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This was written in July 2022. We like to leave these articles active for reference, but please review newer Kinsa articles for the most up-to-date information!
As we continue to wade through a never-ending pandemic, this may feel particularly stressful – we haven’t even had a break from COVID-19 and now there’s another disease? Unfair! Why can’t life go back to normal?
Deep breaths. Instead of spiraling, read on for answers to some common monkeypox questions answered by our nurses and epidemiologists.
What is monkeypox?
hMPXV, or Human Monkeypox Virus, was first discovered in a monkey species in the 1950s. Though this discovery inspired its name, monkeypox typically infects and spreads among rodents, occasionally spilling over to humans where human-wildlife interaction is high. Prior to this year, monkeypox hadn’t typically been passed from human to human.
However, now the virus is behaving differently, spreading through close human contact (more on this later). As of the end of July, the CDC has confirmed over 19,000 cases of monkeypox worldwide and over 3,500 in the US.
What does it look like? Will I know if I have it?
Following exposure to the virus, symptoms appear in 1-2 weeks. Monkeypox infections sometimes start with a fever, achiness, and swollen lymph nodes, rather than the respiratory symptoms that commonly accompany COVID-19. The most unique symptom of monkeypox is clusters of small round lesions – or pox – on the skin, which have historically looked like pus-filled blisters, but more recently resemble localized clusters of tiny scabs. The location of these lesions and the severity of pain vary from person to person, with most symptoms being relatively painless and lasting a few weeks. Asymptomatic infections and transmission are rare.
How does it spread?
Monkeypox is spread primarily via skin-to-skin contact, and also via respiratory droplets at close range over a prolonged time period. Sexual contact is the most common way for the virus to travel from one person to another, due to the close nature of sexual interaction. While the virus has been found in semen, it is unclear whether or not it can be spread through sexual fluids in addition to skin-to-skin contact or close-range droplets. The type of sexual contact impacts the likelihood of transmission as well: the tissues that interact during anal sex tend to be more susceptible to infection (any infection, not only monkeypox) than other parts of the human body, putting those who have anal sex at higher risk of exposure than those who don’t. Monkeypox can survive outside of the human body longer than viruses such as SARS-CoV-2, enabling transmission via surfaces such as countertops, doorknobs, and clothing. However, monkeypox is less transmissible than SARS-CoV-2.
Who is most at risk?
People who interact closely, frequently, and for extended periods of time are most likely to pass the virus to each other. Disease can spread among any groups that share households and social networks (think: work places, sports teams, etc) because of increased contact, but during this outbreak the primary mode of close-contact transmission has been during sexual contact. Most patients diagnosed with the virus this year have identified as men who have sex with men (MSM), but anyone can be infected. A person’s sexual identity isn’t a route of transmission; monkeypox spread is all about the frequency, duration, and type of close contact.
Whenever one group is most or first affected by a disease, we want to make sure we are not stigmatizing - or “othering” - that population. Already, MSM and those from African nations have experienced stigma pertaining to monkeypox. This hinders clear communication, prevents patients in stigmatized groups from seeking help, and prevents others from recognizing that they may be at risk as well. While some researchers and advocates believe that denying the role of sex in monkeypox transmission is the only way to avoid the stigmatization of MSM, understanding modes of transmission is the only way to increase awareness and decrease community spread.
Should I be worried about it?
Based on what we currently know, this is not the next COVID-19. Mortality from monkeypox is low – there have only been five deaths globally during this outbreak – and its transmission routes make it harder to spread than COVID or the flu. But we can’t ignore it: human-to-human transmission of monkeypox is occurring on a broader scale than ever before - and COVID has shown us how transmission can accelerate when we don’t take precautions.
Is there a vaccine? Is there treatment?
The existing smallpox vaccine is known to protect against the closely-related monkeypox. The U.S. has ordered many doses of a newer iteration of the smallpox vaccine, preferred to the older version.
While there is no treatment that has been specifically developed for monkeypox, there are four antiviral medications that are effective at preventing or minimizing the symptoms of smallpox and may work well to treat monkeypox.
Vaccine rollout in the U.S. has begun in a few major cities, but with supply so limited, shots are only available to those at high risk. For now, that means either people who have a suspected exposure, or MSM, who are at higher risk for exposure because this outbreak is currently spreading among their social networks. We’ll keep you updated as the vaccination situation changes.
How can we minimize transmission?
Just as we avoid crowded, indoor spaces to minimize airborne transmission of SARS-CoV-2, it makes sense to limit skin-to-skin contact with lots of people in order to minimize transmission of the monkeypox virus. When attending crowded events, individuals can consider the frequency, duration, and type of contact involved. The more skin-to-skin contact, the higher the risk. When engaging in sexual activity, we encourage the practice of safe sex with condoms and clothing to limit skin-to-skin contact, and strong communication about sexual health and potential recent exposures.
Those who believe they may have been exposed can contact a healthcare provider to see if they are eligible for diagnostic testing, vaccination, and/or antiviral medication for treatment.
We encourage individuals who may have been exposed to monitor for symptoms (fever, swollen lymph nodes, achiness, and/or a rash) and minimize contact with others (especially skin-to-skin contact). We encourage those with suspected or confirmed infection to self-isolate for up to three weeks or until the lesions have scabbed over, fallen off, and intact skin has formed. To increase protection for those you live with (including pets), stay in a separate room, if possible, and cover any lesions with clothing or bandaids if the clothing won’t cover them. If you must be around others, wear a mask to avoid transmission via respiratory droplets.
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