What You Need to Know About Monkeypox

In the last 15 years, a series of viral diseases have begun to spread around the world. Swine flu, bird flu, Ebola, the zika virus, and COVID-19 are all recent examples. The latest virus to cause concern is monkeypox, which is currently spreading across the U.S. and Europe.

A Brief History of Monkeypox

Despite very little discussion in the U.S. about monkeypox before 2022, it is not a new disease. It was first identified in 1958, in Copenhagen, in a colony of monkeys¹. In the years since its discovery, monkeypox has rarely been found in Europe and the Americas. However, it has continued to be consistently present in 10 African countries, including some where it is considered endemic.

The lack of interest in, or widespread knowledge of, monkeypox in the West is reflective of its lack of penetration in the region. The virus’ continued presence in Africa, however, means that scientists in the area have conducted decades of research into the disease that will prove crucial in attempts to combat the current outbreak.

2022 Monkeypox Outbreak

In May, an outbreak of monkeypox was confirmed, beginning with a spate of cases in the United Kingdom². The first confirmed case was an individual who had traveled to Nigeria, one of the countries where monkeypox is endemic. Despite extensive contact tracing and the immediate isolation of the individual after monkeypox was first suspected, the virus spread, and further cases in the UK were confirmed.

On May 18^th, the first U.S. case of the disease was reported in Massachusetts³, and the virus has continued to spread since. As of July 20^th, there were more than 15,000 confirmed cases around the world, including more than 2,300 in the U.S. and a further 604 in Canada. Elsewhere, Spain had reported more than 3,000 cases, and the U.K. and Germany had seen more than 2,100 each.

The Symptoms of Monkeypox

Caused by the monkeypox virus, the monkeypox disease is part of the same family of orthopoxviruses as smallpox and has similar, but milder, symptoms. Common monkeypox symptoms include⁴:

Fever.
Headache.
Muscle aches and backache.
Swollen lymph nodes.
Chills.
Exhaustion.
A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.

The U.S. Centers for Disease Control and Prevention (CDC) advises that: “the rash goes through different stages before healing completely”. Sometimes people get a rash first followed by other symptoms, whereas others only experience a rash. Typically, the illness lasts between two and four weeks.

How Monkeypox Spreads

The World Health Organization (WHO) reports that⁵: “human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects.’ They say: “transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health workers, household members, and other close contacts of active cases at greater risk.”

While intimate physical contact, such as kissing, cuddling, or sexual activity, increases the likelihood of transmission, the WHO states that: “while close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes”, and that “studies are needed to better understand this risk”.

Testing for Monkeypox

Since the start of the outbreak, the White House has endeavored to increase the nationwide availability of monkeypox testing. By partnering with five commercial testing companies, including CNECT-contracted Quest Diagnostics, the Biden-Harris administration has increased testing capacity from 6,000 per week to 70,000⁶.

To conduct the test, the U.S. Food and Drug Administration (FDA) advises that the swab sample comes directly from a lesion, be it a rash or growth⁷, as they are “not aware of clinical data supporting the use of other sample types, such as blood or saliva, for monkeypox virus testing” and warn that “testing samples not taken from a lesion may lead to false test results”.

Monkeypox Vaccines

As of July, the FDA has given license to two monkeypox vaccines: JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000⁸. The CDC reports that “there is currently a limited supply of JYNNEOS, although more is expected in coming weeks and months”, and while there is ample supply of ACAM2000, it shouldn’t be used in people who have certain health conditions, including “a weakened immune system, skin conditions like atopic dermatitis/eczema, or pregnancy”.

In mid-July, the director of the CDC warned that demand for the monkeypox vaccine was outstripping supply⁹. Although the U.S. has ordered nearly 7 million doses of the vaccine in total, most will not be available for months, causing concern that the disease will have spread outside of the networks and communities in which it is currently being transmitted by the time the influx of vaccines arrives.

In the meantime, officials say that states and jurisdictions that are seeing high or increasing cases of monkeypox, and populations that are considered to be at high risk, will receive priority in the allocation of new vaccine doses⁹.