On Nov. 16, a Maryland resident tested positive for monkeypox after traveling to the United States from Nigeria, becoming the second known case in the U.S. this year. This case follows the first positive case of a Texas resident, back in July, who also returned to the U.S. after traveling from Nigeria.
Following the two recent cases in the U.S., Centers for Disease Control and Prevention health officials and medical experts are working with international health stakeholders, industry partners, airlines and local governments to identify all possible contacts.
What is monkeypox?
"It is unusual and it is exotic, but it's not an immediate hazard," Dr. William Schaffner, professor of infectious diseases at the Vanderbilt University Medical Center in Nashville said.
Monkeypox, a cousin of smallpox, is a rare disease caused by contact with an infected animal, human or a contaminated object carrying the virus. Unlike COVID-19 which is an RNA virus, monkeypox is a DNA virus and while it is contagious, “it is not nearly as contagious as smallpox," said Dr. Gregory Poland, founder and director of the Mayo Vaccine Research Group and professor at the Mayo Clinic.
Origins of the virus are unknown, though the pox-like disease was first discovered in Africa and has only been documented out of the continent six times since its discovery in 1958, according to the CDC. The first recorded human case was in 1970 in the Democratic Republic of Congo.
When transmitted human-to-human, the monkeypox virus primarily transfers via large respiratory droplets. According to the CDC, prolonged face-to-face contact is necessary for transmission. Though it is less common, the disease can also be transferred indirectly if the virus is present on an object or surface.
Monkeypox does not occur naturally in the United States. All cases that have been present in the U.S. stemmed directly from international travel in countries where the disease is more commonly found or from the presence of illegally imported animals.
While the disease is not native to the United States, once it is located in an area, monkeypox spreads rather quickly, though it can take up to three weeks for symptoms to develop after the initial infection. At least half of all cases of monkeypox occur in children, according to Schaffner.
Signs and symptoms of monkeypox
Signs and symptoms of monkeypox are vastly similar to those of other illnesses such as the flu or smallpox. Fever, headache, muscle aches and fatigue are typically the first symptoms to develop once infected, though the tell-tale sign of monkeypox is swelling of the lymph nodes.
Look out for these symptoms:
- Swollen lymph nodes.
- Muscle aches.
According to the CDC, the incubation period for the disease can range from five to 21 days. After up to three days of developing onset symptoms, it is common to develop a rash, starting on the face and spreading to other parts of the body. It is also common for lesions, or abnormal tissue growth, to develop in the process before falling off in the form of a scab. "You can have a few lesions or you can have 1000s, and the more you have, the more likely you are to be seriously ill," Schaffner said.
If you have developed any of these symptoms, contact your primary health provider immediately. Poland, said that the development of any of these prior symptoms is “a reason under any circumstance to be evaluated.”
Though monkeypox is highly contagious, Poland said “there is absolutely no reason for panic” as “the chance of anybody in the U.S. being exposed is incalculably small.” The only point at which you should take action is if you have had known contact with an individual who has tested positive for the disease. Because of the incredibly small chances of contraction, unless you were directly contacted by the CDC, Poland sees this as a “non-event to members of the public.”
How to prevent contracting monkeypox
What can you do to prevent contracting monkeypox if you are exposed? Poland said there’s “not much.” Monkeypox is highly contagious but he believes that the common COVID-19 mask-wearing guidelines have helped halt the spread.
“The reason we're not seeing more cases after these imported cases is that people on the airplanes are wearing masks and people in the airports are wearing masks,” Poland explained.
Further prevention techniques include putting people in isolation and stopping contact after a positive case has been recorded.
Treatment for monkeypox
Monkeypox can last anywhere from two to four weeks. If left untreated, the disease can be prolonged or even result in death. “If they got it, and we diagnosed it, it can be treated. The odds of dying would be very, very low because of the treatment and supportive advanced medical care we could provide," Poland explained.
While there is no proven treatment according to the CDC, to control an outbreak, cases of monkeypox may be treated with the smallpox vaccine, antivirals, supportive care and vaccinia immune globulin. VIG is used to take antibodies from people who have been highly immunized against smallpox and administer it into people who have tested positive for monkeypox. Because of its incredible rarity in the U.S., to date, nobody has done randomized controlled clinical trials to know that this procedure is effective. Poland said that smallpox and monkeypox are “close enough related to assume that the smallpox vaccine prevents it.”