As global monkeypox cases spread, there are plenty of questions about how people can protect themselves
Some 3,308 cases of monkeypox have been detected across 42 countries as of June 22, according to the Centers for Disease Control and Prevention. The United States has identified more than 150 cases of monkeypox across 23 states and Washington, D.C. in 2022. While health experts are concerned about these cases, officials from the World Health Organization and the CDC have also said that “this is not COVID,” and these monkeypox outbreaks can be contained.
Part of stopping the spread has included the CDC raising its travel advisory alert to “Level 2” (out of three), which recommends that travelers “practice enhanced precautions.” These include avoiding close contact with sick people and their bedding or other materials, as well as avoiding contact with dead or live wild animals — particularly rodents and non-human primates.
“We need to slow it down, but it does not spread in the air and we have vaccines to protect against it,” said Dr. David Heymann, a leading WHO adviser.
CDC Director Dr. Rochelle Walensky said, “We’ve been preparing for this type of outbreak for decades,” and the country has the resources to respond to the clusters of monkeypox outbreaks.
The U.S. plans to release the Jynneos monkeypox vaccine, made by Bavarian Nordic BVNKF, -3.82%, from its national stockpile to help prevent the virus from spreading. And the government announced earlier in June that it ordered an additional 500,000 doses.
Here is what else you need to know about monkeypox.
What is monkeypox?
Monkeypox is a rare viral disease that occurs mostly in central and western Africa, and was first identified in lab monkeys in 1958. The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo. The virus originated from wild animals like rodents and non-human primates (such as its namesake, monkeys), according to the CDC website, and it is part of the same virus genus as smallpox.
What are the monkeypox symptoms to look out for?
The symptoms are similar to smallpox, but milder. Most monkeypox patients experience minor flu-like symptoms such as fever, body aches, chills and fatigue, while those with more serious cases could also develop rashes or other skin abrasions, which can include fluid-filled bumps, or pox.
Most people recover within about two to four weeks without needing to be hospitalized. Monkeypox can be fatal for 3% to 6% of cases, however, and it is thought to be more severe in children, according to the World Health Organization.
There is still little information on any asymptomatic infections of monkeypox.
The CDC says risk to the general public is low, but you should still seek medical care immediately if you develop any new, unexplained skin rashes on any part of your body, with or without fever and chills. And if you do develop these kinds of lesions, avoid contact with others.
You should also call ahead before going to a healthcare facility, if possible. If you can’t phone ahead, then tell a staff member as soon as you arrive that you are concerned you may have monkeypox. And you should delay using public transportation until you have been cleared by a healthcare professional or public health officials.
Finally, tell your doctor if in the month before developing symptoms, you:
- had contact with a person that might have had monkeypox.
- are a man who has had intimate contact (including sex) with other men.
- were in an area where monkeypox has been reported (currently, Europe, North America, Australia) or in an area where monkeypox is more commonly found (the Democratic Republic of the Congo, Republic of the Congo, Nigeria, Central African Republic, Cameroon, Côte d’Ivoire, Gabon, Liberia, Sierra Leone, Sudan).
How is monkeypox spread?
Monkeypox transmission occurs when a person encounters the virus through close contact with another human, an animal, or items that could be contaminated with body fluids carrying the disease.
“Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding,” the CDC website noted.
“Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required,” the CDC adds. “Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.”
While this disease can be spread through various forms of sex, similar to many viral infections like the common cold or the flu, the CDC has stated that monkeypox is not a sexually transmitted disease like HIV or hepatitis.
Health officials say most of the known cases in Europe have been among men who have sex with men, but it should be noted that anyone can be infected through close contact with a sick person, their clothing or bedsheets. The CDC notes that some cases have been reported among men who have sex with men, but some cases were also reported in people who live in the same household as an infected person. And scientists say it will be difficult to disentangle whether the spread is being driven by sex or merely close contact.
CDC director Walensky said that while some American patients had traveled to areas where monkeypox has been spreading recently, that’s not true for every one, so “we need to presume that there is some community spread.”
What is the CDC’s monkeypox travel warning?
The CDC has three travel advisory levels that it uses when cases of a disease have been reported in dozens of destinations, which include:
• Watch — Level 1: Practice usual precautions
• Alert — Level 2: Practice enhanced precautions
• Warning — Level 3: Avoid nonessential travel
It has issued a “Level 2” warning for travelers related to monkeypox, suggesting the following precautions:
- Avoid close contact with sick people, including those with skin lesions or genital lesions.
- Avoid contact with dead or live wild animals such as small mammals including rodents (rats, squirrels) and non-human primates (monkeys, apes).
- Avoid eating or preparing meat from wild game (bushmeat) or using products derived from wild animals from Africa (creams, lotions, powders).
- Avoid contact with contaminated materials used by sick people (such as clothing, bedding, or materials used in healthcare settings) or that came into contact with infected animals.
Is monkeypox related to smallpox?
The monkeypox virus belongs to a subset of the Poxviridae family of viruses called Orthopoxvirus, and that subset of viruses also includes smallpox, vaccinia and cowpox viruses.
All of the above viruses in the Poxviridae family often can lead to “pox”-like symptoms like rashes, pimples and other lesions on the skin.
Additionally, the WHO says monkeypox is “clinically less severe” than smallpox.
Can monkeypox be cured or treated?
There is currently no specific treatment approved for the monkeypox virus, the CDC says, but antiviral medications developed for smallpox like Tecovirimat (aka TPOXX) may prove beneficial. And there are vaccines that help prevent monkeypox infections.
Where has monkeypox been reported in the U.S.?
U.S. monkeypox cases are usually very rare, according to the CDC.
United States has identified 155 cases of monkeypox across 23 states and Washington, D.C. in 2022 so far. These include: California, Colorado, Florida, Georgia, Hawaii, Illinois, Massachusetts, New York, Pennsylvania, Utah, Virginia and Washington.
Last November, the Maryland department of health and the CDC confirmed a case of monkeypox in November from a U.S. resident who had recently returned from Nigeria. That person presented with mild symptom, and was not hospitalized. In July 2021, the CDC and the Texas Department of State Health Services confirmed a case of monkeypox from a U.S. citizen who traveled from Nigeria.
Who is eligible for a monkeypox vaccine?
Jynneos (also known by the brand names Imvamune or Imvanex) has been licensed in the United States to prevent monkeypox and smallpox. In June, the U.S. had 72,000 Jynneos doses on hand, and was expecting to get 300,000 more doses from manufacturer Bavarian Nordic over the next several weeks. The government has also ordered another 500,000 Jynneos doses to be delivered later in the year. And the country also has 100 million doses of the older smallpox vaccine, which could potentially be used.
But the Jynneos vaccine, given as two doses four weeks apart, is being reserved for health-care workers and people who have been exposed to monkeypox, and is not intended to be a mass vaccination effort. Maria Van Kerkhove, the WHO’s emerging diseases and zoonoses lead, and technical lead on COVID-19, said in a Q&A, “We will be making recommendations on who should be prioritized for this” soon.
“Right now we are hoping to maximize vaccine distribution to those that we know would benefit from it,” Captain Jennifer McQuiston, deputy director of the CDC’s High Consequence Pathogens and Pathology Division, told Reuters. “So those are people who’ve had contact with known monkeypox patients, health care workers, very close personal contacts, and those in particular who might be at high risk for severe disease.”
But some places have expanded eligibility to deal with larger outbreaks. New York City has opened a new monkeypox vaccine clinic, as the city has reported more than 20% of the country’s confirmed monkeypox cases. The NYC health department has also opened eligibility to all gay, bisexual and other men who have sex with men (cisgender or transgender) who are age 18 and older who have had multiple or anonymous sex partners in the last 14 days. This is because, while anyone can get and spread monkeypox, most of the cases in the current outbreak have been among gay, bisexual or other men who have sex with men.
Since the monkeypox virus is closely related to the virus that causes smallpox, smallpox vaccines can also protect people from getting monkeypox. The original smallpox vaccine, ACAM2000, was shown to be about 85% effective in preventing monkeypox, although there were some serious side effects. In fact, roughly half of all Americans have some immunity against monkeypox because they were vaccinated against smallpox, although smallpox vaccinations mostly ended in 1972, after the disease was eradicated in the country.
What are the U.S. and President Joe Biden doing about monkeypox?
President Joe Biden said that the monkeypox disease is a “concern in that if it were to spread it would be consequential.” But Biden has not yet publicly commented on any detailed U.S. plan for vaccinations against monkeypox, should they be necessary.
Jake Sullivan, Biden’s national security adviser, recently told reporters, “we have vaccine available to be deployed for that purpose.” Sullivan added that the president is getting regular updates on the outbreak.
The White House recently announced that it is expanding monkeypox testing to commercial laboratories, to ensure the nation is not undercounting monkeypox cases due to insufficient testing.