What You Should Know About Monkeypox
Touro College of Pharmacy Expert Tyler Maxwell, PharmD, Explains Warning Signs and Drug Treatment of Disease
Monkeypox is a rare disease that is occasionally seen in parts of Central and West Africa. Since May 14, 2022 cases of monkeypox have been reported from areas that do not normally have monkeypox, including countries in Europe, North America, and Australia.
As none of the current cases have reported traveling to places that have monkeypox, many people are wondering: What should we know about monkeypox?
What is monkeypox?
Monkeypox is a virus that may cause fever, headache, chills, muscle aches, exhaustion, and swollen lymph nodes followed by skin lesions that may be filled with a clear fluid and crust. Monkeypox is related to the smallpox virus, but symptoms are not as severe. The virus is spread through three different ways:
- Contact with bodily fluids or infected lesions
- Contact with airborne droplets made when people cough, sneeze, or talk
- Contact with an infected object, such as a person touching an object that has the monkeypox virus on it and then touching their own mouth, nose, eyes, or skin
Once a person has been infected, it may take between 7 and 14 days for symptoms to appear; skin lesions often appear between 1 and 3 days after any fevers. A person can spread the virus from the time symptoms begin until all skin lesions have crusted, fallen off, and a new layer of skin has formed.
People usually recover from monkeypox, but symptoms may last for up to 4 weeks. In some people, more severe infection can lead to complications such as pneumonia, sepsis, and infection of the eyes which can lead to vision loss. According to the WHO and the CDC, the survival rate for monkeypox infection ranges from 89% to 100%.
What can you do to avoid catching monkeypox?
The risk of catching monkeypox is low to the general public but increases if you are planning on traveling. If you plan on traveling to areas where monkeypox is normally found, such as West or Central Africa, or to areas where cases have been seen, such as Europe, North America, or Australia, be sure to wash your hands often with soap and water (or alcohol-based hand sanitizer with at least 60% alcohol) and consider avoiding the following to help decrease your risk:
- Contact with sick people or people with lesions on their skin
- Contact with wild animals
- Touching contaminated objects (such as clothes and bedding) that were used by infected people
What do I do if I think I have monkeypox?
Infection with monkeypox can only be confirmed with a sample from the fluid in the skin lesions, so if you think you may be infected, it is very important to contact a healthcare provider.
If you develop a new, unexplained skin rash with or without fevers, it is important to avoid contact with other people. If possible, contact your healthcare provider before going into the office to avoid exposing others.
Are there any treatments available if I do get infected?
Most cases of monkeypox resolve on their own over time. In the event of more severe infection, there are no specific treatments available to combat monkeypox at this time. However, the smallpox vaccine and medications, such as cidofovir, brincidofovir, and/or tecovirimat may be useful in controlling infection.
The smallpox vaccine (also known as Imvamune) is licensed in the United States to prevent both smallpox and monkeypox. Data has shown that the smallpox vaccine can prevent ~85% of monkeypox infections. In the event of infection, it is also believed that early vaccination may help in reducing how severe a monkeypox infection may become.
Although we do not currently have any data on medications used to treat monkeypox, two medications have been shown to work against similar viruses. Brincidofovir is approved for the treatment of smallpox and cidofovir can be used to treat resistant viral infections. These medications work by inhibiting viral DNA replication and help reduce viral reproduction. It is unknown whether these medications will be effective in treating monkeypox, although they may be considered for use in severe cases.
Tecovirimat is a medication previously used in the treatment of smallpox. Animal studies and a very small human study concluded that treatment with tecovirimat may be beneficial in shortening the length of symptoms in monkeypox infections. Given the size of the study, more studies should be performed and the use of tecovirimat should be reserved for severe cases entering into research trials.
Further References
Monkeypox. Centers for Disease Control and Prevention
Monkeypox in Multiple Counties. Centers for Disease Control and Prevention
