The U.S. Department of Health and Human Services has declared monkeypox to be a public health emergency (New York Times, August 4, 2022), and the U.S. has recorded more than 7000 infections, more than any other country in the world. The only two states that have not yet reported monkeypox infections are Montana and Wyoming.
Most reported cases include a rash with usually painful blisters and pustules that become deep and firm. Not all patients develop a fever. A person can be contagious for up to four weeks. There are almost no deaths reported and in Europe, only eight percent of patients have been hospitalized for isolation or treatment.
A person with monkeypox is contagious from the start of any symptoms until the rash has fully healed and a fresh layer of skin has formed. Symptoms usually start a few days after exposure, as a fever, followed by red lesions one to four days later. The rash can start as pimples or blisters on or near the genitals or anus or on the hands, feet, chest, face, or mouth. They can be painful and itchy and can fill with pus, and usually become scabs before healing. Other symptoms can include chills, swollen lymph nodes, exhaustion, muscle aches, backache, headache, sore throat, nasal congestion, or coughing.
Monkeypox is transmitted by:
• touching any part of an infected person’s skin: hugging, massaging, kissing
• touching an infected person’s clothing, bedding, towels or anything they have touched
• touching surfaces that have been used by someone with monkeypox
• breathing respiratory secretions from an infected person
• touching, being scratched or bitten by an infected animal
• eating the meat or using products from an infected animal
A pregnant woman can spread the virus to her fetus through the placenta.
At this time, we do not know:
• If the virus can be spread when someone has no symptoms
• How contagious monkeypox is when the virus is airborne
• Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces
Vaccines, Testing and Treatment
The Jynneos vaccine from Denmark is effective and is being given usually to those with the greatest risk of catching the virus. The U.S. government has the capacity to distribute 80,000 monkeypox tests per week, and about 1,700,000 treatments with the antiviral drug, TPOXX, which is available to treat severe cases. Two antiviral drugs, tecovirimat and brincidofovir, may treat monkeypox infections, but these drugs are recommended only for patients at high risk for severe disease. Another drug, Brincidofovir, is associated with serious side effects, such as liver toxicity and severe diarrhea. Anyone who develops a rash with blisters should check with their doctor immediately.