Monkeypox

Monkeypox is a disease that we have been hearing in the news for a few days now. Coming on the heels of Covid-19, it is creating quite a stir among people as they are learning more about it.

Monkeypox is caused by a virus. The virus is similar to the smallpox virus but not as lethal.

To the best of our knowledge, the virus is usually transmitted (and not easily) among humans through:

1. Large respiratory droplets (e.g. through Coughing / Sneezing) - One reference states that transmission is "Usually by way of prolonged face to face contact (within a 6 foot radius for greater than or equal to 3 hours, if someone is not wearing personal protective equipment."

2. Close contact with infected skin lesions

3. Contact with infected clothing or linen used by a person who is infected.

The virus enters the human body through broken skin, the respiratory tract, or the mucous membranes (eyes, nose, mouth).

It is unknown what the reservoir for this virus is, although it is thought to be certain rodents.

It appears, as of this writing, that the outbreak that is occurring now is primarily associated with sexual activity among men who have sex with men (Also read this article, and this article); although this disease is not considered a sexually transmitted disease, as such.

A recent NBC news article stated the following:

This article further stated:

A "RAVE" is a large dance party, usually associated with alcohol, drugs (legal and illegal) and illicit sexual activity.

There have so far been about 200 suspected and confirmed cases around the world (as of May 23rd, 2022)

The incubation period of this virus is usually less than 2 weeks.

The Predominant symptoms of Monkeypox are:

1. fever (85%) -

2. rash - (97%) - usually develops within 5 days of the fever onset

3. swollen lymph nodes (71%)

4. myalgias - body aches (56%)

5. chills (71%)

6. possible nausea, vomiting, and difficulty swallowing.

Click on the picture to be taken to a Euronews article on Monkeypox

The following photos were taken at the Marshfield Clinic in Wisconsin

Monkeypox is diagnosed by clinical signs and symptoms and is confirmed by laboratory testing.

When a medical professional is considering the diagnosis of Monkeypox, they will also consider chickenpox, herpes simplex, smallpox (this must be considered because of the potential of bioterrorism), tanapox, Orf and bovine stomatitis.

Most patient who get Monkeypox will have a mild disease experience, and will get better without medical intervention. Sometimes a patient will get seriously ill and will require specific treatment, supportive care and hospitalization. In central Africa, the fatality rate is 10 % but when there was an outbreak in the US in 2003 there were no deaths.

Prior Smallpox vaccine provides a protective barrier against getting Monkeypox.

Also there is another vaccine which may be used (post-exposure - Usually within 4-14 days), called Modified Vaccinia Ankara (MVA)

Another vaccine is called Jynneos. More may be learned about this vaccine here .

“JYNNEOS is a vaccine Indicated for prevention of smallpox and monkeypox disease in adults 18 years of age and older determined to be at high risk for smallpox or monkeypox infection.”

There is also an older small pox vaccine called ACAM2000.

There are two medications which are considered to be effective in treating Monkeypox. They are

1. Ticovirimat (Tpoxx) - Only available through the US government's Strategic National Stockpile, and

2. Brincidofovir (Tembexa) - This medication is not available for general public use. Supplies are owned by the US Federal government.

3. Cidofovir (No clinical data in relation to use in humans)

A person who has monkeypox is considered infectious until all the scabs from the lesions have fallen off and there is intact or healed skin underneath.

If you think you have a case of Monkeypox, contact your local health provider or reach out to Ministry Medicine International.