Editor’s note: This information is current as of Aug. 5, 2022. The World Health Organization is considering renaming monkeypox but has not yet announced a new name. As such, we currently use the term monkeypox to describe the disease.
Until just a few months ago, you probably hadn’t heard of monkeypox. That’s because before May 2022, it has rarely been seen outside of central and west Africa. But, what is it? And how likely are you to come in contact with the virus, now that it’s spreading at a more rapid pace? Dr. Katie Passaretti, vice president and enterprise chief epidemiologist at Atrium Health, explains what people should know.
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“Monkeypox is rare and, until recently, not often seen outside of the African continent,” Passaretti says. “It also doesn’t spread as easily as viruses like COVID-19 or the flu, so most people are less likely to come into contact with it. But, it’s important to know what to look out for and when to get checked out by your doctor.”
In May 2022, cases of monkeypox were identified in Europe in people who had not traveled to places where monkeypox is endemic. More cases were confirmed across Europe and, by August 2022, the Centers for Disease Control and Prevention (CDC) reported more than 25,000 cases of monkeypox have been confirmed worldwide, with more than 7,000 cases in the United States, including in North Carolina.
“Monkeypox spreads primarily through prolonged direct contact with an infected person, direct contact with a rash or through unprotected contact with contaminated clothing or linens,” Passaretti explains. “While it can spread through respiratory droplets, that is not the primary way this virus spreads. You’re unlikely to get it by bumping into someone at the grocery store. An exposure that results in infection is typically thought to take several hours of close contact.”
She adds people are at low risk of contracting it through contact with door handles, handling money or using public restrooms, among other common, everyday occurrences.
People who are most at risk would be those who have had contact with someone who has monkeypox, those who develop a new rash after coming into contact with a similar rash or those who are part of a social network where there has been spread of monkeypox. Cases in the United States, so far, have mostly been identified in men who have sex with men, but there have been some sporadic cases in women and children. It’s important to remember that men who have sex with men are not the only people being impacted by this outbreak, especially as we see more spread. It is very likely other groups will be impacted.
Not Another COVID-19 Pandemic
Despite the rising cases, currently, the threat of monkeypox to the general U.S. population remains low.
“It’s important to identify cases and prevent the spread so we don’t continue to see ongoing spread in our communities,” Passaretti says. “Fortunately, many people with monkeypox have mild illness that does not require hospitalization and resolves over time. However, it’s important to remember this infection can cause scarring and significant pain in those who are infected. Early identification of cases allows for prompt treatment, as well as an earlier opportunity to vaccinate people with close contact. That helps prevent further spread.”
People who are at risk for more severe disease are those with weakened immune systems, chronic skin conditions like eczema/atopic dermatitis, pregnant women and children under 8 years old.
Because of similarities, the smallpox vaccine (most commonly a vaccine called Jynneos) can be used to prevent infection in people who have had prolonged close contact with someone who has a confirmed case of monkeypox. The Jynneos vaccine is approved for those over 18 years of age but, in some cases, may also be given to children who are considered high risk. This vaccine is also appropriate for those at high risk of exposure. Currently, vaccine supply is limited, but certain local health departments and high-risk clinics in the area have a small supply of vaccines. The North Carolina Department of Health and Human Services has more information on monkeypox vaccine supplies.
Symptoms and Treatment
The most common symptom associated with monkeypox is a rash. Some people will get flu-like symptoms or swollen lymph nodes first, but will still almost always get a rash. Monkeypox in this outbreak typically isn’t a severe illness. For most people, it resolves in two to four weeks. The rash can leave scars for some individuals.
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“Cases of monkeypox may sometimes be confused with a sexually transmitted infection, because of the appearance or location of the rash,” Passaretti says. “But it’s important to note that, while it has spread to individuals after sexual contact, the spread is thought to be caused by contact with the rash and is not thought to be spread solely through sexual contact. Anyone who has prolonged contact with someone who is infected could be exposed, regardless of their sexual orientation.”
Atrium Health is working closely with the CDC, state and local health departments to monitor any possible cases. This includes monitoring, isolating and contact tracing for individuals who may be at risk of contracting the disease.
“Are we going to see more cases? Definitely,” Passaretti says. “But this is not a cause for panic. It is another reminder, though, to practice good hand hygiene and healthy habits, stay home when sick, as well as still wearing face masks when appropriate. All the behaviors we’ve become accustomed to in preventing the spread of COVID-19 would also help prevent the spread of monkeypox.”
