• Alan Frischer, MD, MPH


Evidently, COVID-19 hasn’t been enough. Now we have monkeypox. What is it? Should we worry?

The virus that causes monkeypox is in the same family as the smallpox virus. However, note that monkeypox is far less severe than smallpox. Its symptoms are similar, including fever, headache, swollen lymph nodes, back and muscle pain, lack of energy, skin eruption, and rash. However, smallpox had a mortality rate close to 30%, and the rate for monkeypox is in the range of 3-6%.

With the eradication of smallpox, the United States stopped administering vaccinations in 1972. As it turns out, that vaccine was and still is protective against monkeypox. In fact, the most severe cases today occur among those younger than 50, who would not have received the vaccination against smallpox.

This virus was originally transmitted from animals (monkeys and apes, rodents, and rabbits) to humans. The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo. Monkeypox still occurs mostly in Central and Western Africa, and often near tropical rainforests, although it has been increasingly appearing in more urban areas. The virus first reached the United States in Texas in 2003, from a shipment of animals from Ghana.

From an infected animal, humans can contract monkeypox from a bite, or through direct contact with the animal’s lesions or body fluids. In order for the virus to spread from one human to another, there must be close contact with an infected person’s lesions, body fluids, respiratory droplets, or contaminated materials (such as bedding). In this country, monkeypox has been found in humans in Chicago, Atlanta, Los Angeles, Philadelphia, and New York City.

Don’t be alarmed. Monkeypox does not spread easily between people. 2,580 cases worldwide are a very far cry from the 539 million total cases of COVID-19 to date (and over six million COVID-19 deaths). Nonetheless, monkeypox could become a significant global public health risk if the virus finds an easy way to spread to our vulnerable population of children, to those who are immune-suppressed, and to those who did not receive the smallpox vaccine. We are gaining a better understanding about its spread, and are studying its epidemiology, sources of infection, and transmission patterns. Newer vaccines have been developed for prevention, and we now have antiviral medications to help treat it.

Stay tuned for new developments.

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