The facts about monkeypox

On the heels of one global disease outbreak, comes another — monkeypox. Cases of this viral illness are climbing across the United States and the world. Here in Washington state, more than 100 cases of monkeypox have been identified as of August 1, and the rapid global spread of the disease has led the World Health Organization to declare monkeypox a public health emergency of international concern.

While this situation may feel eerily similar to the COVID-19 pandemic, monkeypox and the virus that causes COVID-19 are much different. Here’s what we know so far about monkeypox, including how to keep yourself safe and how to get tested.

What is monkeypox?

Unlike the virus that causes COVID-19, monkeypox is not new. The disease traces back to 1958, when two outbreaks occurred among monkeys used for research, according to the Centers for Disease Control and Prevention (CDC).  The first human case was documented in 1970.

Monkeypox belongs to the same family of viruses as smallpox; however, its symptoms are much less severe, reports the CDC. Monkey pox is endemic, which means commonly present, in Central and West African countries though outbreaks outside of those countries have happened before, often due to international travel.

This is isn’t the first time monkeypox has made an appearance in the U.S. There was an outbreak in 2003 linked to animals imported from Ghana.

Why it’s a concern

So if monkeypox outbreaks have happened before, what makes this one unusual?

Part of the concern is how quickly monkeypox is spreading across countries where it doesn’t typically occur. For example, cases in the U.S. have grown to more than 5,000 in the span of a few months, but this is likely an undercount of the actual case numbers because monkeypox is presenting in ways that aren’t typical.

“In the past, people with monkeypox would usually first experience systemic symptoms like fever and fatigue,” says Mary Fairchok, MD, a pediatric infectious disease specialist at Mary Bridge Children’s Hospital. “Those symptoms would typically be followed by a rash that progressed to blisters and lesions and eventually spread down the body.

“What we are seeing now is that there may not be fever or fatigue, and people may only have a few blisters that appear in specific regions of the body, like the genital or anal area or the mouth. The symptoms are much more subtle, which can make them harder to catch and track, and they can also look like symptoms of some sexually transmitted diseases like syphilis or herpes.”

While monkeypox is rarely fatal, the lesions can be painful, particularly when they occur on sensitive areas of the body.

How it spreads and who’s at risk

Another aspect of this monkeypox outbreak that makes it different from past outbreaks is how easily it’s spreading from person to person. The virus is transmitted through coming into close contact with the blisters or lesions, bodily fluids or respiratory droplets of an infected person, according to the World Health Organization.

“It primarily seems to be spreading now through activities that involve prolonged skin-to-skin contact with someone who has the virus,” Dr. Fairchok says. “That could include sex as well as kissing or cuddling or hugging, for example. It can also spread if you share bedding, clothing or other items with a person who has an active infection.”

Some people are at higher risk of contracting monkeypox than others, including men who have sex with men. A New England Journal of Medicine study reports that 98 percent of cases between April and June have occurred among this group. However, monkeypox can happen to anyone.

“While a majority of cases so far have been among men who have sex with men, monkeypox isn’t a sexually transmitted disease and it isn’t restricted to this group,” Dr. Fairchok says. “There have been cases of monkeypox spreading among households and there have been a few cases in children as well. Someone who is pregnant can also spread monkeypox to their fetus.”

Other groups at higher risk of getting monkeypox include people of any gender or sexual orientation who are sexually active with multiple partners, reports the Washington State Department of Health (DOH).

Testing

It’s a good idea to get tested for monkeypox if you are in a high-risk group and have an unexplained rash, blister or lesion. You should also get tested if you have been in close contact with someone that has a probable or confirmed case of monkeypox. Symptoms of monkeypox that can precede a rash include fever, headache, fatigue and swollen lymph nodes.

“I recommend calling your doctor’s office or urgent care clinic ahead of time and letting them know that you’re concerned you might have monkeypox,” Dr. Fairchok says. “That way they can take the appropriate precautions before you walk in the door. Testing usually involves swabbing a lesion and then sending it off to a lab.”

While you’re waiting for the results, you’ll need to quarantine — isolate yourself from others. If you test positive, the CDC recommends quarantining until the illness has fully resolved, which can take between two and four weeks.

If you’re concerned that you may have monkeypox, contact your provider or visit one of MultiCare’s Indigo Health locations.

Treatment and vaccination

There are no specific treatments for monkeypox. However, treatments for smallpox are sometimes used since the two viruses are similar.

“Most people with monkeypox don’t require treatment,” Dr. Fairchok says. “But in some cases, providers may prescribe antiviral medication for groups that are at high risk for severe illness — such as young children, those who are pregnant or breastfeeding or people with compromised immune systems — or those who have lesions in concerning areas, such as around the eyes or the rectum.”

Treatment is available at MultiCare, but supply is limited and is currently reserved for those who fall among the high-risk groups mentioned above.

Vaccines for monkeypox are available and can be given to prevent or reduce the severity of an infection in patients who have been exposed to a known case; however, similar to monkeypox treatment, there is also a limited supply of vaccines and that supply is controlled by the Washington State Department of Health.

“We’re just starting to receive monkeypox vaccines in Washington state and the priority is to vaccinate those who are close contacts of confirmed and probable cases,” Dr. Fairchok says. “As supplies increase, we may move on to vaccinating other high-risk groups.”

Preventing monkeypox

While it’s important to be aware of monkeypox and take appropriate precautions, it’s just as important not to panic. Monkeypox can’t spread without close contact and unlike the virus that causes COVID-19 it doesn’t come from a family of viruses that mutate rapidly.

To keep yourself safe, the CDC recommends the following tips:

• Avoid close contact with people that have a monkeypox-like rash.
• Avoid sharing items, such as towels, utensils, sheets and clothes, with a person who is infected.
• Practice good hand hygiene — wash frequently with soap and water or use an alcohol-based hand sanitizer.
• Consider limiting the number of sexual partners you have to help reduce the risk of exposure.
• Consider minimizing skin-to-skin contact with others at raves, parties, clubs or other large social events.

Want to know more about monkeypox vaccines and treatments?

For more information about monkeypox, including vaccine and treatment availability, visit your local county health department or the Washington State Department of Health website.