What is Monkeypox?
Monkeypox is a zoonotic virus (a virus that can be transmitted from animals to humans and vice-versa) that is symptomatically similar to smallpox, though typically less severe. Some rodents (for example: rats and dormice) and non-human primates can be carriers of the virus. Through a scratch, bite or other contact, the virus can cross from one species to another and infect human beings. Transmission can also occur from humans to humans. Most cases of monkeypox are not fatal, but about 3-6% are. The disease can be painful and can, in some cases, leave long-term complications for those infected.
How is it contracted?
Between human beings, transmission can occur through two pathways: close contact with respiratory secretions (droplets in the breath) or close contact with the lesions caused by the virus (rashes and bumps) or the secretions of those lesions.
Methods of transmission:
*Close face-to-face contact
*Contact with the blood or bodily fluids
*Contact with mucosal lesions (rash in the mouth, vagina or anus)
*Physical contact with items that have been contaminated (for example: unwashed towels, bedding or clothing)
*Pregnant people infected can transmit the virus to a fetus through the placenta
This virus is very easily spread within households. People infected with monkeypox can spread the virus for 2-4 weeks from the first on-set of symptoms until their rash subsides and a new layer of skin has formed over all affected areas. Monkeypox is a self-limited disease, meaning that without treatment, it will resolve, but those infected by this virus should seek clinical care to alleviate symptoms, manage potential complications and prevent possible long-term effects of the disease.
What are the symptoms?
After an incubation period of 5-21 days (typically 6-13), the first set of symptoms appear:
*Swelling of the lymph nodes
*Back pain and muscle aches
*Extreme fatigue or lack of energy
Usually within 1-3 days of developing a fever, a rash begins to appear. The rash changes from flat to raised and fluid-filled, eventually crusting over. During all stages of this rash, a person remains contagious. Rashes most often appear on the face, hands and feet of those infected, but they can also appear in the mouth and throat, on,in and around genitalia and the anus, and even on and around the eyes. (Those with rashes near the eyes should seek care immediately.) These lesions can be painful and can sometimes cause scarring.
Prevention of Monkeypox
Though the smallpox vaccine has been shown to give considerable protection against monkeypox as well, most people in the United States under 50 years of age have never gotten one of those, and those over 50 that did get one, probably got that in the 1970s or earlier, too long ago to still have immunity. There is not broad immunity for this disease in America right now, so any communities where it appears will have transmission.
It is 2022. We all know some prevention strategies to broadly help mitigate infection risk. Simple things like hand-washing and using alcohol-based sanitizer continue to be helpful. Wearing masks in places where you will be within 6 feet of someone for a prolonged period of time also remains helpful, and anyone with a fever should be staying home. More specifically for monkeypox, do not physically touch someone with a rash or scabs resembling monkeypox lesions or someone known to be currently infected by the virus. Don’t handle clothing, towels or bedding that has come into contact with someone infected with monkeypox or share cups or utensils.
There are two vaccines licensed by the FDA available for preventing monkeypox infection, JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000. In the United States, there is currently a limited supply of JYNNEOS, although more is expected in the coming weeks and months. There is an ample supply of ACAM2000, but this vaccine should not be used in people who have some health conditions, including weakened immune systems, eczema or pregnancy.
In our area, the Richmond City and Henrico County Health Districts are currently distributing vaccines as post-exposure prophylaxis to those that have close contact with someone with a confirmed monkeypox case. They also are opening up vaccination to those groups most profoundly affected by the virus at this time: gay and bisexual men, and non-binary people assigned male at birth and transgender women that have sex with men, as well as those engaged in sex-work and staff at establishments where sex occurs. (This is the specific terminology used on their website.) It is important to note that though the queer communty is currently the group most affected by the virus, it is not “a queer virus,” in the same way that Covid was not “a Chinese virus.” The recent labeling of it as such is an attempt by some to attach unwarranted stigma and blame, and will not only harm gay, bisexual and queer people, as was the case in the early days of Corona when some stoked anti-Asian sentiment and encouraged violence towards those in that community, but will also actively hinder public health strategies at large. Disinformation, stigma and fear will not help us find a path through this.
Individuals in the Richmond/Henrico area seeking the monkeypox vaccine can call 804-205-3501 or visit rhhd.gov/monkeypoxvax
You can find a press release from the Virginia Dept of Health on the vaccine roll-out here: