What is Monkeypox?

Monkeypox, a relatively unknown virus, is gaining attention for an unexpected global outbreak. Dr. Leyla Best, infectious disease, explains everything you need to know to stay informed.

What is Monkeypox?

Monkeypox is a virus that’s a member of the Orthopoxvirus genus in the Poxviridae family. It’s closely related to other viruses like smallpox and cowpox.

This infectious disease was initially discovered in 1958 in monkeys used for research — thus, how it got its name. In 1970, the first case of monkeypox in humans was reported in the Democratic Republic of Congo in Africa. Since then, most cases have occurred in that continent. Until now, all outbreaks outside of Africa have been connected to travel or contact with an infected animal.

In 2022, the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) began monitoring monkeypox outbreaks in countries not usually known for carrying the virus, including the U.S.

How Contagious is Monkeypox?

Monkeypox isn’t considered to be very contagious, but it can spread from person-to-person by contact with the virus’ blisters, body fluids (urine, wound drainage), respiratory droplets (saliva, mucus) and bedding or clothing used by someone infected with the virus. 

“The 2022 outbreak suggests close contact via sexual exposure is a possibly more efficient, but not the only, mode of transmission,” Dr. Best says.

What are Monkeypox Symptoms?

Monkeypox virus has an incubation period of 5 to 21 days. Dr. Best says that means after having contact with the virus, it might take anywhere between 5 to 21 days for symptoms to appear.

The illness begins with flu-like symptoms:

• Fever (anything above 100.4 degrees Fahrenheit)
• Headache
• Muscle aches
• Backache
• Swollen lymph nodes
• Chills
• Exhaustion/fatigue

After a few days, a painful rash typically develops, usually starting on the face and then spreading to other parts of the body. The blisters will go through a series of stages before falling off. The virus can last up to four weeks.

What Does Monkeypox Look Like?

After the flu-like symptoms, the monkeypox blisters are the most recognizable part of the virus. The blisters are known for their white, milky-like appearance. While the blisters are traditionally known to show up on the face and spread from there, the 2022 outbreak looks a little different for some people.

“The rash is often starting in the genital area, and some aren’t experiencing any fever. Also, the rash isn’t always spread to other parts of the body, which means some cases could easily be confused with sexually transmitted infections,” Dr. Best says.

What’s the Difference: Monkeypox Vs. Smallpox?

Monkeypox and smallpox are both in the same virus family, which means they’re closely related and very similar.

The fluid-filled bumps for both viruses are all in the same stage at the same time. Unlike, for example, chickenpox where the blisters are in different stages, with some being blisters and others scabbed over. 

Besides the rash, other symptoms between monkeypox and smallpox are also similar. But, according to the CDC, the main difference is that monkeypox causes lymph nodes to swell while smallpox does not. 

Overall, smallpox is considered to be more dangerous and deadly than monkeypox.

Is Monkeypox Deadly?

“Most individuals recover from monkeypox. The infection tends to be self-limited, which means you’ll recover without any specific treatment. Historically, death due to monkeypox has been reported between 1-10% but potentially lower with early supportive care, such as IV fluids and monitoring vital signs,” Dr. Best says.

She adds there are two strains of monkeypox — one from Central Africa and another from West Africa. The strain from West Africa is what’s currently circulating, but the likelihood of a case being deadly from this strain is very low — about 1%.

Is Monkeypox Only in Humans?

Monkeypox virus can live and be detected in many animals, such as rodents and monkeys. Small rodents are one of the primary ways this virus is transmitted to people.

Does Monkeypox Impact a Certain Age of the Population?

There’s no age associated to higher or lesser risk of contracting monkeypox virus. 

However, Dr. Best says smallpox vaccination has proven to provide some immunity against monkeypox. Routine vaccination of people in the U.S. against smallpox stopped in 1972 after the disease was eradicated here. Therefore, some people over the age of 50 who were vaccinated for smallpox may have some immunity against monkeypox.

Is there a Monkeypox Vaccine?

Because monkeypox virus is closely related to the virus that causes smallpox, smallpox vaccine can also protect people from getting monkeypox. Past data from Africa suggests the smallpox vaccine is at least 85% effective in preventing monkeypox. 

If someone is knowingly exposed to monkeypox, they can still get a vaccine for protection. But, it’s a race against the clock. The CDC recommends the vaccine be given within four days from the date of exposure to prevent the illness. If it’s given anywhere between 4 and 14 days, the vaccine might reduce the symptoms of the disease but not prevent it.

What is the Treatment for Monkeypox?

Dr. Best says there’s currently no specific proven treatment for monkeypox. 

However, the CDC says antivirals developed for people with smallpox could be used in some situations. Usually, only those who develop severe monkeypox symptoms, or complications from the virus would qualify for those treatments. People with low immune systems, children under the age of 8 and pregnant or breastfeeding individuals might also qualify for the medication.

What’s Unusual About the 2022 Spread of Monkeypox?

“It’s suspected that as people have resumed traveling after the initial lockdown from COVID-19, abroad travelers have substantially increased and facilitated the spread of the monkeypox virus from an endemic country to non-endemic countries. However, there have been several cases among individuals with no travel history, and this is unusual for the transmission of this virus,” Dr. Best says.

Finally, it’s expected the WHO will rename the virus and its variant. It got its name after being discovered in monkeys, but most often carried by rodent species, which is where the virus likes to live and grow.