Monkeypox questions and answers

The current outbreak of monkeypox is spreading mostly through intimate contact with an infected person. Find out how to prevent infection and what to do if you think you have monkeypox.

The current outbreak of monkeypox is spreading mostly through close, intimate contact with an infected person. Monkeypox had been virtually nonexistent in the United States until earlier this summer. Reported cases surpassed 100 per week in mid-July and 1,000 per week in early August.

We turned to Paul S. Schulz, M.D., infectious diseases physician with Norton Infectious Diseases Specialists and system epidemiologist at Norton Healthcare, for some information on this disease.

“The first thing to know is this is still not a cause for panic,” Dr. Schulz said. “Knowing some basics can help you understand your risk as well as help prevent you from becoming infected. In the current outbreak, most cases of monkeypox have been mild and self-limited, but there are medications for people who become infected.”

What is monkeypox?

Monkeypox is a virus known for causing fever, aches, chills and swollen lymph nodes — followed a few days later by a skin rash of many small fluid-filled spots that then scab over. This rash often starts on the face and spreads to other areas of the body. Monkeypox is related to smallpox, which, thanks to a strong vaccination campaign in the world, was declared eradicated by the World Health Organization in 1980. In the United States, the campaign was so successful that vaccines no longer were given routinely after 1972.

It is called monkeypox because it was first discovered in monkeys. In 1970, the first human case of the virus was found in the Democratic Republic of Congo. Until the current outbreak, most human cases have been in central and western Africa.

How does monkeypox spread?

Monkeypox most often is spread by close, often skin-to-skin contact, with someone who is infected. This can include direct contact with monkeypox rash, scabs or body fluids from a person with monkeypox; touching objects, fabrics (clothing, bedding, or towels) and surfaces that have been used by someone with monkeypox; and contact with respiratory secretions from an infected person.

The virus also can be spread by infected animals, as was the case in 2003 when people in Indiana, Illinois and Wisconsin were sickened by pet prairie dogs.

What are monkeypox symptoms?

It generally takes one to two weeks after exposure to start having symptoms. Initial symptoms are similar to most viral illness such as the flu: fever, headache, back/muscle aches, chills and fatigue. It often also comes with swollen lymph nodes.

A few days after these symptoms begin, a patient will get a rash. In some patients, the rash starts on the face and can spread to other parts of the body. Some patients have had rash primarily in the genital region. The rash starts out looking like small flat spots (macules) that turn into raised spots of less than 1 centimeter (papules) and then fluid-filled sacs (vesicles) before becoming a pus-filled sac similar to a pimple (pustules). These lesions then turn into scabs that fall off. This takes between two and four weeks.

What to do if you think you have monkeypox

Contact your primary care provider or make an appointment with Norton eCare telehealth providers.

What is the treatment for monkeypox?

Most individuals infected with monkeypox have mild disease and recover without medication. For people who have severe disease, or who are risk for severe disease, an antiviral medicine is available.

How sick can I get from monkeypox?

People who are immunocompromised or have existing skin conditions such as eczema are most at risk for severe issues if they get monkeypox. Also, lesions in more sensitive parts of the body, such as eyes, can cause damage. Lesions also can become infected and cause scarring.

The West African type of monkeypox that is currently spreading is rarely deadly. More than 99% of people with this infection are likely to survive, according to the Centers for Disease Control and Prevention (CDC).

Those more likely to become seriously ill or die include those with weakened immune systems, children under age 8, people with a history of eczema, and people who are pregnant or breastfeeding, according to the CDC.

What should I do if I think I have monkeypox?

If you have symptoms, you should contact your medical provider right away. If you do not have a provider, use your free MyNortonChart account to schedule a Norton eCare telehealth visit. If you make an in-person appointment, be sure to wear your mask and inform the staff that you are concerned you may have monkeypox.

Can I prevent monkeypox?

As with other viruses, washing your hands, especially before eating, is very important to prevent infection. If you are around someone who has monkeypox, avoid contact with them, their clothes or bedding. If you are infected, isolate from others until your lesions have healed. When infected people must be around others, they should cover the rash, and anyone over age 2 should wear a mask. Respiratory droplets from coughing or sneezing are thought to carry the virus.

Is there a vaccine for monkeypox?

Jynneos vaccine is a vaccine that is licensed to prevent smallpox and monkeypox in people who are at least 18 years old. Jynneos is recommended only for certain people at high risk of coming into contact with monkeypox. If you think you are a person at high risk, talk to your health care provider.

Jynneos also can be given to people who are exposed to monkeypox. When given to people within four days of exposure, it often can prevent infection. If given within two weeks of infection, it can lessen the severity of illness. Children who have close contact with someone with monkeypox can receive the vaccine under special approval issued by the U.S. Food and Drug Administration.

More information is available from the CDC.

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