What to know about symptoms, threat

A healthcare workers takes a sample from a scab suspected to be monkeypox infection in a childShare on Pinterest
Being examined by Congolese doctors, a Manfuette village teenage boy is suspected of having monkeypox in Manfuette, Republic of Congo Tuesday, August 29, 2017. The Washington Post/Getty Images
  • Since early May 2022, many countries in Europe, as well as Australia, and the U.S. have reported an increasing number of monkeypox cases.
  • As a viral disease native to Africa, monkeypox is usually transmitted by animal-to-human contact, producing skin lesions, fever, and body aches in people the virus infects.
  • Some recent cases of monkeypox have involved men who have had sex with men, however, experts say the disease is not a sexually transmitted infection but can spread via direct contact during sex.

This is a developing story. We will provide updates as more information becomes available.

On the heels of the ongoing COVID-19 pandemic, a zoonotic virus seems to be spreading throughout Europe and into North America.

Monkeypox has been making headway across the U.K., Spain, and Portugal since early May 2022. France, Germany, Italy, Belgium, and Australia have since confirmed at least one case in each country as well.

In the U.K., 20 monkeypox cases have been confirmed since early May. During a press conference on May 17, World Health Organization (WHO) officials said that these are mostly separate occurrences except for “a family cluster with two confirmed cases and one probable case[…]”

Recently, Canada and the U.S. joined these nations in tracking and tracing the virus.

As of May 19, Canada confirmed two monkeypox cases and said it was investigating 17 suspected cases. The Massachusetts Department of Health also announced a single case in an individual who had recently been in Canada. Several of the Canadian cases have been linked to this person.

On May 18, Scott Pauley, press officer at the Centers for Disease Control (CDC), told Medical News Today:

“The U.K. notified the U.S. of 8 people in the U.S. who might have been seated near the U.K. traveler when they flew from Nigeria to London [on May 3-4, 2022]. Of these, one is no longer in the U.S., and one was not a contact. The remaining six are being monitored by their respective state health departments. None of these six travel contacts have monkeypox symptoms and their risk of infection is very low.”

The WHO officials have been tracking monkeypox’s path through Europe and North America for several weeks. However, with the data available so far, they do not know long the virus has been spreading.

Monkeypox is a zoonotic virus, which transmits disease from animals to humans. Cases typically occur near tropical rainforests, where animals that carry the virus live.

The monkeypox virus is a member of the orthopoxvirus family. It also has two distinct genetic strains or clades: the Central African (Congo Basin) clade and the West African clade. The Congo Basin clade is known to spread more easily and cause more severe symptoms.

Monkeypox naturally occurs in Africa, especially in west and central African nations. Cases in the U.S. are rare and associated with international travel from places where the disease is more common.

Monkeypox symptoms and signs include headache, skin rash, fever, body aches, chills, swollen lymph nodes, and exhaustion. It produces symptoms similar to smallpox, but milder.

The time from infection to the onset of symptoms, which is referred to as the incubation period, can range from five to 21 days. The illness typically resolves within two to four weeks.

Severe cases are more common among people with underlying immune deficiencies and young children. In recent times, the case fatality ratio of monkeypox is around 3-6%.

Transmission of the monkeypox virus among humans is limited, but it can happen through close skin contact, air droplets, bodily fluids, and virus-contaminated objects.

Most of the recent cases of monkeypox in the U.K. and Canada have been reported among attendees of sexual health services at health clinics in men who have sex with men.

Regarding this trend, Dr. I. Socé Fall, the regional emergencies director for the WHO’s Health Emergencies Program, cautioned:

“This is new information we need to investigate properly to understand better the dynamic of local transmission in the U.K. and some other countries.”

During a press conference on May 17, Dr. Fall acknowledged that public health officials still have much to learn about the monkeypox virus.

“But the most important thing is we really need to invest in understanding the development of monkeypox because we have so many unknowns in terms of the dynamics of transmission, the clinical features, the epidemiology. In terms of therapeutics and diagnostics also, we still have important gaps,” he said.

WHO experts believe that solutions for monkeypox calls must go beyond addressing the disease.

During the press conference, Dr. Michael Ryan, executive director of the WHO’s Health Emergencies Program, said: “[G]etting answers isn’t just about getting answers about the virus. We’ve got to get answers about the hosts, we’ve got to get answers about human behavior and practice, and we’ve got to operate at all levels to try and ensure that human populations are protected.”

For more insight, Medical News Today spoke with Dr. Kartik Cherabuddi, clinical associate professor in infectious diseases and director of the Global Medicine and Antimicrobial Management Program at the University of Florida.

“Being aware of the rash of monkeypox which presents as vesicles is very important. Additional measures include vigilance in those who have traveled in the past 30 days to countries that have reported cases of monkeypox [and] who have contact with a person who is confirmed or suspected of monkeypox.”
— Dr. Kartik Cherabuddi

Dr. Cherabuddi mentioned that smallpox vaccinations offer some protection against monkeypox. He said the Democratic Republic of Congo is currently employing ring vaccination for close contacts of confirmed cases.

The U.K. is also using ring vaccination, in addition to contact and source tracing, case searching, and local rash-illness surveillance, he added.

Smallpox and monkeypox vaccines

Dr. Cherabuddi believes that more cases will arise in the U.S., but it’s difficult to predict how many.

He said he was concerned that with fewer people in the U.S. having had smallpox vaccinations, this could be putting “a majority of the population below the age of 40-50 years at risk for infection[…]”

Dr. Ryan also noted that preventing the disease may not entirely rest on vaccines. He pointed out that “the protection offered by previous smallpox vaccination also has reduced[…]”

He said there might be a need to change agricultural, social, and food storage practices to prevent further outbreaks. Officials hope to help communities understand how the virus spreads so they can address it at its sources.

Dr. Cherabuddi told MNT that vaccines for monkeypox have also been approved for limited circulation.

“An approved vaccine for monkeypox—MVA-BN—is not widely available. Tecovirimat (TPOXX), as both oral and IV medication is approved in the U.S. for treating smallpox and oral form in Europe to treat cowpox, monkeypox, and smallpox. The FDA also approved brincidofovir (Tembexa) in 2021 to treat smallpox. These medications are not widely available,” he said.

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