Monkeypox: Symptoms, Causes, Treatment And Prevention

Have you noticed fever with pus-filled bumps on your body that eventually crust and fall off? Before noticing these symptoms, did you travel to western or central Africa, such as Nigeria or the Democratic Republic of the Congo? Have you had contact with a wild animal that was imported from Africa? Have you come into contact with someone with similar bumps to yours? If so, you may have an infection called monkeypox. Read on to learn more about monkeypox causes, symptoms, diagnosis, and treatment.

What Is Monkeypox?

Monkeypox is a health condition from the monkeypox virus, which is related to smallpox and cowpox viruses. The first case of monkeypox was in – you guessed it – monkeys. Today the virus is thought to be carried by small rodents and squirrels. There are two types of monkeypox virus: The West African strain and the Congo Basin strain.

The monkeypox virus causes a rash with raised bumps, similar to the rash seen with smallpox. Monkeypox infection usually begins with certain symptoms before the rash starts, like:

Fever
Headache
Muscle aches
Swollen lymph node

You can get monkeypox if an infected animal scratches or bites you or come into direct contact with an infected animal’s bodily fluids, blood, or rash. You can also get monkeypox from an infected person if you touch their rash or breathe in droplets from their cough or sneeze.

Monkeypox In the News

Monkeypox is endemic in parts of West and Central Africa, which means there are always some cases there. This is similar to how the flu is endemic in the US. Monkeypox can spread to other countries by infected travelers or shipping infected animals. The most recent outbreak began on May 7, 2022, when the World Health Organization was informed of a confirmed case of monkeypox in the United Kingdom. Monkeypox has since spread to several countries, including Australia, Canada, France, Germany, and the US.

There has been an outbreak of monkeypox outside of Africa before. In 2003, there was an outbreak of monkeypox in six states in the midwest US, and 47 people were infected. This outbreak was due to importing 800 pet prairie dogs from Ghana, several of which carried the monkeypox virus. Public health departments in the US contained this outbreak using several measures, including banning the importation of certain foreign animals, tracking potentially infected animals, and using smallpox vaccination and antiviral treatment.

There were also two cases of monkeypox in the US in 2021, both in people who had recently traveled to Nigeria.

Risk Factors

The virus can spread through contact with body fluids, skin, and respiratory droplets. Therefore, some people are more likely to get monkeypox than others, including:

People who have recently traveled to certain areas of Africa
People who work in health care
Men who have sex with men (MSM)

However, regardless of your travel history, occupation, or sexual orientation, if you have come into contact with someone who has monkeypox, you are at risk of getting it.

Signs and Symptoms of Monkeypox

If you have monkeypox, you may have the following symptoms:

Fever
Headache
Muscle aches
Backache
Swollen lymph nodes
Chills
Exhaustion
Rash

The time between getting infected with the virus and having symptoms can be as short as five days and as long as 21 days. Usually, you get a rash one to three days after developing a fever. This rash has itchy bumps all over the body, including the palms of your hands and the soles of your feet. It starts on your face and then spreads to other body parts. Nearly everyone who gets monkeypox also get fever and rash.

The symptoms of monkeypox are very similar to those of smallpox, except that you can have swollen lymph nodes with monkeypox, which you won’t get with smallpox.

Diagnostic Tests

To diagnose monkeypox doctors use skin samples and blood cultures. If your doctor suspects you have monkeypox, they will take a sample of one of the bumps on your skin and send it to a lab for review under a microscope. Your doctor may also get a blood sample from you and send it to a lab to see if the monkeypox virus is in your blood. Your doctor may also run other diagnostic tests if they think you may have another similar diagnosis.

Preventing Monkeypox

There are a few ways you can avoid getting monkeypox:

Avoid contact with infected animals
Avoid contact with materials like bedding contaminated with the monkeypox virus
Wash your hands with soap and water after coming into contact with an infected animal
Thoroughly cook all animal meat
Avoid contact with people who might have monkeypox
Use personal protective equipment when taking care of people who have monkeypox

You can also reduce your likelihood of infection by getting a vaccine against smallpox. The smallpox vaccine is highly effective against monkeypox. While the general public is no longer getting vaccines against this disease, the CDC might recommend that you get the smallpox vaccine if your job requires you to work closely with the monkeypox virus, like if you work in a lab with infected animals.

If you have already been exposed to monkeypox, you should still get vaccinated, and the sooner you get vaccinated, the better. The CDC recommends getting vaccinated within four days of monkeypox exposure to prevent the disease.

Treatments

There are no specific treatments for monkeypox infections. This virus is rare, and most cases are mild. Treatment involves symptomatic management while your body fights off the virus.

Whether you’re recovering from monkeypox at home or in the hospital, you should be isolated from other people until the bumps on your skin completely heal. Most people who get monkeypox have mild symptoms, so if you get this disease, you should expect to recover over two to four weeks without treatment. Your doctor will monitor you to make sure you get better. However, some groups of people are more likely to have serious disease:

People that have severe health conditions before they get monkeypox
People with weak immune systems, such as those with HIV/AIDS or cancer
Kids, especially those younger than eight years old
Pregnant or breastfeeding people
People who get monkeypox in their eyes, mouth, genitals, or anus

Treatment Options

Although most people recover within a couple of weeks without treatment, based on your specific case, your doctor may recommend one of the following treatments:

Vaccine: If you have been exposed to the monkeypox virus, you should get the smallpox vaccine, which could prevent you from getting monkeypox if treated early enough. The CDC recommends getting vaccinated within four days of exposure to avoid getting the condition. If you get vaccinated four to 14 days after exposure, your symptoms may not be as severe, but the vaccine may not be able to prevent you from getting monkeypox.
Antivirals: There are no specific monkeypox treatments, but some antivirals may be used to manage monkeypox infection. Your doctor might treat you with tecovirimat and cidofovir, antivirals developed for other viruses but available during an outbreak for treatment of monkeypox.
Antibodies: Vaccinia immune globulin intravenous (VIGIV) might also be used to treat your monkeypox. VIGIV is a collection of antibodies from people who received the smallpox vaccine and donated blood. There is no data to suggest how effective VIGIV is in treating monkeypox. However, your doctor may use it if you cannot receive a smallpox vaccination because you have a weak immune system.

Next Steps

Talk to your doctor about your symptoms if you think you have monkeypox. Your doctor will isolate you if you’re hospitalized to ensure you don’t infect other people. If you stay at home while recovering from monkeypox, you should self-isolate. While you will likely recover without treatment, you may be treated with antivirals if your case of monkeypox becomes severe. If you have further questions about monkeypox, ask your doctor for more information.

Resource Links:

“Monkeypox” via CDC
“Multi-country monkeypox outbreak in non-endemic countries” via WHO
“Monkeypox” via Cleveland Clinic
“Monkeypox – United Kingdom of Great Britain and Northern Ireland” via WHO
“Press release: UKHSA latest findings into monkeypox outbreak” via UKHSA
“Monkeypox” via https://www.ncbi.nlm.nih.gov/books/NBK574519/
“CDC issues new guidance on monkeypox symptoms as US cases balloon” via NBC News