The World Health Organization said on June 25 that smallpox is not yet a public health emergency of international importance. More than 4,500 cases have been reported worldwide, with more than 300 in the United States. And because public health officials cannot follow all transmission chains, they are likely to underestimate the cases. Everyone should be aware of its symptoms, how it spreads and the risks of deterioration.
Question: Do I have to worry about monkeypox?
The American public is currently at low risk for monkeypox. It spreads among men who have sex with men, but it is only a matter of time before it spreads to others. As of June 27, the European Center for Disease Prevention and Control reported 10 cases among women. Smallpox is usually a mild illness, but can be serious or even fatal for people with weakened immune systems, pregnant women, fetuses or newborns, breastfeeding women, young children, and people with severe skin conditions such as eczema.
But monkeypox can become endemic in the United States and around the world if it continues to spread without control.
Question: How does monkeypox spread?
Monkeypox is a viral infection, a close cousin of smallpox. But it causes a much milder disease.
It is transmitted through close contact, including sex, kissing and massage – any kind of contact with the penis, vagina, anus, mouth, throat or even the skin. In the current epidemic, monkeypox is transmitted mainly sexually.
Condoms and dental barriers will shrink, but will not prevent any transmission because they only prevent transmission to and from the skin and mucous membranes that are covered by these devices. It is important to know that the virus can enter injured skin and penetrate mucous membranes, such as the eyes, nose, mouth, genitals and anus. Scientists do not know whether monkeypox can be transmitted through semen or vaginal fluid.
Monkeypox can be transmitted through respiratory droplets or “splashes” within a few feet, but this is not considered a particularly effective mode of transmission. Whether monkeypox can be transmitted through aerosols such as covid-19 is not known, but has not been documented.
It is not known whether monkeypox can be transmitted when someone has no symptoms.
Question: What are the common symptoms of monkeypox?
Symptoms of monkeypox may develop up to 21 days after exposure and may include fever and chills, swollen lymph nodes, rash, and headache.
It is not known whether monkeypox always shows some or all of these symptoms.
Experts now believe that smallpox, like smallpox, will always cause at least some of these symptoms, but this belief is based on science from before 1980, before there were more sophisticated diagnostic tests.
Question: What does a monkey rash look like?
The rash in monkeypox usually begins with red spots and then develops into fluid-filled and then pus-filled bumps that may look like blisters or pimples. The bumps then open into wounds and scabs form. People with monkeypox should be considered infectious until the wounds have healed and fallen. Monkeypox wounds are painful. In the past, the rash was often seen on the palms and soles of the feet, but many people have had external and internal lesions of the mouth, genitals, and anus. People may also experience rectal pain or a feeling of need to move their bowels when their bowels are empty.
Q: How do I get tested for monkeypox?
If you have symptoms of monkeypox, including oral, genital, or anal lesions, go to the nearest sexual health clinic for testing. A medical professional should rub any suspicious lesion for examination. There is also evidence that throat swabs may be helpful in monkeypox screening, but US health officials do not recommend them at this time.
Question: Is there a monkey vaccine?
Yes. Two vaccines are effective in preventing monkeypox: the Jynneos vaccine and the ACAM2000 vaccine. The FDA has approved the Jynneos vaccine to prevent monkeypox and smallpox in people 18 years of age and older. ACAM2000 is FDA approved for smallpox prevention. Currently, the United States uses only the Jynneos vaccine because it is safer and has fewer side effects.
The Jynneos vaccine is safe. It has been tested in thousands of people, including people with weakened immune systems or skin diseases. Common side effects of Jynneos vaccine are similar to those of other vaccines and include fever, fatigue, swollen glands and irritation at the injection site.
Jynneos vaccine is effective in preventing monkeypox disease for up to four days after exposure and may reduce the severity of symptoms if given up to 14 days after exposure.
Question: Can I be vaccinated against monkeypox?
The Centers for Disease Control and Prevention currently recommends monkey vaccination only for those at high risk: people who have had close contact with someone with monkeypox; men who have sex with men and trans women who have recently had multiple sexual partners in a place where monkeypox is known to occur or in an area where monkeypox is spread; and some health workers, laboratory staff, first aid personnel and members of the military who may come into contact with those affected.
Currently, supplies of the Jynneos vaccine are limited. The US Secretary of Health and Human Services’ Assistant Secretary’s Office of Readiness and Response will immediately release 56,000 doses from the strategic national stockpile. An additional 240,000 doses will be provided in the coming weeks, 750,000 doses later this summer and 500,000 this fall, for a total of more than 1.5 million doses.
Question: What are other ways to reduce the risk of transmitting monkeypox?
The best way is to educate yourself and your sexual partners about monkeypox. If you are worried that you may have monkeypox, get tested at a sexual health clinic. Many emergency departments, emergency centers and other health facilities may not be relevant for monkeypox. The CDC’s link to finding the nearest sexual health clinic is
Refrain from sex if you or your partner have monkeypox. And keep in mind that condoms and dental barriers can reduce, but not eliminate, the risk of transmission. The CDC also warns of the risk of going to raves or other parties where many people wear little clothes and from saunas and sex clubs. There are other offers such as sex toy laundry and bed linen.
Question: Is there a cure for monkeypox?
There is no proven safe treatment specifically for monkeypox. Most cases of monkeypox are mild and improve without treatment within a few weeks. Drugs such as acetaminophen and ibuprofen can be used to reduce fever and muscle pain, and drugs such as acetaminophen, ibuprofen and opioids can be used for pain. In rare cases, some patients – such as immunocompromised people, pregnant women, fetuses or newborns, nursing mothers, young children and people with severe skin conditions – will develop more severe disease and may need more specific treatment. Doctors are trying experimental therapies such as cidofovir, brincidofovir, tecovirimate and vaccine immunoglobulin. If given early in the course of infection, Jynneos and ACAM2000 vaccines can also help reduce the severity of the disease.
Question: What misinformation is circulating about monkeypox?
Conspiracy theories about monkeypox abound. Monkeypox is not a scam. Monkeypox is real. Covid vaccines cannot give you monkeypox. Monkeypox was not invented by Bill Gates or pharmaceutical companies. Monkeypox does not come from a laboratory in China or Ukraine. Migrants crossing the US-Mexico border have not brought monkeypox to the United States. Monkeypox is not a trick that allows voting by mail during elections. There is no need for a mandate for monkeypox vaccine or blockade due to monkeypox.
Céline Gounder: cgounder@kff.org
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