Monkeypox: Everything You Should Know About It
What Is Monkeypox?
Monkeypox is the disease that occurs when one becomes infected with the monkeypox virus. Before the year 2022, monkeypox occurred mainly in the western and central parts of Africa, usually near tropical rainforests. (1)
The Monkeypox Virus
The virus lives in a number of animals including tree squirrels, dormice, monkeys, and other animals.
The virus can be transmitted from these animals to humans. Humans can also transmit it to animals. Before the current worldwide outbreak (in the year 2022), the virus rarely spread from human to human. (1)
Types Of Monkeypox Virus
There are two main types (also known as clades) of this virus:
- The clade that originated in West Africa, and that causes the mild disease and was thought to be less transmissible
- The clade that originated in Central Africa, and that causes the more severe disease. It was thought this clade could be transmitted easily
The current outbreak in the world (2022) is caused by the clade that originated in West Africa. (1)
How Did Monkeypox Start?
According to the National Institutes of Allergy and Infectious Diseases, the disease was discovered in 1958 when a pox-like disease occurred twice in groups of monkeys being used for research. (2)
Additionally, according to the World Health Organization (WHO), the first human case of monkeypox was recorded in a 9-month-old boy in 1970 in the Democratic Republic of the Congo (DRC), where cases occur from time to time. Before 2022, these outbreaks were usually controlled and didn’t spread to other countries. Since 1970, monkeypox has infected people in 11 African countries. (1)
How Monkeypox Spreads
Animal-to-Human Transmission
According to the WHO, this disease can spread from an infected animal such as a monkey, anteater, hedgehog, prairie dog, squirrel, shrew, or dog, to a human when the human comes into direct contact with the blood, bodily fluids, or lesions on the body of the infected animal.
It can also spread through the consumption of improperly cooked infected meat and other animal products.
Another way this disease spreads is through the bites or scratches of an infected animal. (1)
Human-to-Human Transmission
According to the CDC (3), you can get the disease when you touch:
- objects that have been touched by an infected person
- clothes, bedsheets, and towels used by an infected person
- hard surfaces (phones, computers, tables, chairs, door handles etc) that an infected person has also touched
- the mouth, sex organs, and anus of an infected person during foreplay and sex
It also spreads when you:
- come into contact with droplet respiratory secretions (e.g. when an infected person sneezes or coughs on you)
- have prolonged face-to-face contact with someone who is infected
- come into contact with the mucus or saliva of an infected person
Other ways it spreads are when:
- you hug, kiss, or massage an infected person
- your skin comes into contact with the rash on the skin of an infected person
- your skin contacts the fluid that comes from the lesions on the skin of an infected person
Pregnant women can pass it on to their fetuses through the placenta or during close contact after birth.
An infected person can spread it to others from the time symptoms start until the rashes heal fully and new skin forms.
The disease can only spread when large numbers of the virus are transmitted from an infected animal or person in sufficient quantities to cause an infection. Other factors, such as the type of contact and the immune response of the person who gets infected, play a role in whether an infection will take hold or not.
Symptoms
Typical Systemic Symptoms
The incubation period (period from infection to when symptoms start) takes between 6 and 13 days. (4)
The symptoms include:
- fever
- chills
- severe headache
- backache
- muscle aches
- fatigue
- enlargement of the lymph nodes
- respiratory symptoms (sore throat, nasal congestion, cough)
Usually a rash breaks out on the skin 1-3 days after the infected person develops the fever.
What The Monkeypox Rash Looks Like
The rash mainly affects the face, palms, and soles of the feet. Other parts of the body it affects are the mouth, genitals (penis, testicles, vagina), and eyes.
The rash starts as flat lesions. It then forms bumps on the skin (like pimples). The bumps may be painful or itch. A clear liquid fills the bumps. Later, pus fills the bumps. Eventually, the bumps dry out and fall off.
Unusual Symptoms
A recently published study in The BMJ has revealed that unusual symptoms are being manifested in the current monkeypox outbreak in the world (2022). Notable signs to watch out for are (5):
- no fever
- no swollen lymph nodes
- single pox lesion inside the mouth, throat or rectum
- rash before the systemic symptoms
- rectal pain or penile edema.
- no systemic symptoms at all
Who Is At Risk?
Anybody who has prolonged, close contact with someone who is infected is at risk. This includes romantic partners, siblings, schoolmates, coworkers, parents, or children among others. (1)
Tourists who travel to Central and West Africa, and who come into direct contact with the monkeypox virus, are also at risk of being infected. (1)
Children from 0 to 8 years of age, people whose immune systems have been compromised by diseases, and pregnant women or breastfeeding mothers have a greater risk of getting infected and becoming seriously sick. (1)
People who have multiple sexual partners also have a high risk of contracting the infection. (6)
Places Where There Is A High Risk For Monkeypox Infection
- Within households
- Settings where people who are not related to each other congregate, live close to each other daily, and share at least one common room (e.g., sleeping room, kitchen, bathroom, living room etc.).
- Health facilities (Clinics and hospitals)
- Nude beaches and other beaches where people don’t wear clothes and sexual activities occur
- Parties and nightclubs where there is minimal clothing, and where there is constant, direct, personal contact
- Enclosed spaces, such as offices, saunas
- Sex clubs or sex parties where intimate sexual contact with multiple partners occurs (7,6)
How Dangerous Is Monkeypox?
According to the CDC, the disease rarely kills people. The survival rate for the West African version (which is spreading throughout the world in 2022) is 99%. (8)
And according to the WHO, only between 0 and 11 % of people who have been infected with the disease died in the past. And in recent times, only between 3 and 6 % of people who get the disease die. (1)
Recent research published in Nature Medicine in the summer of 2022 has also revealed the monkeypox virus strain currently infecting people belongs to a group of monkeypox strains categorized as clade 3. These strains have a fatality rate less than 1 %. (9)
Complications
Certain groups of people are more susceptible to get very sick and have complications. These include (1):
- people with weakened immune systems
- children 8 years old and younger
- pregnant or breastfeeding women
- people who have a clinical history of eczema
- people who experience secondary bacterial infections
Possible complications of monkeypox include (1):
- bronchopneumonia (difficulty breathing as a result of constricted airways)
- sepsis (the immune system responds to the infection and can cause tissue damage, organ failure, and death)
- inflammation of brain tissue, also known as encephalitis
- infection of the cornea, the clear outer layer of your eye, which may lead to vision loss
How Do You Prevent Monkeypox?
Preventing Wild Animals From Infecting You
According to the WHO, people living in West and Central Africa, and tourists from America and Europe who visit these areas, should avoid unprotected contact with wild animals, especially wild animals that are sick or dead. They should also avoid touching the meat, blood and other parts of sick or dead animals. (1)
Preventing Your Pet From Infecting You
Your pet can infect you with the virus if its infected and you pet, cuddle, hug, kiss, share food with it, and you allow it to lick you and share your bed.
Scientists don’t know yet all the symptoms that show when pets have monkeypox, but watch out for these signs (10):
- lack of appetite
- lack of energy
- coughing
- secretions from the nose or eyes
- skin rash on the abdomen or anus of the pet that looks like a pimples or blisters
If you see any or all of the signs above (10):
- Separate the sick pet from your other pets
- Isolate the pet
- Minimize direct contact with it for 21 days
- Wear clothes that fully cover your skin (i.e. long sleeves, long pants), gloves, eye protection (safety glasses, goggles, or face shield), well-fitting mask or respirator (a N95 filtering face-piece respirator), when you have direct contact with your pet.
- Wash your hands with soap and water or use an alcohol-based hand sanitizer containing at least 60% ethanol to sanitize your hands after removing the protective wear
- Get your pet tested if it’s had close contact with someone confirmed to have monkeypox
Preventing Another Human From Infecting You
And according to the CDC, these are some measures one can take to prevent getting monkeypox (11):
- keep a distance from people you see a rash on
- don’t hug, kiss or have sex with someone with a strange rash
- don’t touch objects and materials an infected person has touched
- don’t drink from a cup a person with monkeypox has drunk from
- don’t eat from the same plate, and use cutlery, that someone with monkeypox has eaten with or used
- don’t touch the clothes, bed sheets, or towels of infected people
- wash your hands with soap and water often or use an alcohol-based hand sanitizer containing at least 60% ethanol to sanitize your hands. Always do this before you eat or touch your face, and after using the bathroom
Preventing Monkeypox From Spreading In Your Home And Car
According to the CDC, monkeypox viruses can be killed by many disinfectants. If your home or car becomes contaminated it’s advisable you disinfect them. Any EPA-registered disinfectant can do the job. (12)
Focus on disinfecting objects and surfaces that the skin of the infected person touched.
Don’t dry dust or sweep your house or car because this may spread infectious particles. Rather, use disinfectant wipes, sprays, and mopping to clean your house or car.
Preventing Monkeypox With A Vaccine
According to the CDC, two vaccines have been approved for the prevention of monkeypox disease (13):
- JYNNEOS vaccine
- ACAM2000 vaccine
There is no current data on the efficacy of both vaccines in the current outbreak.
The JYNNEOS vaccine is in short supply currently.
According to the FDA, potential common side effects of the ACAM vaccine include (14):
- Pain, redness and swelling at the injection site
- Muscle pain, headache and fatigue
- Less common monkeypox vaccine side effects include nausea and chills
Call 911 when you have any of these symptoms. And report the side effects to FDA at 1-800-FDA-1088
Looking Ahead
Infectious disease outbreaks evolve over time. As scientists learn more about the monkeypox disease, it’s important that you keep reading Wellness.com to get updates to help you protect yourself and stay safe.
Sources
1. World Health Organization. (2022). Monkeypox.
https://www.who.int/news-room/fact-sheets/detail/monkeypox
2. National Institutes of Allergy and Infectious Diseases. (2022). Monkeypox.
https://www.niaid.nih.gov/diseases-conditions/monkeypox
3. Centers for Disease Control and Prevention. (2022). Monkeypox: How It Spreads.
https://www.cdc.gov/poxvirus/monkeypox/if-sick/transmission.html
4. Centers for Disease Control and Prevention. (2022). Monkeypox: Signs and Symptoms.
https://www.cdc.gov/poxvirus/monkeypox/symptoms/index.html
5. Patel A, et al. (2022). Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series.
https://doi.org/10.1136/bmj-2022-072410
6. Centers for Disease Control and Prevention. (2022). Safer Sex, Social Gatherings, and Monkeypox.
https://www.cdc.gov/poxvirus/monkeypox/prevention/sexual-health.html
7. Centers for Disease Control and Prevention. (2022). Considerations for Reducing Monkeypox Transmission in Congregate Living Settings.
https://www.cdc.gov/poxvirus/monkeypox/specific-settings/congregate.html
8. Centers for Disease Control and Prevention. (2022). Frequently Asked Questions.
https://www.cdc.gov/poxvirus/monkeypox/about/faq.html#:~:text=Is%20monkeypox%20deadly%3F,disease%20are%20likely%20to%20survive.
9. Isidro J, et al. (2022). Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus.
https://www.nature.com/articles/s41591-022-01907-y
10. Centers for Disease Control and Prevention. (2022). Pets in the Home.
https://www.cdc.gov/poxvirus/monkeypox/prevention/pets-in-homes.html
11. Centers for Disease Control and Prevention. (2022). Monkeypox: How to Protect Yourself.
https://www.cdc.gov/poxvirus/monkeypox/prevention/protect-yourself.html)
12. Centers for Disease Control and Prevention. (2022). Disinfecting Home and Other Non-Healthcare Settings.
https://www.cdc.gov/poxvirus/monkeypox/specific-settings/home-disinfection.html
13. Centers for Disease Control and Prevention. (2022). Interim Clinical Considerations for Use of JYNNEOS and ACAM2000 Vaccines during the 2022 U.S. Monkeypox Outbreak.
https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html
14. Food and Drugs Administration. (2022). ACAM2000 (Smallpox Vaccine) Questions and Answers.
https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000-smallpox-vaccine-questions-and-answers
