On July 23, the World Health Organization (WHO) declared monkeypox a global health emergency. Only four previous disease outbreaks have received this designation: Polio, Ebola, Zika, and Covid-19. Two weeks late, on August 4, Biden declared monkeypox a public health emergency in the US.
What is monkeypox? Monkeypox virus is a member of the same family of viruses as the variola virus, the smallpox virus. It’s NOT related to chickenpox.
In 1958 there were outbreaks of a “pox-like” disease in colonies of research monkeys, hence the name; however, the disease source is unknown. African primates and rodents may harbor the disease and infect humans. Monkeypox was first recorded in people in 1970, and before 2022, it had spread in areas of Central and Western Africa. Previous cases in other countries on multiple continents besides Africa were linked to international travel to endemic regions or via imported animals.
What are the signs & symptoms? The physically prominent symptom is a blistering rash on the face, inside the mouth, and other body parts, i.e., hands, feet, chest, genitals, or anus. The rash can be extremely painful.
Other symptoms include fever, headache, muscle and backaches, swollen lymph nodes, and chills. Some experience nasal congestion, sore throat, or cough. The illness lasts two to four weeks.
How does monkeypox spread? Two ways: (1) direct contact with the rash, scabs, or body fluids, and/or (2) respiratory secretions during intimate physical contact or prolonged face-to-face contact. The virus is “sexually transmissable,” i.e., sex is one way it can be spread. Any sustained, close skin-to-skin contact is risky, but it doesn’t have to be sexual or intimate.
Monkeypox is infectious from the time of symptom onset until the rash is fully healed with the formation of a fresh layer of skin. Anyone with close personal contact is at risk.
Transmission can occur in congregate living settings. Other events with ascending risk of spread are (1) festivals/concerts with fully clothed attendees, (2) raves, parties, or clubs with minimal clothing and direct contact, and (3) saunas, sex clubs/parties with intimate, anonymous sexual contact with multiple partners. Sex workers are at very high risk.
How can monkeypox be prevented? Avoid skin-to-skin contact with those with a monkeypox-like rash and objects the person has used. Use hand sanitizer or wash your hands often with soap & water, especially after using the bathroom and before eating or touching your face.
Most cases (99%) in the US have been in gay, bisexual or other men that have sex with men. Ethnic minority groups are disproportionately affected. Several children and a pregnant woman have been confirmed positive, and today a daycare worker in Illinois was reported.
Vaccination is an essential tool, but there is currently a limited worldwide supply of the vaccine. In the US, it is now being allocated to states based on population and cities with the highest number of at-risk individuals. Of note, smallpox was considered eradicated in the US years ago. National smallpox vaccination was halted in 1972, so the general population is unprotected.
If you are a member of a high-risk group, consider vaccination and safe sex practices. All others should maintain awareness in close contact situations and take precautions as appropriate.
Our world is an increasingly dangerous place; with world air travel, an infectious disease can travel from one continent to another in a matter of hours and days. The Covid 2020 pandemic has not yet burnt out; in fact, continues to smolder, and now we are faced with another challenge. Take care and be safe, my friends.