Facing the monkeypox outbreak carefully, without fear [column] | Local voices

In May this year, cases of the rare disease monkeypox began to appear and spread in countries other than a few central African countries where it has existed for decades. In July, the World Health Organization declared the monkeypox outbreak a global health emergency, and on Thursday the Biden administration declared the monkeypox outbreak a public health emergency in the United States.

To date, the Centers for Disease Control and Prevention had confirmed more than 26,000 cases of monkeypox in 81 countries that had never reported the disease. The United States leads the global ranking of monkeypox cases, with more than 7,000 confirmed cases, followed by Spain, Germany, the United Kingdom and France, each with 2,000 to 5,000 case.

There were 192 confirmed cases in Pennsylvania, according to the CDC as of Friday morning.

A Pennsylvania Department of Health spokesperson told LNP | LancasterOnline the “department does not provide county-level case counts to protect patient confidentiality.”

Learning the facts about monkeypox can help protect you and your family from the virus, while reducing fear of its spread. Here are answers to some of the most frequently asked questions about monkeypox.

What is monkey pox? Is it a new disease?

Monkeypox is not new, but its spread from Africa across the world this year is unprecedented. It is caused by the monkeypox virus, which causes a disease characterized by highly contagious pustules on the skin (smallpox). While it belongs to the same family of viruses as the scourge of smallpox, monkeypox is a milder disease and rarely fatal. Monkeypox is not related to chickenpox, although the rash has similar characteristics.

Monkeypox is a zoonosis, a disease transmitted between animals and humans. The virus was discovered in 1958, when two epidemics broke out in monkeys intended for research. The first recorded human case of monkeypox occurred in Africa in 1970. Monkeypox has previously been observed in the United States, rarely in travelers from endemic areas of Africa, and in a small outbreak in 2003 linked to imported prairie dogs.

What are the symptoms?

Symptoms of monkeypox usually appear one to two weeks after infection, during which time sufferers may feel relatively well. Symptoms may include fever, headache, muscle aches, swollen glands, chills and exhaustion. An itchy, painful rash then develops that may look like pimples or blisters. The rash may appear on the face, inside the mouth, on the hands, feet, chest, genitals, or anus. Some monkeypox infections may be more subtle, with mild disease and only a few skin lesions.

Skin lesions can take two weeks to heal, and it is important to remember that the disease is contagious until all skin lesions have closed and are covered with new skin.

How serious is monkeypox?

Monkeypox usually resolves on its own without requiring hospitalization. Deaths from monkeypox are extremely rare. With the current global epidemic, in fact, only a handful of deaths have occurred, with none in the United States. People with weakened immune systems, young children, and pregnant or breastfeeding women may have a higher risk of serious illness.

Should I be worried about catching monkeypox?

Currently, the risk of contracting monkeypox in the United States is low. While anyone can be infected with monkeypox, approximately 98% of infections identified in the current global epidemic have occurred in certain high-risk groups, including men who have sex with men.

However, people outside this group can also become infected with monkeypox, and it is important not to stigmatize any group, as the spread of the disease to other segments of the population is inevitable.

The CDC website is a good source for the latest updates on the outbreak.

How is monkeypox spread?

People who do not show symptoms of monkeypox cannot spread the virus. Monkeypox is spread from person to person by:

— Direct contact with the contagious rash, scabs or bodily fluids.

— Respiratory secretions during prolonged physical contact, face to face or intimate.

— Contact with objects, such as clothing or bedding, that have already touched the infectious rash or body fluids.

Contact your health care provider if you have a new or unexplained rash or fever. If you have been in direct contact with someone diagnosed with monkeypox or with someone who has an unexplained rash, quarantine yourself at home and contact your health care provider. In consultation with state and federal authorities, your healthcare provider will determine if testing is needed.

How is monkeypox treated?

Supportive care at home with fluids and painkillers is usually enough to treat monkeypox. Although the United States Food and Drug Administration has not approved any specific treatment for monkeypox, effective antiviral drugs and vaccines against smallpox are used because the viruses are very similar. Antivirals such as tecovirimat may be recommended for people who are more likely to become seriously ill from monkeypox, such as those with weakened immune systems.

Is there a monkeypox vaccine?

There are two vaccines (Jynneos and ACAM2000) approved for the prevention of smallpox which are used for monkeypox. The CDC recommends vaccination for people who have been exposed to someone with monkeypox or are at higher risk of exposure.

It is important to keep in mind that, unlike the COVID-19 pandemic, vaccines and antiviral treatments have been available since the start of the monkeypox outbreak. The US government has stockpiled these vaccines and treatments for years in preparation for a potential smallpox outbreak.

Can monkeypox be prevented?

There are steps you can take to help prevent monkeypox:

— Wash your hands often with soap and water or use an alcohol-based hand sanitizer.

— Avoid close skin-to-skin contact with a person who has a rash. Do not touch the blisters or scabs of a person with suspected or confirmed monkeypox.

— Avoid hugging, kissing, sexual contact or other intimate contact with someone who has monkeypox.

— Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.

— The CDC recommends people with monkeypox, and their close contacts, wear masks. However, monkeypox is not an airborne virus and transmission by respiratory droplets (e.g. coughing) is not likely to result in infection unless exposure is continuous for several hours.

Today, two and a half years after the start of the COVID-19 pandemic, the thought of facing another global contagious disease can seem overwhelming. Keep in mind, however, that the monkeypox outbreak is a top priority for public health officials, and tests, vaccines, and antiviral drugs are already available.

As we as a society face another infectious disease challenge, by following the advice above, along with the advice and expertise of local, state, and federal health care experts, we together we can minimize the impact and ultimately defeat this latest threat.

Joseph M. Kontra, MD, is chief of infectious diseases at Penn Medicine Lancaster General Health.

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