Unfortunately, as with any piece of health news, there are lots of social media posts, articles, and opinions. The purpose here is to set the record straight and hopefully be concise and informative for my readers. So here it goes:
WHAT THE HECK IS "MONKEYPOX"?
No, it does not come from monkeys and the planet of the apes will not become a reality. Stop it.
Monkeypox is a viral zoonotic infection that results in a rash similar to smallpox. It is an orthopoxvirus that is in the same genus as variola (causative agent of smallpox) and vaccinia viruses (virus used in smallpox vaccine).
TELL ME A LITTLE MORE ABOUT THIS LITTLE GUY...
Monkeypox was first isolated in Denmark in the late 1950s from a colony of monkeys from Singapore that were going to be used for polio virus research. In the decades that followed, there were more outbreaks in lab animals in the US. The first disease in humans was identified in 1970s in the Democratic Republic of the Congo.
Since the discontinuation of smallpox immunization, which does protect against monkeypox, most cases have occurred in Central and West Africa. In the US, the first cases were seen in 2003. Since that time, there were a few cases popping up here and there which were mostly due to travel.
SO...WHAT IS ALL THE EXCITEMENT ABOUT?
Between 2018 and 2021, 7 cases were diagnosed in the United Kingdom. 4 of these cases were related to travel to endemic countries and 2 cases resulted from household transmission from one of the travelers and 1 health care worker acquired it through contact.
Fast forward to 2022. Let’s go to Europe where we see the reported case. By July 2023 World Health Organization (WHO) declared a public health emergency of international concern. Thousands of confirmed cases in dozens of countries were reported.
HOW DO WE GET INFECTED?
Once lesions are scabbed over and new tissue is being produced, the infectivity risk is reduced.
WHAT ARE THE SIGNS OF ACUTE INFECTION?
Every bug likes to “cook” for a bit in the human body – otherwise known as incubation period. This is the time period from exposure to onset of symptoms. Monkeypox ranges from 5-13 days but can also range 4-21 days.
WHO IS AT MOST RISK FOR INFECTION AND POOR PROGNOSIS?**Immunocompromised individuals. These include anyone with history of active cancer, on active chemotherapy, taking medications that suppress their immune system.
RISK OF DEATH?
Very low, especially in the US. Hospitalizations occurred due to pain control, secondary infections, and had favorable outcomes.
WHEN SHOULD AN INFECTION BE SUSPECTED?
Rash WITH other symptoms AND exposure history. Since this virus is transmitted through close human contact with respiratory secretions, any genital lesions with exposure history must be investigated.
WHAT LAB TESTS SHOULD BE ORDERED?
Viral testing – Polymerase chain reaction (PCR) test. Skin lesions or abscesses can be cultured as well. Throat swabs are available but not used to confirm diagnosis.
HOW CAN WE PREVENT THIS?
Isolation and standard precautions. PPE use in health care settings helps spread of the virus in the hospital.
ANY TREATMENT OPTIONS?
No Ivermectin please. Tecovirimat is the first antiviral indicated for the treatment of smallpox that was approved in 2018. Brincidofovir, analog of cidofovir, was approved in US 2021. Both of these agents are not available for commercial sale.
Vaccination for smallpox eradicated this from the world. Now with growing cases of Monkeypox, vaccinations are starting again. But again, these are not readily available at this time. US has 2 vaccines in its stockpiles: JYNNEOS and ACAM2000. CDC does not recommend widespread vaccination against monkeypox at this time
Here is a list of phone numbers for KS health departments:
Currently, no widespread vaccination programs in MO and KS, but both states have stored vaccines.
Please review CDC website for more information.
"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."