in the Congo basin. So far, the strain in the current outbreak seems similar to the one seen in West African countries and has caused mild illness in most people infected with that virus.

Monkeypox Treatment

Although many cases resolve on their own, people who are more ill from monkeypox can be treated with antiviral agents. No other drugs are approved for monkeypox — smallpox therapies may be used, although data on their effectiveness for this condition is limited.

The Centers for Disease Control and Prevention (CDC) suggests that people with severe monkeypox disease, patients who are immunocompromised, children younger than age 8 and people who are pregnant should be considered for antiviral treatment following consultation with the CDC.

Vaccines including Jynneos (which the Food and Drug Administration has approved for monkeypox), when given early enough after exposure, may lessen the severity of the disease, so health care professionals may recommend vaccines for those who have had close contact with a person who is infected. Also, antivirals are being tested to see if they are safe and effective in easing symptoms.

How to Prevent Monkeypox

The best ways to keep from getting sick with monkeypox are:

  • Avoid close contact with people who are infected or their personal belongings, bedding, etc.
  • Wash your hands frequently and thoroughly.
  • Wear a mask and gloves or other protection when caring for someone who has monkeypox or symptoms of the disease.

What to Do If You Are Exposed to Monkeypox

According to the CDC, people who have been exposed to an infected person or animal should monitor their health for three weeks after that exposure. As long as you don’t have any symptoms, you can go about your normal activities. Do not donate blood, cells, tissue, breast milk, semen or organs during this three-week period.

Follow these steps:

  • Take your temperature twice daily.
  • If you develop a fever (100.4 or above), chills, swollen lymph nodes or a new rash, immediately self-isolate and contact your local or state health department for further guidance.
  • If you only have chills and swollen glands but no fever or rash, isolate at home for 24 hours.
    • If you get a fever during this time, contact the health department.
    • If you don’t develop a fever but still have chills or swollen glands after 24 hours, contact your doctor for a diagnosis.

Is monkeypox fatal?

It can be. Monkeypox has a death rate ranging from 1% to 10%, based on data from cases in some African countries. The monkeypox death rate in cases in the current outbreak has been much lower.

Will there be a monkeypox pandemic?

A monkeypox pandemic is unlikely for several reasons:

  • First, the monkeypox virus is not new. What is new is the patterns of infection among people.
  • Second, vaccines and medicines that can help lessen the impact of this disease are already available.
  • Finally, since monkeypox transmission requires person-to-person contact, it is less likely than other viruses (such as SARS-CoV-2, which causes COVID-19) to spread among large numbers of people who do not have close physical contact.

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