Monkeypox: what you need to know about the virus

Eight regions have recently reported unexpected cases of monkeypox: Australia, Canada, Italy, Portugal, Spain, Sweden, United Kingdom and United States.

Although the outbreak is currently small, it has raised concerns because monkeypox, a viral disease that causes fever and rashes, does not usually spread globally. But the virus appears to cross several new communities, which happens when an infected person comes into close contact with someone else.

“I anticipate that over the next few weeks we will continue to see more cases identified, but I don’t expect that we will see an exponential growth in that,” he added. Dr. Richard Martinelloa Yale Medicine infectious disease expert and associate professor of medicine and pediatrics, told HuffPost.

What is monkey pox?

Monkeypox is a viral DNA disease that causes fever and a characteristic bumpy rash. It can also cause headaches, muscle aches, swollen lymph nodes, and fatigue. The zoonotic disease has been around for decades and mainly gets its name from the fact that it was first identified in an outbreak in monkeys in 1958.

It mainly spreads via spread events from infected animals to humans. Then people can spread it via several different forms of close contact, primarily through blood and respiratory droplets.

“It certainly doesn’t seem as transmissible as something like COVID or the flu,” Martinello said.

Over the years, various cases of monkeypox have appeared in the United States and other parts of the world. But it doesn’t often spread outside of endemic areas in Africa, according to Dr. Amesh Adalja, an infectious disease expert and senior fellow at Johns Hopkins University’s Center for Health Security.

Monkeypox is in the same viral family as smallpox, and the smallpox vaccine is incredibly effective at preventing disease and minimizing symptoms. Evidence suggests that the vaccine is at least 85% efficient in the prevention of monkeypox.

The vaccine may also work when given post-exposure prophylaxis (meaning it can prevent disease or make it less severe, even after a person has been exposed). This is primarily how the vaccine is used now, since the World Health Organization declared smallpox eliminated in 1980.

Monkeypox has a long incubation period of around 12 days. Its death rate is estimated at between 1% and 10%, but Adalja thinks the actual death rate could be lower, depending on where the cases are occurring. “Monkey pox tends to be a disease that is not as deadly as smallpox,” Adalja said.

Treatment for monkeypox usually involves supportive care. Most cases are mild and self-limiting. There are antivirals specifically designed to treat smallpox, but they’re usually reserved for severe cases, Adalja said.

What about the current monkeypox epidemic?

Monkeypox is endemic to Africa, and outbreaks and cases outside of Africa are not unheard of. In 2021, the United States documented two cases of monkeypox in people who had recently traveled from Nigeria. There was also an outbreak in the United States in 2003which involved animals transmitting the disease to humans. No human to human transmission was recorded and of the 47 cases identified – in Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin – only three were serious.

Some monkeypox outbreaks have lasted about a year, but they don’t tend to be explosive outbreaks that grow exponentially like we’ve seen with COVID-19, according to Martinello.

“People are becoming aware that there is monkeypox in their community,” he said. “When people get sick, they isolate themselves from others and that helps stop that transmission.”

What’s strange about the current outbreak is how monkeypox seems to be spreading. Typically, outbreaks are very localized, but this one involves multiple countries.

“The clusters we’re seeing right now, in several countries, are not travel-related,” Adalja said. “There is transmission that occurs outside of travel and outside of animal exposures, which are the usual routes through which we see cases occurring.”

It’s unclear how monkeypox may have made the leap to certain areas, but experts believe that once they got there, transmission likely occurred from the exchange of saliva, respiratory secretions, and bodily fluids. According to The Atlantic, the first case identified in the UK fits the traditional pattern of the disease spreading via travel. However, other cases in other regions do not appear to have been linked to travel or contact with someone with the disease.

Epidemiologists will continue to explore if there is anything unique about the way monkeypox is currently spreading, or if it may have simply spread through close contact through the social networks it entered.

People don’t need to rush to get smallpox vaccinations right now, Adalja said. The vaccine is only given to people who have been in close contact with an infected person, ideally within four days to prevent illness and within 14 days to minimize symptoms. If this outbreak takes off in an unprecedented fashion, the government has a stockpile of smallpox vaccines that can be deployed, Martinello said, but neither he nor Adalja currently expect that will be necessary.

When you have outbreaks of monkeypox, the standard approach is to isolate infected people and vaccinate everyone around them who has been in contact with an infected person. Epidemiologists call this strategy “ring vaccination“, and it is known to be an effective way to stop outbreaks before they can start.

“Monkeypox is a very different virus from COVID-19,” Adalja said. “It has no pandemic potential, and we have countermeasures like the smallpox vaccine that are able to stop outbreaks.”


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