In May 2022, there were 257 reported cases of monkeypox in 23 countries. As of August 2022, there have been over 35,000 cases among 92 countries, with more than 16,500 cases in the United States alone. The outbreak has been spreading rapidly and in August, the U.S. declared monkeypox a public health emergency. As the state of monkeypox quickly evolves, many are left questioning what’s true about the virus and whether they should be concerned. While there’s still much left to figure out about the current monkeypox outbreak, this article aims to provide some key facts we do know.

What is Monkeypox?

Monkeypox is a rare disease caused by the monkeypox virus (MPV), which belongs to a family of viruses that causes smallpox. The infection can cause similar symptoms to smallpox, but MPV is far less severe, less contagious and is rarely fatal. The virus was first discovered in 1958 in monkeys and the first human case was recorded in the Republic of Congo in 1970. Prior to the current 2022 outbreak, MPV has been considered endemic, or constantly present in certain areas, in ten western and central African countries, which report dozens of human cases every year.

What are the Signs and Symptoms?

Symptoms of monkeypox can range from unpleasant to painful, but are rarely deadly. Typically, symptoms will begin within three weeks of exposure and infected people aren’t contagious until symptoms are present. Symptoms can include flu-like symptoms such as fever, chills, swollen lymph nodes, exhaustion, muscle aches, headache and respiratory symptoms like sore throat, nasal congestion and cough. Additionally, most people will develop a rash with painful or itchy pimples or blisters that can appear on or near the genitals, hands, feet, chest, face or mouth. The rash may be extremely painful and can leave scars on the skin.

A typical MPV infection lasts two to four weeks, or until the rash has fully healed and a fresh layer of skin has formed. An infected person is contagious from the onset of symptoms until this point. Complications are rare, but can include pneumonia, inflammation of the brain and eye infections. While the current strain of monkeypox is rarely severe, young children, the immunocompromised, pregnant people and people with eczema are at heightened risk for severe infections. However, most people will recover fully without the need for medical intervention.

How is Monkeypox Transmitted?

Unlike COVID-19, MPV doesn’t spread primarily through the air or respiratory droplets. Instead, it can be spread to anyone through close, personal contact. This is most commonly through skin-to-skin contact, but can also include:

• Direct or indirect contact with body fluids or skin lesions of an infected person
• Contact with objects, fabrics and surfaces that’ve been used by an infected person
• Exposure to respiratory secretions during prolonged face-to-face contact
• From a pregnant person to their fetus

Most infections in the current outbreak have occurred through close contact during sex, but monkeypox isn’t considered a sexually transmitted infection (STI). As it stands, about 98 percent of cases worldwide are among men who have sex with men. While this group may be at higher risk right now, everyone is susceptible to monkeypox and should take precautions:

• Avoid close contact with people who have a rash resembling MPV
• Don’t share cups or eating utensils with an infected person
• Don’t touch the used clothing, bedding or towels of an infected person
• Clean and disinfect frequently touched surfaces
• Wash hands often with soap and water

What are the Current Vaccination Options and Requirements?

Due to the genetic similarities between MPV and smallpox, existing vaccines originally developed for smallpox can offer protection against monkeypox. The U.S. has access to two smallpox vaccines – Jynneos and ACAM2000 – and recently secured over 1.8 million doses of the Jynneos vaccine for use in thwarting the current monkeypox outbreak. This vaccine is given in two doses, 28 days apart, and immunity develops two weeks after the second dose. The ACAM2000 vaccine is administered in one dose, but has more significant side effects and can’t be given to those with psoriasis, eczema or dermatitis. After receiving ACAM2000, one lesion will develop at the injection site and immunity develops within 28 days. There’s a risk of this lesion spreading to other parts of the body or to other people.

If you have been exposed to monkeypox and have not been vaccinated, it’s not too late. The Jynneos vaccine is very effective at preventing MPV if administered within four days of exposure to the virus and effective at preventing severe disease if administered between four and 14 days of exposure. These vaccines are primarily for people in at-risk groups, but as more doses become available, more people are becoming eligible. Check your local health department to see whether you’re eligible for a monkeypox vaccine.

[Hannah Sabitoni]