Monkeypox Is Here

Jul 22, 2022

Monkeypox is here. There were 866 reported cases in the US on July 11 and the number has increased to 1814 by July 16.

The bad news is that, unlike Ebola, the previous African microbe to hit our shore, this one is unlikely to be passing a fad. The good news is that we already have a vaccine, the same one that prevents smallpox.

Monkeypox is a virus similar to smallpox, which has been eradicated in nature. The first case in humans was recorded in Central Africa in 1970. In Africa it has an animal reservoir and causes a disease similar to smallpox, but milder. It traditionally starts with a fever and viral syndrome followed by a characteristic rash, involving the face and extremities. But in the current outbreak, the virus has been behaving in new ways. The disease is currently spreading in the US and Europe, primarily among gay, bisexual and other men who have sex with men. It consists primarily of a rash in the oral and/or anogenital region, with or without a viral syndrome which can include fever, headaches, muscle aches, and swollen lymph nodes,. It Is spread via close physical contact with an infected individual.

It is diagnosed by lab PCR testing of a skin lesion which is currently available. An infected individual is contagious for 2-4 weeks until the skin lesions are completely healed. It is recommended that infected individuals use condoms for 12 weeks as the virus may remain in the semen for a prolonged time.

Due to their location, the skin lesions can be painful.

The current approach to the outbreak is to vaccinate at-risk people. However, the supply of vaccines is presently limited and is being prioritized for individuals with known recent exposure to the virus. As supplies increase, they will probably be offered to all individuals at risk. While mortality in previous outbreaks of Monkeypox in Central Africa has reached 10%, the current outbreak in the US has not been associated with mortality.

Important unknowns include: whether the disease will cross into the general population and what form it will take in the future.

The presentation can be confused with herpes, other sexually transmitted illnesses, and other causes of rashes. An experimental antiviral drug is available for severe cases.