Monkeypox

Monkeypox is a rare viral disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as smallpox. It is usually found in Central and West Africa. Monkeypox was first discovered in laboratory monkeys in 1958, hence its name. In 1970, monkeypox was reported in humans for the first time. Monkeypox can be fatal, but that is very rare and has never happened in the United States.

2022 U.S. Monkeypox Outbreak

CDC is closely tracking cases of monkeypox that have been reported since mid-May in the United States and many other countries without a history of monkeypox activity, including in Europe, the Americas, the Middle East, Australia and some countries in Africa.

While monkeypox activity continues in the U.S. and is unexpected, the risk to the general population is low. People with monkeypox in the current outbreak generally report having close, sustained physical contact with other people who have monkeypox. 

Anyone can catch monkeypox if they have close contact with someone who has monkeypox, regardless of gender identity or sexual orientation, though many of those affected in the current global outbreaks are gay, bisexual or other men who have sex with men. Monkeypox is NOT a sexually transmitted infection.

On July 23, 2022, the World Health Organization (WHO) declared monkeypox as a “public health emergency of international concern."  Monkeypox received this classification because it is spreading rapidly through new modes of transmission that we are working to understand at this time. Monkeypox has been a concern for years in African countries, but in recent weeks the virus has spread worldwide across at least 75 countries.

On August 4, 2022, the United States Department of Health and Human Services, with support from the White House, declared monkeypox a public health emergency in an effort to contain the continued spread of monkeypox. This declaration allows federal health officials the ability to expedite vaccines and treatment options for monkeypox, and may open up funding to the states. 

Health officials are concerned because monkeypox is spreading and cases are presenting in ways not typically seen in past monkeypox outbreaks. Although the current strain of monkeypox that is circulating in the United States is rarely fatal, symptoms can be extremely painful, may lead to hospitalization, and may result in permanent scarring from the rash.

Current Information and Data on the 2022 U.S. Monkeypox Outbreak

Symptoms

Symptoms of monkeypox can include:

  • Fever;
  • Headache;
  • Muscle aches and backache;
  • Swollen lymph nodes;
  • Chills;
  • Exhaustion;
  • A rash that looks 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.
MonkeyPox Rash

Sometimes people experience the flu-like symptoms first and later develop a rash. Sometime people only develop a rash or lesions. 

Symptoms usually start a week or two after exposure to someone with monkeypox. The rash and lesions can last up to two to four weeks.

Anyone experiencing monkeypox symptoms, or thinks they have been exposed, should seek care immediately with their doctor, or visit an urgent care facility. Avoid close contact, including intimate physical contact, with other people and avoid contact with pets/animals until you have been examined by a doctor. 

Transmission

Monkeypox can spread to anyone through:

  • Direct contact with monkeypox rash or scabs on a person’s skin.
  • Contact with items (such as clothing, bedding or towels) and surfaces that previously touched the infectious rash or body fluids.
  • Contact with respiratory secretions during prolonged, face-to-face contact.

Monkeypox can be spread during intimate contact, including: 

  • Oral, anal, and vaginal sex, or touching the genitals or anus of a person with monkeypox. 
  • Hugging, massage, kissing, or talking closely. 
  • Touching fabrics, shared surfaces, and objects that were used by a person with monkeypox, such as bedding, towels and sex toys.

At this time, it is unknown if monkeypox can spread through semen or vaginal fluids.

It is also possible for people to get monkeypox from infected animals, either by getting scratched or bitten by the animal, or by preparing or eating meat or using products from an infected animal.

Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2 to 4 weeks. 

Testing

Monkeypox is diagnosed through a laboratory confirmed test. Prior to being tested an individual must be evaluated by a healthcare provider. If monkeypox is suspected, the healthcare provider must collect a specimen that is then sent to a certified laboratory for confirmatory testing. Individuals with a concern about an unexplained or newly developed rash should contact their healthcare provider. Individuals seeking an evaluation for monkeypox and testing should call their healthcare provider and make them aware of the need prior to walking into the facility. 

Monkeypox procedure (4)

Diagnosis

Monkeypox is diagnosed through a laboratory confirmed test. Individuals who are diagnosed with monkeypox should:

  • Avoid close contact (including intimate physical contact) with others.
  • Avoid contact with animals including pets, domestic animals and wildlife.
  • Isolate at home separate from household members and pets until the rash has healed, all scabs have fallen off, and a fresh layer of intact skin has formed; if you cannot isolate limit your contact with people, avoid crowds and ensure rash/lesions are covered with clothing.
  • Keep rash areas clean and dry to protect against secondary infections.
  • Wash your hands often with soap and water or use hand sanitizer.
  • Wash surfaces and materials that you have touched while you had symptoms, including bedding, towels, clothing, sex toys and surfaces such as door handles or counter tops. Standard household cleaning/disinfectants may be used in accordance with the manufacturer’s instructions.

Treatment

Antiviral medications exist to treat monkeypox, which may be appropriate for some people. Individuals diagnosed with monkeypox must consult their healthcare provider to be prescribed antiviral medications. 

The rash or skin lesions resulting from monkeypox can very painful and spreads throughout the body. Talk to a healthcare provider about over-the-counter oral antihistamines and topical agents such as calamine lotion, cortisone 10, petroleum jelly and lidocaine cream or gels, and consider over-the-counter stool softeners to help reduce peri-anal discomfort.

Vaccines exist that can help reduce the chance and severity of infection in those who have been exposed (known as close contact) or for individuals who have increased risk of being exposed. Widespread vaccination against monkeypox is not recommended at this time. Vaccination includes 2 doses of the JYNNEOS vaccine 28 days apart. An individual receiving the vaccine should continue to practice prevention until they are considered fully vaccinated, which is 2 weeks following the second dose. 

Widespread vaccination against monkeypox is not recommended at this time. Previous smallpox vaccination does provide protection, but it may not necessarily be lifelong. 

Prevention

The following may help in preventing monkeypox and other diseases:

  • Ask sexual partners whether they have a rash or other symptoms consistent with monkeypox.
  • Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
    • Do not touch the rash or scabs of a person with monkeypox.
    • Do not kiss, hug, cuddle, have sex with or masturbate someone with monkeypox. 
  • Avoid contact with objects and materials that a person with monkeypox has used.
    • Do not share eating utensils or cups with a person with monkeypox.
    • Do not handle or touch the bedding, towels or clothing of a person with monkeypox.
  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom
  • Avoid contact with animals that can spread the monkeypox virus.  
    • Do not handle sick or dead animals, or the bedding and other materials they touched. 

Healthcare Providers

Currently, healthcare providers can test patients with suspected monkeypox. Specimens can be sent for testing to the following laboratories:

The Chester County Health Department receives all test results for monkeypox. For all positive test results, the Health Department will conduct an investigation and contact tracing. Any individual suspected of being a close contact of someone who tested positive for monkeypox will be contacted directly by the Chester County Health Department and given post-exposure recommendations. Individuals who have been told they are a close contact of a somone who does not live in Chester County but has tested positive for monkeypox should contact the Chester County Health Department to discuss post-exposure recommendations at 610-344-6225.

More information for healthcare providers can be found here:

Additional resources