Monkeypox: Everything You Need to Know

Medically Reviewed By Karen Gill, M.D.
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Monkeypox is a rare disease caused by the monkeypox virus. Symptoms are similar to those of smallpox but not as severe. Monkeypox mostly occurs in Africa, although cases have been reported in other parts of the world. Scientists first identified monkeypox in monkeys in 1958. Human cases of the disease did not occur in the United States until 2003.

Monkeypox typically spreads between animals and humans, usually when somebody is bitten by an infected animal. It can also spread from human-to-human contact, but this is rare.

Read on to learn more about monkeypox. This guide includes information about symptoms, causes, treatments, and more.

Quick facts about monkeypox

  • Monkeypox is a rare disease caused by the monkeypox virus.
  • Symptoms are similar to those of smallpox, only milder.
  • It typically occurs in tropical rainforest areas of central and West Africa.
  • Only a handful of monkeypox cases have been reported in the U.S. since 2003.
  • Transmission usually happens when an infected animal bites a human.
  • There is currently no specific monkeypox treatment, but a vaccine has been approved in case of an outbreak.

What is monkeypox?

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Human monkeypox is a zoonotic viral disease, which means that it is transmitted from animal to human. It is caused by the monkeypox virus.

Monkeypox produces symptoms similar to those of smallpox, but they are not as severe. Cases mostly occur in tropical rainforest areas of central and West Africa, but a few cases have been reported over the years in the U.S. and Europe.

The disease has been recorded as far back as 1958, when scientists discovered it among monkeys called cynomolgus macaques. Although the name suggests that the disease is transmitted only by monkeys, it is possible to contract monkeypox through other infected animals, such as squirrels or rats.

The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC).

Is monkeypox deadly?

Monkeypox can be a deadly disease, with a fatality rate of around 11%. The number of deaths is higher among young children.

Vs. smallpox

Monkeypox is caused by the monkeypox virus, which belongs to the Orthopoxvirus genus. The variola virus belongs to the same genus and is responsible for smallpox.

Symptoms of monkeypox and smallpox are similar. They can include fever, headache, rashes, and scabs. Symptoms of monkeypox tend to be milder than symptoms of smallpox, and you may experience swollen lymph nodes with monkeypox.

The World Health Organization (WHO) declared smallpox eradicated in 1980. However, there are still reported cases of monkeypox, typically in parts of Africa.

Learn more about smallpox.

Who can get monkeypox?

Any person who has been bitten by an animal infected with monkeypox can contract the disease. However, it is more prevalent in certain parts of the world, namely countries in central and West Africa.

The first reported case in a human was in a 9-year-old boy in the DRC. Children can get monkeypox and may be more likely to die from the disease than adults.

However, anybody under the age of 40 or 50 may also be susceptible to monkeypox.

Monkeypox typically occurs in Africa. Since 1970, cases of monkeypox have been reported in the following African countries:

  • Benin
  • Cameroon
  • Central African Republic
  • DRC
  • Gabon
  • Ivory Coast
  • Liberia
  • Nigeria
  • Republic of the Congo
  • Sierra Leone
  • South Sudan

It is important to be aware of any potential risks surrounding infected animals when you are traveling to any of these countries.

Monkeypox in the United States

It is rare for a person in the U.S. to contract monkeypox, and when it does occur, it is typically imported. In 2021, there were two reports of monkeypox in the U.S. The Texas Department of Health and Maryland Department of Health reported cases of monkeypox in July and November respectively.

Prior to this, there were 47 cases of monkeypox in the U.S. in 2003. These were located in Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin. This occurred due to contact with pet prairie dogs, and this was the first time that monkeypox had been reported outside of Africa.

What are the symptoms of monkeypox?

Symptoms of monkeypox are similar to those of smallpox, only milder. One main difference is that monkeypox affects the lymph nodes, whereas smallpox typically does not.

Initial symptoms of monkeypox include:

Around 1–3 days after the appearance of fever, you will experience a rash. This typically begins on the face and then spreads to other areas of the body.

The rash will turn into skin lesions. These will go through various stages before falling off. These stages are as follows:

  • macules, which is a discolored area of skin
  • papules, which looks like a small bump on the skin
  • vesicles, which resemble blisters
  • pustules, which is a bump filled with white pus
  • scabs, which forms during healing before falling off

Symptoms of monkeypox typically last around 2–3 weeks. However, this can range anywhere from 7–21 days.

Is there a monkeypox vaccine?

There is no monkeypox vaccine currently administered to the general public. However, in the event of a breakout in the U.S., the Food and Drug Administration (FDA) has licensed the vaccine JYNNEOS to protect against smallpox and monkeypox. Previous data from Africa suggests that the smallpox vaccine is around 85% effective in guarding against monkeypox.

If there is an outbreak of monkeypox in the U.S., the Centers for Disease Control and Prevention (CDC) will advise on who can receive the vaccine.

How is monkeypox treated?

Currently, there is no treatment for monkeypox. In the event of an outbreak, the CDC will advise on administering smallpox vaccines, which can help to protect against monkeypox.

However, in most cases of monkeypox, treatment typically involves isolation while the disease runs its course. It is advisable that anybody who has been infected also avoids immunocompromised persons until all crusted lesions are gone.

What causes monkeypox?

Monkeypox is caused by the monkeypox virus, which is part of the Orthopoxvirus genus. Variola virus, which causes smallpox, is also part of this genus. It spreads among animals and occurs in humans when they are bitten by an infected animal.

How is monkeypox transmitted?

Monkeypox is typically transmitted from animals to humans. However, it is also possible for human-to-human transmission to occur, as well as transmission via contact with contaminated materials.

Animal-to-human transmission can occur when an infected animal bites or scratches you. You may also contract the virus when preparing bushmeat, or by having direct contact with body fluids.

Human-to-human contact can occur through large respiratory droplets, such as a breath, cough, or sneeze. These particles cannot travel more than a few feet, so contact needs to be close.

The monkeypox virus can enter your system through broken skin, the respiratory tract, or mucous membranes such as the eyes, nose, or mouth.

The main carrier of the disease is not known. However, researchers believe that African rodents are partly responsible for transmission.

How is monkeypox diagnosed?

If a doctor suspects that you are experiencing symptoms of monkeypox, they are required to collect a sample and transport it to a laboratory. It will then be tested to either rule out or confirm the virus.

Polymerase chain reaction is the most accurate way to test for monkeypox, so the sample will most likely be from a skin lesion, such as dry crust or fluid from a pustule.

In order to reach a diagnosis of monkeypox, your doctor will need the following information:

  • when you first experienced the fever
  • when you first noticed the rash
  • the date that the sample was collected
  • what stage of the condition you are currently at, such as the progress of lesions

This information will help your doctor determine whether your symptoms are running the natural course of monkeypox.

To ensure an accurate diagnosis, your doctor will examine you, and they may also run tests to rule out conditions with similar symptoms. These can include:

Lymphadenopathy, or swollen lymph nodes, is the main way to differentiate between smallpox and monkeypox, particularly in the early stages.

Is it possible to prevent monkeypox?

If you travel to an area where monkeypox is reported, it may be possible to prevent monkeypox. Steps you can take include:

  • avoiding contact with any animal that might be carrying the virus
  • avoiding contact with any bedding or other materials that an infected animal or human has been in contact with
  • washing your hands with soap and water or using alcohol-based sanitizer

If you are caring for people with monkeypox, you should

  • always wash your hands after contact
  • wear proper personal protective equipment, such as gloves and face masks
  • keep people who have contracted monkeypox separate from people who do not have monkeypox

What are the complications of monkeypox?

If you have contracted monkeypox, you may experience complications. These can include:

Summary

Monkeypox is a rare disease that typically occurs in central and West Africa. Only a few cases of monkeypox have been reported in the U.S. since the condition was first discovered in 1958.

Animals tend to transmit monkeypox to humans, either by biting or scratching them. Human-to-human transmission and transmission through contaminated materials are also possible, but these are less frequent.

Although a vaccine is available in case an outbreak of the disease occurs, there is currently no treatment for monkeypox. If you have the disease, you will remain in isolation while it runs its course. This typically lasts for around 2–3 weeks, during which time you may experience fever, headaches, swollen lymph nodes, a rash, and skin lesions.

Contact your doctor if you are experiencing symptoms of monkeypox. Be sure to mention if you have traveled recently, particularly if you have visited a country where monkeypox is more likely to occur.

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Medical Reviewer: Karen Gill, M.D.
Last Review Date: 2022 Apr 13
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