As news begins to pour in about new, potentially but rarely lethal virus, the Oregon Health Authority put together a fact sheet on monkeypox, with tons of information.
Can humans get monkeypox?
Yes. the lower-case "h" in the name hMPXV stands for "human," and the rest of the letters are shortened from the words "monkeypox" and "virus." (Just as COVID-19 was derived from "coronavirus disease of 2019.")
So, what is it?
It's a DNA virus related to smallpox. It infects animals and is really common in forested areas of Central and West Africa. It's unclear what animals act as a reservoir for hMPXV, but rodents are the prime suspects, along with rats, squirrels, prairie dogs and some monkeys.
A "zoonotic" is a disease that can transfer from animals to humans. When did monkeypox become a zoonotic?
It was first identified in 1970 in the Democratic Republic of the Congo. There are two strains of monkeypox: MPXV-1 is typically more severe and has a case fatality rate of up to 10%. MPXV-2 causes milder illness, with an estimated case fatality rate in endemic countries of around 1%.
Well, which strain are we seeing in Oregon?
MPXV-2, which tends to be the less severe of the two strains. It's responsible for most illnesses in the current outbreak. Most people are recovering at home without any special treatment.
Is it similar to smallpox?
Kind of. But hMPXV is much harder to catch, and it's not as severe. There are two strains of this virus, and the main one that's circulating now causes milder disease.
Why is it called monkeypox?
It got its name because the first recognized outbreak was in monkeys in a Danish laboratory in 1958. The scientific community likely will give it a new name soon, since the old name isn't very descriptive.
How is it spread?
Historically, people have become infected by handling wild animals and bush meat, although hMPXV also can be transmitted person-to-person. This can happen through prolonged, close contact, either skin-to-skin; contact with fluid from hMPXV lesions; or possibly from large respiratory droplets. Most infections in the current outbreak appear to be due to skin-to-skin contact.
Can hMPXV spread through the air?
Possibly. An ill person who coughs or sneezes on someone else could spread the infection. However, most transmission in the current outbreak appears to be from prolonged, skin-to-skin contact.
What are the symptoms?
Typically, it starts with fever, headache and muscle aches. This is followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks.
How long after exposure do symptoms start?
Usually within seven to 14 days, but with a possible range of five to 21 days.
When can a person ill with hMPXV spread it to others?
Ill people potentially can transmit the infection from when symptoms start until the rash has resolved. However, this is not an easy infection to catch. It typically requires prolonged, close contact. People at increased risk include sexual partners of an ill person, or family members and health care workers caring for someone ill with monkeypox.
Can the virus spread before a person knows he or she is sick?
As far as researchers can tell so far, no. The spread of the disease before symptoms develop hasn't been reported.
Who is most at risk for hMPXV in the current outbreak?
Many of the infections in the current outbreak are from prolonged, skin-to-skin contact during sexual activity. Most, but not all, infections have been among gay, bisexual and other men who have sex with men who have traveled to countries with hMPXV cases, or who have had contact with someone else with hMPXV.
Does that make it a sexually transmitted disease?
The virus spreads through close, prolonged, skin-to-skin contact, not sex specifically. Though risk of infection is not high, anyone who has close, prolonged, skin-to-skin contact with someone ill with monkeypox could possibly catch it, regardless of whether they're having sex.
What's so different about this outbreak?
First, many people in the current outbreak have not had typical symptoms. Many had no symptoms prior to developing a rash, which often has been a localized rash in the genital or perianal area. Second, most people with hMPXV haven't traveled to areas where the virus typically circulates. This suggests some transmission in countries that don't usually experience it.
Could hMPXV spill over from people into domestic and wild animals in the United States, and become endemic?
It's theoretically possible but considered to be a very low risk.
Are there vaccines for hMPXV?
There is a vaccine specifically for hMPXV and smallpox called Jynneos. It could be used to protect people with high-risk exposure to someone ill with hMPXV. There is another vaccine, ACAM2000, that is approved to prevent smallpox. It could be used under special arrangements with the U.S. Centers for Disease Control and Prevention, or CDC, but it is more likely to cause adverse effects.
Are there treatments for hMPXV?
Currently there are no specific treatments approved for hMPXV virus infections. However, antivirals developed for use in patients with smallpox may be helpful in treating people with a severe bout of the disease, or who are at risk for severe or complicated infections.
Should I vaccinate my children against it now?
No. No vaccine is needed at this point. Vaccines would be used to protect people who have known exposure to someone ill with hMPXV infection. It actually works to prevent or decrease disease even after someone was exposed.
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