Monkeypox Outbreak Hype or Hazard

Is monkeypox really something that you have to be worried about?

Monkeypox

Cases of monkeypox are typically found in Central and West Africa, including Cameroon, Central African Republic, Democratic Republic of Congo, and Nigeria, where there have been over 1,300 cases this year.

Although monkeypox clinically resembles smallpox, fortunately, monkeypox is less contagious and typically causes less severe disease. In fact, it is usually a self-limiting disease, going away without treatment, although it can be deadly.

“Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding. The incubation period of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.”
Multi-country monkeypox outbreak in non-endemic countries

Unlike smallpox, monkeypox is a viral zoonotic disease – it is transmitted through close contact with an infected animal, including rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species.

“Since 13 May 2022, cases of monkeypox have been reported to WHO from 12 Member States that are not endemic for monkeypox virus, across three WHO regions. Epidemiological investigations are ongoing, however, reported cases thus far have no established travel links to endemic areas. Based on currently available information, cases have mainly but not exclusively been identified amongst men who have sex with men (MSM) seeking care in primary care and sexual health clinics.”
Multi-country monkeypox outbreak in non-endemic countries

Contact with an infected person can also transmit monkeypox, although again, it is less contagious than smallpox.

As of 21 May 2022, 12 countries have reported monkeypox cases: Australia, Belgium, Canada, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, the United Kingdom, and the United States of America. — As of 21 May 2022, 12 non-endemic countries have reported monkeypox cases: Australia, Belgium, Canada, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, the United Kingdom, and the United States of America.

If you do develop monkeypox, you will likely develop fever, chills, lymphadenopathy and a characteristic rash, which according to the CDC “involves vesicles or pustules that are deep-seated, firm or hard, and well-circumscribed; the lesions may umbilicate or become confluent and progress over time to scabs.”

Wait, that kind of sounds like chickenpox, doesn’t it?

Monkeypox vs Chickenpox

If you develop these symptoms, how will you know you don’t simply have chickenpox or another disease?

“The rash associated with monkeypox can be confused with other diseases that are encountered in clinical practice (e.g., secondary syphilis, herpes, chancroid, and varicella zoster). However, a high index of suspicion for monkeypox is warranted when evaluating people with a characteristic rash, particularly for men who report sexual contact with other men and who present with lesions in the genital/perianal area or for individuals reporting a significant travel history in the month before illness onset or contact with a suspected or confirmed case of monkeypox.”
2022 United States Monkeypox Case

Are you immune to chickenpox (previous disease or fully vaccinated)?

Unlike with monkeypox, different stages of lesions (macules, pustules, crusts, etc.) are found together when you have chickenpox (like this child).

Do you have other risk factors for monkeypox, which seems to be spreading as a sexually transmitted disease in this outbreak?

“Clinical diagnosis of MPX based on rash examination during the early macule and papule stages can be challenging. Key differences between MPX and VZV disease presentation at symptom onset and during illness progression can help to establish a presumptive diagnosis.”
A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo

If you still aren’t sure if you have monkeypox or chickenpox, remember that:

unlike chickenpox, folks with monkeypox typically have a high fever for several days before they develop a rash
lymphadenpathy is more common with monkeypox
you are more likely to develop lesions on the palms of your hands and soles of your feet if you have monkeypox
chickenpox lesions are typically superficial and rapidly crust, while monkeypox lesions are “firm, deep-seated, well-circumscribed with a central point of umbilication”
different stages of chickenpox lesions (macules, pustules, crusts, etc.) are found together, while monkeypox lesions will all be in the same stage of development on any one site of the body

Your health care provider can also test you if they think that you might have monkeypox.

What to Do if You Are Exposed to Monkeypox?

What if you have been exposed to monkeypox?

“Vaccination after exposure to monkeypox virus is still possible. However, the sooner an exposed person gets the vaccine, the better.”
Monkeypox and Smallpox Vaccine Guidance

In addition to being quarantined, you can get a smallpox vaccine after being exposed to monkeypox to prevent you from getting sick (if vaccine given within 4 days of exposure) or reduce your symptoms (if vaccine given between 4 and 14 days of exposure).

Do you have a vaccine scar on your arm? Photo by Earl Hershfield

What if you have previously been vaccinated against smallpox?

“Persons exposed to monkeypox virus and who have not received the smallpox vaccine within the last 3 years, should consider getting vaccinated.”
Monkeypox and Smallpox Vaccine Guidance

You may have some protection, although if you didn’t get a recent, more modern smallpox vaccine, then you should likely get revaccinated if you are exposed to monkeypox.

Monkeypox Conspiracy Theories

Again, we don’t know what is causing the monkeypox outbreaks, but of course, that isn’t keeping the usual suspects from blaming vaccines…

In addition to Alex Jones saying that covid vaccines are causing the monkeypox outbreak, Rep. Marjorie Taylor Greene (R-Georgia) claims ‘they’ are going to use monkeypox to scare you into wearing a mask and that Bill Gates is going to use it to “make a lot of money.”