Monkeypox Scare: Don’t Worry (Yet)

We all have questions about #monkeypox, right? I got to talk to yesterday with Andrea McCollum, who leads @CDCgov's poxvirus epidemiology team. She had answers. https://t.co/abIU2o0IEa

— Helen Branswell 🇺🇦 (@HelenBranswell) May 19, 2022

TL, DR:  This is not, unlike covid, a new / unknown disease.  It’s a close relative of smallpox, which means stockpiled smallpox vaccines provide pretty good immunity, as does previous smallpox inoculation.  (Although those of us whose inoculation scars have faded probably shouldn’t rely entirely on our aging immune systems.)   Monkeypox is mostly spread, according to current science, by direct contact with infected material:  animal bites / scratches, touching an infected person’s lesions, contact with bedding or clothing that’s been soiled, and ‘prolonged’ respiratory exposure.  If you’re worried, keep masking up in public places — especially airplanes! — and remember to wash or sanitize your hands frequently.  Which, of course, we’re all pretty much doing anyway…

… Monkeypox causes a flu-like array of symptoms, but also comes with a distinctive rash; one telltale sign is the fact that lesions often appear on the palms of hands. So far it seems that the cases are being caused by viruses from the West African clade, which triggers milder disease than the other family of viruses, called the Congo Basin clade. All monkeypox viruses are cousins of the one that caused smallpox, the only human virus to have been eradicated.

STAT had many questions about monkeypox. Fortunately, Andrea McCollum, the poxvirus epidemiology team lead in the CDC’s division of high consequence pathogens and pathology, had many answers…

Do we know how efficient monkeypox virus is at transmitting from person to person?

Monkeypox is transmissible really from the time when signs or symptoms appear, throughout the entire course of illness. And the definition of “course of illness” is until all lesions have healed, crusts have separated, and a fresh layer of skin has formed. That can be quite a long period of time. That can be several weeks…

I think we can take away a lot from what we know about monkeypox in Congo Basin and in West Africa. Even if human-to-human transmission is documented, it is generally documented among very close contacts. So family members, people taking care of ill patients. Or health care providers…

Are the lesions so distinctive that people will go see a doctor to get them looked at? Or might they think it was hives or something like that?

It depends on the person and it depends on the extent of the rash. I think certainly if people have a very defuse, disseminated rash across multiple parts of the body and it’s very visible and evident, that may prompt somebody to go to a medical provider. If it’s more contained to a single body site or a few body sites that can easily be covered up by clothing, then maybe they’re less likely.

Monkeypox patients that I’ve spoken with, they often talk about quite a protracted illness with kind of flu-like syndrome with respiratory involvement. They talk about a lot of malaise, achiness. They’re tired. And the lesions themselves often are described as being very painful, irrespective of where they occur on the body.

That’s what we usually hear from patients, that due to these sorts of signs or symptoms, they knew that they were really sick….

Much more (trigger warning: graphic descriptions) at the link.

A handful of monkeypox cases have now been reported in Britain, Portugal, Spain and the United States — raising alarm. The viral disease spreads through close contact and was first found in monkeys.

Here's what scientists know so far https://t.co/QWMI6Ti9r7 👇 1/4

— Reuters (@Reuters) May 19, 2022

Vaccination after exposure to monkeypox virus is still possible. However, the SOONER an exposed person gets the vaccine, the BETTER.

— Chise 🧬🧫🦠🔬💉 (@sailorrooscout) May 19, 2022

▶️Complications: pneumonia, bacterial skin superinfection, encephalitis, tonsillitis, nausea/vomiting
▶️Mortality as high as 11% in African cases, but was 0% in US cases
▶️Treatment: none proven; ?cidofovir (used for CMV), ?tecovirimat, ?brincidofovir (active vs smallpox)

— John Ross 💉💉💉 (@JohnRossMD) May 18, 2022