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On July 23, the World Health Organization declared a global health emergency for the second time in two years. This time, it’s for the monkeypox virus.
The virus is endemic and found in the Democratic Republic of Congo, Benin, Cameroon, Central African Republic, Gabon, Cote d’Ivoire, Liberia, Nigeria, and Sierra Leone. Any cases outside of these countries are both rare and alarming.
The first European case that sparked the global health emergency declaration was reported on May 7 in an individual who returned to the United Kingdom from Nigeria. Since this first case, the virus has rapidly spread. As of September 27, approximately 65,971 cases have been identified globally in 99 non-endemic countries. Of these, 25,341 are in the United States.
According to the World Health Organization, most of these cases outside of the endemic countries, including in the US, are unusual for three reasons:
- most patients do not travel history to areas where monkeypox is endemic,
- many are being detected through sexual health services and among men who have sexual interactions with other men, and
- the broad geographic spread suggests that transmission may have occurred for some time before the first official diagnosis.
How is it spread?
The virus most commonly transmits from infected individuals via open body lesions, bodily fluids, respiratory droplets, or contaminated materials such as bedding and clothing. Less commonly, the virus is transmitted through the bite, eating of, or preparation of the meats of infected animals. The overall incubation period is 6 to 13 days.
What are the symptoms of Monkeypox?
Symptoms of monkeypox typically last 2 to 4 weeks. The virus is a member of the same viral family (Orthopoxvirus) as smallpox, leading to the symptoms of monkeypox being similar but milder than smallpox. These typically include fever, headache, muscle aches, and exhaustion. In addition, unlike smallpox, monkeypox typically causes the lymph nodes of the infected to swell. Within 1 to 3 days after the appearance of fever, infected individuals are likely to develop a rash that starts on the face and then spreads to other body parts.
Can the virus be treated or prevented? What are US officials doing?
There are no proven, safe monkeypox treatments available in the United States. Despite this, many antiviral agents are tested for safety and effectiveness in treating the virus.
In terms of prevention, two vaccinations, JYNNEOS and ACAM2000, have been FDA-approved to prevent smallpox. As mentioned, because of the similarities between smallpox and monkeypox, these vaccinations have, so far, proven effective against monkeypox.
Despite their effectiveness, these vaccinations are not readily available to the public in the US. As a result, the CDC does not recommend mass vaccination against the virus. Instead, in coordination with the CDC on June 28, the White House released a monkeypox vaccination strategy. According to the strategy, the only people that should be vaccinated at this time are:
- individuals with known exposure to someone with monkeypox,
- if a vaccine is administered within four days of exposure, there is a good chance that infection can be prevented,
- high-risk individuals, including men who have sex with men and especially those with multiple sex partners, and
- health care workers taking care of patients with monkeypox infections.
Following this strategy, the United States is significantly expanding the deployment of vaccinations. Over the coming months, US officials have indicated that an additional 1.6 million doses will become available for high-risk individuals. The monkeypox vaccination strategy also stresses the need for local healthcare officials to streamline monkeypox testing protocols and access. To aid this, the CDC has shipped monkeypox tests to five of the nation’s largest commercial laboratories, dramatically increasing access and convenience for patients and healthcare providers.
Should I worry about Monkeypox?
Some reports from Africa demonstrate case fatality rates of 10%. However, the global case fatality rate is estimated to be approximately 3% to 6% at the time of this report.
According to the World Health Organization’s latest situation update, published on June 27, 2022, the risk posed by monkeypox is moderate at the global level. While most individual countries maintain the moderate risk rating, the risk is estimated to be higher in Europe. Based on the continued increase in cases, it is likely that the WHO will revise the risk assessments upward in one or more regions, including the Americas. This risk level has been steady since late June despite the July 23 declaration of a global health emergency.
In conclusion, there is no need to panic. Though cases continue to rise globally and, in the US, a widespread outbreak similar to COVID-19 is not expected. VIGILINT does, however, recommend that individuals avoid animals and individuals showing symptoms of monkeypox, avoid contact with items and materials that may have been exposed to monkeypox, isolate the infected from those at risk, and use PPE and good hygiene measures when caring for patients with the virus.