Monkeypox: What you should know

August 9, 2022 in Disease Management  •  By Miles Varn, MD
integrative oncology

A little over a week ago, the World Health Organization declared the current global monkeypox outbreak a public health emergency of international concern, the organization’s highest alert level indicating that the outbreak is a threat that requires a coordinated international response to prevent further spread of the disease. Globally, more than 23,000 cases have been reported in 80 countries, with the majority of cases in countries that usually don’t have cases.

In the U.S., the first case was reported in May. Currently, the U.S. has one of the highest number of monkeypox cases in the world—nearly 5,800 cases as of August 1. The cases have been reported in 46 states, Washington, D.C., and Puerto Rico. Public health officials believe the actual number of cases may be higher because of the difficulty accessing testing and the fact that many healthcare providers are unfamiliar with the disease and may misdiagnose it.

This Q&A answers some of the most common questions about monkeypox and what steps you can take to protect yourself from this disease.

Q: What causes monkeypox?

A: It’s caused by the monkeypox virus, part of a group of viruses called orthopoxviruses in the Poxviridae family, which also includes smallpox and cowpox. There are two strains of this virus. The one currently circulating in the U.S. is the less severe West African strain.

Q: What are the symptoms of this disease?

A: According to the CDC, symptoms can include:

  • Fever
  • Rash anywhere on the body, including inside the mouth, that resembles pimples or blisters (A recent study found that some people with monkeypox only experienced a single lesion or sore, which differs from typical symptoms and may increase the risk of misdiagnosis.)
  • Swollen lymph nodes
  • Headache
  • Muscle aches
  • Respiratory symptoms (sore throat, cough, congestion)
  • Chills
  • Fatigue

Once a person develops, symptoms, they are contagious and can spread the virus to others.

Q: How long is the incubation period for the virus?

A: Incubation takes one to two weeks.

Q: How does monkeypox spread?

A: The virus spreads through contact with fluid from the blisters or lesions, other bodily fluids, and respiratory droplets from coughs and sneezes. It can also spread through exposure to bedding, towels, clothing, dishes and utensils, and surfaces contaminated with those fluids.

Q: How long does a case of monkeypox usually last?

A: Symptoms usually improve in two to four weeks with supportive care like acetaminophen and fluids for fever. For most people, medical care isn’t necessary.

Q: Are some people at greater risk of serious illness from the virus?

A:  People with compromised immune systems, children under 8, and people who are pregnant or breastfeeding may develop medical complications that are life threatening. Those complications include secondary infections, bronchopneumonia, sepsis, encephalitis, and cornea infections that can cause scarring and vision loss.

Q: How is monkeypox treated?

A: If you’ve been exposed to someone with monkeypox or develop any symptoms associated with the virus, the first step is to call your doctor and isolate from others until the scabs have fallen off any skin lesions and a new layer of skin has formed. Your doctor will let you know if testing for monkeypox is appropriate.

There are no treatments that specifically target this virus, but some antiviral medications used to treat smallpox may be effective against monkeypox. Tecovirimat (TPOXX) was approved for use against all known orthopoxviruses by the FDA in 2018.

Q: Is there a vaccine that protects against the virus?

A: Imvamune or Imvanex, marketed as JYNNEOS, has been approved by the FDA for use in people 18 and older who are at high risk for smallpox or monkeypox infection. ACAM2000 is also available as a vaccine and can be given to patients younger than 18. People who were vaccinated against smallpox as a child are expected to have immunity against monkeypox, but people younger than 50 will have not received that vaccine.

The JYNNEOS and ACAM2000 vaccines are being given to people at higher risk of exposure to monkeypox and people who have been exposed to the virus. According to the CDC, vaccinating people who have been exposed within four days of exposure may prevent disease. Vaccinating within 4 to 14 days of exposure may reduce the severity of symptoms.

Q: What steps can I take to protect myself?

A: Avoid skin to skin or face to face contact with anyone who has symptoms, practice safer sex to prevent transmission through bodily fluids, avoid touching surfaces and materials that have been used by a person with the virus, and keep your hands clean with water and soap or alcohol-based hand sanitizer. If you have symptoms, isolate from others, wear a mask that fits well if you must be around other people, wash clothes, linens, and towels regularly with hot water, and cover your coughs and sneezes well.

A health advisor can help you get the evidence-based information you need about this virus or any other health problem.