In the recent news, there have been talks about the monkeypox cases in Europe and now the United States. President Biden called it something “to be concerned about” and is being very closely monitored here and internationally. Monkeypox was first identified in 1970 in the Democratic Republic of the Congo and has since expanded over the last 10 years to many other African nations. Despite the name, monkeys, like humans, are accidental hosts. The wild animal reservoir remains unknown.
Here is some current information on the situation and monkeypox in general.
From the CDC About Monkeypox | Monkeypox | Poxvirus | CDC as of today:
- A patient was confirmed in Massachusetts to be infected with a West African strain after returning to the US from Canada, they are currently being isolated and poses no risk to the public. See 2022 United States Monkeypox Case | Monkeypox | Poxvirus | CDC for more information.
- Monkeypox is a rare viral disease. The virus belongs to the same family and genus as variola virus (causing smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox. The rash is indistinguishable from smallpox.
- CDC is also tracking multiple clusters of monkeypox cases reported in several countries that don’t normally report monkeypox, including in Europe and North America.
- The rash associated with monkeypox involves vesicles or pustules that are deep-seated, firm or hard, well-circumscribed, and grow synchronously (all lesions at the same stage as the disease progresses, as opposed to chickenpox); the lesions may umbilicate or become confluent and progress over time to scabs.
- Presenting symptoms typically include fever, chills, a distinctive rash, or new lymphadenopathy (swollen lymph nodes).
- The rash associated with monkeypox can be confused with other diseases that are encountered in clinical practice (e.g., secondary syphilis, herpes, chancroid, and varicella-zoster).
- The illness typically lasts for 2−4 weeks. Although rare, in Africa, monkeypox has been shown to cause death in as many as 1 in 10 persons who contract the disease.
- Based on the limited information available at this time, the risk to the public appears low.
- Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose, or mouth).
- Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required.
- Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.
- The secondary attack rate is estimated 10% in contacts unvaccinated against smallpox.
- The vaccine JYNNEOSTM (also known as Imvamune or Imvanex) has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. The Advisory Committee on Immunization Practices (ACIP) is currently evaluating JYNNEOSTM for the protection of people at risk of occupational exposure to other orthopoxviruses such as smallpox and monkeypox in a pre-event setting.
- Smallpox (vaccinia) and monkeypox vaccines are effective at protecting people against monkeypox when given before exposure to monkeypox. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe. In addition to smallpox vaccine, vaccinia immune globulin and some limited use medications are available for monkeypox outbreak control.
- Routine vaccination of the American public against smallpox stopped in 1972 after the disease was eradicated in the United States and is no longer available to the public. Those of us that are old enough have a faded but unique vaccination scar on their left upper arm.
About the Author
Dr. Joe Mignogna is Acuity’s Chief Medical Officer. Connect with him at email@example.com