Monkeypox

The United States is experiencing an outbreak

World Health Organization (WHO) declared monkeypox outbreak a global health emergency.
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Overview

Monkeypox is a rare disease caused by infection with the Monkeypox virus (MPV). Monkeypox was first identified in 1958 when two outbreaks of pox-like disease occurred in colonies of research monkeys. 

Monkeypox is a disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus. This genus also includes variola virus, which causes smallpox, and vaccinia virus (used in the smallpox vaccine), and cowpox virus. However, monkeypox is not related to chickenpox.

Monkeypox is a zoonosis, which is a disease that is transmitted from animals to humans. Monkeypox occurs in rodents and non-human primates and is generally found in central and west Africa. The first human case of monkeypox was observed in 1970.

Symptoms

Monkeypox has symptoms that are similar to smallpox, a related virus; however, monkeypox symptoms are milder and the disease is rarely fatal. The incubation period for monkeypox ranges from 5 to 21 days, although symptoms are most likely to occur within 7 to 14 days after infection. Symptoms can include the following:
  • Fever
  • Headache
  • Muscle aches and backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • A pimple or blister like rash on the face, inside the mouth and other parts of the body like the hands, feet, chest, genitals, or anus

Some people get the rash before other symptoms follow. Others only have the rash. The illness usually lasts from two to four weeks, and the rash goes through different phases before healing.

The rash typically forms on the face, arms, legs and hands, except in cases where a person was infected during sexual activities, which is more likely to lead to a rash on the genitals. In cases of infection during anal sex, infected individuals may experience anal or rectal irritation. After forming, the rash turns into raised bumps which fill with fluid. The rash scabs over and, eventually, the scabs fall off.

Most people recover in 2 to 4 weeks. The disease can be more serious in people who are pregnant, children or immunocompromised.

Transmission

Monkeypox is spread through close personal contact, including:
  • Direct contact with an infected rash, scab or body fluids 
  • Respiratory droplets during prolonged, face-to-face contact or during intimate physical contact such as kissing or sex
  • Touching items that have been in contact with an infected rash or body fluids, such as clothing or bed sheets
  • From a pregnant person to the fetus through the placenta

A person can become contagious when their symptoms start until the rash is fully healed. Illness typically lasts 2 to 4 weeks. People without symptoms cannot spread the virus.

Treatment

There are no specific treatments for MPV infection. Patients who are more likely to get severely ill may be recommended an antiviral like tecovirimat (TPOXX), which is approved for treatment of smallpox.  

Vaccines

Two vaccines licensed by the FDA are available for preventing monkeypox infection. In the United States, there is currently a limited supply. Vaccines may be used for post-exposure prophylaxis in individuals with high risk exposures. 
  • JYNNEOS
  • ACAM2000