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  • Writer's pictureAlan Frischer, MD, MPH


Updated: Jul 29, 2022

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

The virus that causes monkeypox shares the same family as smallpox. However, note that monkeypox is far less severe. Its symptoms are similar, and include fever, aches, chills, exhaustion, sore throat and swollen lymph nodes, and skin lesions that can be intense. However, smallpox had a mortality rate close to 30%, and the rate for monkeypox is in the range of 3-6%. Those who fare the worst are young children.

Due to 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 under 50, who would not have received the smallpox vaccination.

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. The virus first reached the United States in Texas in 2003, from a shipment of animals from Ghana.

Humans can contract monkeypox from a bite from an infected animal, or through direct contact with the animal’s lesions or body fluids. In order for the virus to spread from one human to another, it takes close contact with an infected person’s lesions, body fluids, respiratory droplets, or contaminated materials (such as bedding).

Don’t be alarmed. Monkeypox does not spread easily among people. Still, confirmed cases in California have climbed to 136, mostly in Los Angeles and San Francisco. It is of particular concern among the LGBTQ community, especially through skin-to-skin contact in gay men. Some seven thousand cases worldwide are a very far cry from the 557 million total cases of COVID-19 to date (and well 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. Vaccines have been developed for prevention (although there is currently a serious shortage) and we now have antiviral medications to help treat it.

Stay tuned for new developments.

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