Monkeypox: What You Need To Know About The Virus

Over the weekend, the World Health Organization declared monkeypox ― a viral illness that causes fever and rash ― a global health emergency after outbreaks have been detected in more than 70 countries.

The illness doesn’t usually spread across the world, but it’s currently going through multiple new communities, which happens when an infected person has close contact with someone else. Declaring a global emergency means that a coordinated international response is needed to address the virus. The last time the WHO declared a global health emergency was for COVID-19 in January 2020.

Here’s what you need to know:

Monkeypox is a DNA viral illness that causes fever and a distinctive, bumpy rash that looks like blisters or pimples until it eventually scabs over as a person recovers. The lesions can show up on the face, hands, feet, inside the mouth and more. The virus can also cause headaches, muscle aches, swollen lymph nodes and fatigue.

The zoonotic disease has been around for decades, and primarily got its name because it was first identified during an outbreak in monkeys in 1958. Now experts are calling for a reframing of the illness, and want to switch its name to hMPXV to eliminate stigma attached to contracting the virus.

It predominantly spreads via spillover events from infected animals to humans. Then, people can spread it via multiple different forms of close contact ― mostly through blood and respiratory droplets.

At this point, “it certainly does not seem to be as transmissible as something like COVID or the flu,” Dr. Richard Martinello, a Yale Medicine infectious disease expert and associate professor of medicine and pediatrics, told HuffPost.

Over the years, there have been various instances of monkeypox appearing in the U.S. and other parts of the world. But it doesn’t transmit often outside of the endemic areas in Africa, according to Dr. Amesh Adalja, an infectious disease expert and senior scholar at the Johns Hopkins University Center for Health Security.

Monkeypox has a long incubation period of around 12 days. Its fatality rate is estimated to range between 1% and 10%, but Adalja believes the actual fatality rate may be lower, depending on where cases occur. “Monkeypox tends to be an illness that’s not nearly as fatal as smallpox was,” Adalja said.

Monkeypox is endemic in Africa, and outbreaks and cases outside of Africa aren’t unheard of. In 2021, the United States documented two cases of monkeypox in people who had recently traveled from Nigeria. There was also a U.S. outbreak in 2003, which involved animals spreading the disease to people. No human-to-human transmission was recorded, and of the 47 cases identified — in Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin — only three were severe.

Some monkeypox outbreaks have lasted for a year or so, but they haven’t been explosive outbreaks that grow exponentially like we’ve seen with COVID-19, according to Martinello. “People become aware there is monkeypox in their community,” he said. “When people get sick, they isolate from other people, and it helps to bring that transmission to an end.”

What’s odd about the current outbreak is the way monkeypox seems to be spreading. Typically, outbreaks are very localized, but this one involves several countries.

“The clusters that we’re seeing currently, in multiple countries, are not linked to travel,” Adalja said. “There’s transmission occurring outside of travel and outside of animal exposures, which are the usual routes that we see cases occur.”

It’s not clear how monkeypox has been able to leap between certain regions, but experts theorize that once it jumps, transmission most likely occurred from the exchange of saliva, respiratory droplets and bodily fluids. The virus typically is transmitted through prolonged physical contact, whether sexual or not. Touching or handling clothes or bedding used by a person with virus can also spread the illness.

According to The Atlantic, the first case identified in the U.K. fit the traditional pattern of the disease spreading via travel. However, other cases in other regions don’t appear to have had any connection to travel or contact with someone who had the illness.

The outbreak in the United States and in most Western countries has predominantly affected men who have sex with men, but there have also been two documented cases in children and a few cisgender women. The virus isn’t exclusive to one group of people.

Treatment of monkeypox typically involves supportive care. Most cases are mild and self-limited. There are antivirals specifically designed to treat smallpox, but they are generally reserved for severe cases, according to Adalja.

Monkeypox is part of the same viral family as smallpox, and the smallpox vaccine is incredibly effective at preventing the disease and minimizing symptoms. Evidence suggests the vaccine is at least 85% effective in preventing monkeypox.

The vaccine also can work when given as a post-exposure prophylaxis (meaning it can prevent the disease or make it less severe, even after a person has been exposed). This is primarily how the shot is used now, since the World Health Organization declared smallpox eliminated in 1980.

Usually, the vaccine is only given to people who had close contact with an infected individual, ideally within four days to prevent the disease and within 14 days to minimize symptoms.

The standard approach in monkeypox outbreaks is to isolate the infected individuals and vaccinate everyone around them who’s had contact with an infected person. Epidemiologists call this strategy “ring vaccination,” and it’s known to be an effective way to stop outbreaks before they can start.

Demand for the vaccine is now reaching a point where it exceeds the supply, but U.S. health officials plan to release another 1.6 million doses in the coming months, according to NPR. Testing availability has also expanded. Areas with a growing number of cases, like New York, have been offering the vaccine to individuals who are at a higher risk for contracting the virus, like health care workers and people who had multiple sexual partners in the past few weeks.

Right now, it depends on government leaders and the public. Many experts fear that the U.S. is losing the opportunity to get the virus under control.

“We’re now at the cusp of this becoming an endemic virus, where this now becomes something that’s persistent that we need to continue to deal with,” Scott Gottlieb, the former commissioner of the Food and Drug Administration, said earlier this month. “I think the window for getting control of this and containing it probably has closed. And, if it hasn’t closed, it’s certainly starting to close.”

Following the WHO’s declaration, the Biden administration is considering whether to declare monkeypox a U.S. health emergency. Nearly 3,000 Americans (and counting) have been infected.

The good news is that there are prevention measures people can take to help get the outbreak under control and protect themselves. People should avoid close contact or sharing utensils, bedding, drinks and other personal materials with people who have monkeypox-like rashes or who have a known exposure to the virus. You should also wash your hands frequently. If you believe you’ve been exposed or are infected, isolate at home and contact your health care provider for information on treatment.

But it will take more than just personal habits to make a difference. Access to testing, vaccines and a targeted public health approach that educates people will be necessary. Dr. Preeti Malani, an infectious disease specialist at the University of Michigan, told NPR that containment still needs to be the goal of health officials and the public.

“What we do in the coming days and weeks will really determine where we are a few months from now,” Malani said.

We don’t have to let what happened with COVID ― where many gave up trying to prevent the spread ― occur with monkeypox.

This article has been updated with the latest developments. The information in this story is what was known or available as of publication, but guidance can change as health officials learn more about the outbreak. Please check the Centers for Disease Control and Prevention for the most updated recommendations.