Monkeypox poses a concern for those in the public health and medical field. The spread of the disease raises questions regarding infection rates, treatment, and prevention. As a result, global, national, and local health organizations are gathering all the information they can to help protect people from being diagnosed with monkeypox.
Furthermore, the World Health Organization (WHO) will rename monkeypox to reflect current standards for naming diseases.
Monkeypox is a virus transmitted from animals to humans. The symptoms of monkeypox are similar to those of smallpox. However, monkeypox symptoms are often less severe than smallpox.
The eradication of smallpox in 1980 meant many countries stopped requiring children to be vaccinated against smallpox. Because of the smallpox vaccine cessation, monkeypox became a concern for public health officials.
Monkeypox Origins
Central and Western Africa are the primary areas where monkeypox outbreaks occur. There are two types of monkeypox strands. Although one of the types of monkeypox viruses originates in central Africa, most cases are reported from the Congo region. The Congo Basin strand has proven to be the more severe of the strands and is thought to be the more infectious of the two.
The first human cases of monkeypox were reported in the Democratic Republic of the Congo in 1970. An infant was diagnosed in a region where the last case of smallpox was in 1968. Since 1970, most outbreaks have been near tropical rainforests and across 11 African countries.
While examining a concurrent outbreak of monkeypox with a higher attack rate and chickenpox (a different type of virus than monkeypox) in Nigeria during 1996-97, public health officials, scientists, and epidemiologists believe they found the point when the transmission of monkeypox changed. The change allowed the virus to spread further than in previous outbreaks.
Over the years, more people in urban areas, Europe, or the Americas have been diagnosed with the virus. Dr. Daniel Bausch, President of the American Society of Tropical Medicine and Hygiene and Senior Director of Emerging Threats & Global Health Security at FIND, reports that a possible cause of the spread of the virus is people’s desire for exotic pets. Numerous animal species are susceptible to monkeypox, including rope squirrels, tree squirrels, Gambian pouched rats, non-human primates, and other species. When people bring an animal sensitive to monkeypox into their home, they risk becoming infected.
Transmission
Non-human Transmission
The initial origin or source of monkeypox is yet to be determined. Some experts believe rodents are carriers of monkeypox. Other potential sources of monkeypox are:
Animals. Animals can spread monkeypox to humans when people directly contact an infected animal’s bodily fluids, blood, or lesions. For more information about how to care for and protect your pet follow the CDC’s guidelines.
Food. Inadequately cooked animal products or meat from infected animals could increase the risk of infection.
Geography. People who live in or near forests may come into contact with an infected animal.
Human Transmission
Public health and other health officials believe human-to-human infection occurs when people are in close contact with:
Signs of Monkeypox Infection
The onset of monkeypox symptoms can range from 5 to 21 days after infection. A person diagnosed with monkeypox will experience symptoms for approximately two to four weeks. During that time, they will experience two phases.
Invasion period. Once the incubation period ends, the first signs of the virus begin to appear. People will experience these symptoms up to five days after their symptoms appear
Skin eruption period. One to three days after a fever begins, a rash will appear. Most people have a rash on their face, arms, hands, feet, or legs. The rash can also affect the mouth, genitalia, inner eyelid, or cornea. As the rash evolves, its appearance goes from flat to slightly raised lesions to lesions with a clear fluid to lesions with yellow liquid to crusts that eventually dry and fall off.
Severe cases of monkeypox most often occur in children due to their exposure or in those with underlying health issues like immune deficiencies.
Isolation and Prevention
Isolation
While experiencing any symptoms (fever, respiratory symptoms – sore throat, cough, nasal congestion), stay home or away from others. People should avoid close contact with people and animals. Lesions should be covered, and a mask worn when close to others. Additionally, don’t share utensils, cups, or clothes.
The Centers for Disease Control and Prevention (CDC) recommended that those infected with monkeypox isolate themselves while they’re ill. However, the CDC acknowledges that for some, isolation isn’t possible.
Prevention
People can decrease the risk of becoming infected if they take the necessary precautions outlined by the CDC and the World Health Organization (WHO).
Disinfecting the Home
A person with monkeypox comes into contact with several objects throughout the day, even in isolation. As a result, the virus can remain in linens, clothing, and other surfaces for several days to months. Therefore, the following steps must be taken to prevent the spread of the virus.
Disinfectant
An EPA-registered disinfectant is an effective way to disinfect the home or other non-healthcare setting. The recommended order to clean and disinfect an area affected by monkeypox is:
The State of Monkeypox
In late July 2022, the WHO declared monkeypox a public health emergency of international concern. A week later, several states in the United States declared monkeypox a public health emergency. Lastly, in the first week of August 2022, President Biden announced monkeypox as a public health emergency.
Declaring monkeypox as a public health emergency allows medical providers and public health officials to coordinate and create an appropriate response system to an outbreak.
A public health emergency declaration also frees up resources (funds), so medical providers can give or distribute vaccinations (smallpox vaccinations help prevent monkeypox), tests for monkeypox, and treatment.
While there isn’t a dedicated monkeypox treatment, smallpox treatments are most effective. As a result, public health officials, researchers, and medical professionals are working towards finding a reliable cure for monkeypox.
Additionally, the Americans with Disabilities Act protects everyone diagnosed with monkeypox. Employers cannot discriminate against or tell others about a person diagnosed with monkeypox.
What Remains Unknown
Monkeypox is a virus gaining global attention, but little is known about how it spreads or who is at a higher risk. So, while public health officials continue to research the risk rates for children, immunocompromised, pregnant, or people with skin issues like eczema, they focus on discovering more about the virus.
What public health and medical professionals warn is to avoid putting yourself at harm or stigmatizing certain groups. The initial infection rate in specific populations may not reflect the overall rates once more is known or more cases are reported. As monkeypox continues to affect the world, medical and public health officials will ensure the general public is kept up to date.
Christina Sisti, DPS, MPH, MS is a bioethicist and health care policy advocate. She works to create awareness and improve health care policy for those with long-term health issues.
This publication was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $160,000 with 100% funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, ACL/HHS or the U.S. government.