Protect yourself from monkeypox

The number of confirmed cases of monkeypox, a virus related to smallpox that is typically limited to Africa, is growing—particularly in Europe and North America.

Scientists at the Centers for Disease Control and Prevention (CDC) are tracking multiple cases of monkeypox that have been reported in several countries that don’t normally experience the infection, including the United States.

CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox. Cases have been found in California, New York, Florida, Colorado, Illinois, Utah, Georgia, Hawaii, Massachusetts, Pennsylvania, Virginia, and Washington.

Although the virus is less deadly than smallpox, it typically lasts for two to four weeks and symptoms can appear anywhere from five to 21 days after infection.

Although health professionals across the globe stress that the risk to the general population is low, it is important to know how monkeypox spreads and what you can do to protect yourself from infection.

The World Health Organization recommends taking measures to reduce exposure to the monkeypox virus, which is transmitted between people through close contact with secretions from the respiratory tract or skin lesions, as well as recently contaminated objects.

Recommendations from health experts include washing your hands frequently, avoiding contact with infected people and wearing a face mask, among other measures.

Typically, monkeypox is known to spread to people who have had contact with infected animals. This could be following a bite, scratch or consuming uncooked animal meat.

Monkeypox can also spread from human to human. Although this was originally thought of as rare, the recent and unusual rapid rise of infections outside of the west and central Africa has raised concerns.

It is typically spread between people in three ways: inhaling respiratory droplets; directly touching an infected person; and, less often, through indirect contact—such as through clothes or linen that have been in contact with fluid from sores.

Respiratory transmission involves large droplets that don’t linger in the air or travel far. As a result, person-to-person spread typically requires prolonged, intimate contact.

Monkeypox is also spread through close personal contact, like skin-to-skin contact or kissing.

The virus is generally not considered a sexually transmitted infection and it is not known to be spread through semen during intercourse.

However, “it can be transmitted during sexual and intimate contact”, Dr John Brooks, an epidemiologist with the US Centers for Disease Control and Prevention, said on 23 May.

So far, the majority of cases have been spread through sex with a particular concentration among gay and bisexual men. However, anyone can be at risk of catching the virus.

According to the US Centers for Disease Control and the United Kingdom’s National Health Service, the best precautions you can take are:

• Washing your hands with soap and water regularly or using an alcohol-based hand sanitiser.
• Use personal protective equipment (PPE) when caring for patients who are confirmed or infected with the monkeypox virus.
• Only eating meat that has been cooked thoroughly.
• Do not go near wild or stray animals, including dead animals, as well as animals that look unwell.
• Do not eat or touch meat from wild animals.
• Do not share bedding or towels with people who are unwell and may have monkeypox.
• Do not have close contact with people who are unwell and may have monkeypox.
• What should you do if you catch monkeypox?
• Initial symptoms of monkeypox can consist of headaches, muscle aches, swelling, back pain and fever.

Within one to five days of infection, lesions and rashes typically occur across the body – on the hands, face, feet, eyes, mouth and genitals. These eventually turn into raised bumps which form blisters, some also fill with white fluid before breaking and scabbing over. This fluid can be infectious.

If you have these symptoms or suspect that you may have contracted the virus you should isolate yourself from physical contact with others and seek medical advice immediately.

If you have contracted the virus, you will be required to isolate until you have recovered.

Individuals who catch monkeypox typically recover within two to four weeks. The symptoms can be confused with other illnesses – such as herpes, syphilis or chickenpox – so it is important to confirm with a medical professional as soon as possible.

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in countries of central and west Africa.

Two distinct organisms believed to have evolved from a common ancestor are identified: the west African clade and the Congo Basin clade, also known as the central African clade.

Monkeypox is a zoonosis: a disease that is transmitted from animals to humans.

Cases are often found close to tropical rainforests where there are animals that carry the virus. Evidence of monkeypox virus infection has been found in animals including squirrels, Gambian poached rats, dormice, different species of monkeys and others.

Human-to-human transmission is limited, with the longest documented chain of transmission being six generations, meaning that the last person to be infected in this chain was six links away from the original sick person.

It can be transmitted through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets and contaminated objects.

Detection of viral DNA by polymerase chain reaction (PCR) is the preferred laboratory test for monkeypox. The best diagnostic specimens are directly from the rash – skin, fluid or crusts, or biopsy where feasible. Antigen and antibody detection methods may not be useful as they do not distinguish between orthopoxviruses.