How do you catch monkeypox?
Until this global epidemic, monkeypox was usually spread by infected rodents – including rats, mice and even squirrels – in West and Central Africa.
Humans can catch the disease – which belongs to the same family as smallpox – if they are bitten by infected animals, touch their blood, body fluids or scabs, or eat wild game or bushmeat.
The orthopoxvirus, which causes monkeypox, can enter the body through broken skin, even if it is not visible, as well as through the eyes, nose and mouth.
Although mainly spread by wild animals, monkeypox was known to be transmitted between people. However, health chiefs insist it was very rare until the current outbreak.
Human-to-human spread can occur if someone touches the clothing or bedding used by an infected person, or by direct contact with telltale scabs of the virus. The virus can also be spread through coughing and sneezing.
In the continuing rise in cases, experts believe the virus passes through skin-to-skin contact during sex – although this exact mechanism has never been observed until now.
How deadly is it?
Monkeypox is usually mild, with most patients recovering within weeks without treatment.
However, the disease kills up to 10% of cases. But that high rate is believed to be partly due to a historic lack of testing, meaning a tenth of known cases have died rather than a tenth of all infections.
However, with milder strains the death rate is closer to one in 100 – like when Covid first hit.
The West African version of the virus, which is mild compared to the Central African strain, is causing the current spread. No deaths have been reported in the ongoing outbreak.
How is it tested?
Diagnosing monkeypox can be difficult because it is often confused with other infections such as chickenpox.
But when a case is suspected, doctors send samples to their local health authorities to be tested for orthopox viruses – the family of viruses that includes monkeypox and smallpox. If the result is positive, the sample is then sent to the Centers for Disease Control and Prevention (CDC) or a private laboratory for confirmatory testing.
The test involves taking samples of skin lesions, such as part of the scab, fluid leaking from it, or pieces of dry scabs.
What are the symptoms?
It can take up to three weeks for patients infected with monkeypox to develop any of its telltale symptoms.
Early signs of the virus include fever, headache, muscle aches, back pain, swollen lymph nodes, chills and exhaustion, meaning he could, in theory, be mistaken with other common illnesses.
But its most unusual feature is a rash that often starts on the face and then spreads to other parts of the body, usually the hands and feet.
The rash changes and goes through different stages before finally forming a scab, which later falls off.
How long is a person contagious?
An individual is contagious from the time their rash appears until all scabs have fallen off and there is intact skin underneath.
The scabs may also contain infectious viral material.
The infectious period is thought to last three weeks but can vary from individual to individual.
What should I do if I have symptoms?
The CDC advises anyone with an unexplained rash or other warning sign to contact their healthcare provider for a medical evaluation and testing for monkeypox. Anyone without insurance should go to a public health clinic.
Suspected patients should also avoid close contact – including sex or intimate relationships – with others, they add.
When visiting a clinic, it is also advisable to wear a mask and remind the healthcare professional that the virus is circulating in the area. Gay and bisexual men have been asked to be particularly alert to symptoms as most cases have been detected in men who have sex with men.
What is monkey pox?
Monkeypox was first discovered when an outbreak of a smallpox-like disease occurred in monkeys kept for research in 1958.
The first human case was recorded in 1970 in the Democratic Republic of the Congo and the infection has been reported in a number of countries in West and Central Africa since then.
Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent.
The UK, US, Israel and Singapore are the only countries to have detected the virus before May 2022.
But as testing increased globally, cases were quickly detected in other countries – including the first case in the United States in May in a man who had recently returned from Canada by car.
Monkeypox is a rare viral infection that kills up to one in ten infected people but does not spread easily between people. The tropical disease is endemic to parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)
Nurses and doctors are advised to stay ‘watchful’ for patients who have a new rash or scabbed lesions (as above)
Is it related to chickenpox?
Although it causes a similar rash, chickenpox is not related to monkeypox.
The infection, which usually strikes children, is caused by the varicella zoster virus.
For comparison, monkeypox – like smallpox – is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.
Are young people more vulnerable?
According to the World Health Organization, Americans under the age of 50 may be more susceptible to monkeypox.
This is because American children routinely received the smallpox vaccine, which protects against monkeypox, until 1972. The program was discontinued after smallpox was eradicated.
The WHO also warns that the death rate has been higher in young children.
Does it spread as easily as Covid?
Leading experts insist we won’t see Covid-like levels of transmission during the monkeypox outbreak.
A World Health Organization report last year suggested that the natural R-rate of the virus – the number of people each patient would infect if they were living normally while sick – is two.
This is lower than the original Wuhan variant of Covid and about a third of the R rate of the Indian “Delta” strain.
But the true rate is likely much lower because “distinctive symptoms greatly facilitate its early detection and containment,” the team said, meaning cases are easy to spot and isolate.
Covid is mainly transmitted through droplets that an infected person releases each time they breathe, speak, cough or sneeze.
There are a handful of antivirals and smallpox therapies that seem to work on monkeypox, including the drug tecovirimat or TPOXX, which was approved for monkeypox in the United States in August.
Is there a vaccine against this?
The smallpox vaccine, called Imvanex in the UK and Jynneos in the US, can protect against monkeypox because the viruses that cause the disease are closely related.
Data shows it prevents about 85% of cases and has been used in the United States since 2019.
The vaccine, which is estimated to cost $24.16 per dose, contains a live modified vaccinia virus, which resembles both smallpox and monkeypox but does not cause disease in humans.
Due to its similarity to pox viruses, antibodies produced against this virus provide cross-protection.
Are there medications to treat it?
There are a handful of antivirals and smallpox therapies that seem to work on monkeypox.
This includes the drug tecovirimat – also known as TPOXX – which was approved for use against monkeypox in the United States in August.
Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus in the body.
An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).
It also works by stopping the growth of the virus.
Gay and bisexual men have less sex because they fear getting monkeypox