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What Is Monkeypox?

Rarely seen outside Central Africa, the disease is turning up in Europe and the U.S. Here’s what to know

monkeypox virus

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While the COVID-19 pandemic has us all more alert to viral outbreaks, health officials are treating the latest monkeypox outbreak as a “concerning situation” even as it poses a “very low risk” to most individuals, according to Rosamund Lewis, head of the Smallpox Secretariat of World Health Organization (WHO) Emergencies Program. “The important thing to realize right now is this outbreak can be contained with contact tracing and isolation,” she said at a recent news briefing.

Health officials suspect more than 250 individuals — primarily men in their 30s — have contracted monkeypox over the past month, including at least one confirmed case on May 18 of a Massachusetts resident who had recently traveled to Canada by private transportation. The Centers for Disease Control and Prevention (CDC) is aware of at least five other individuals who are presumed to have monkeypox, pending blood tests to confirm the infection. CDC is also tracking multiple clusters that have been reported within the past two weeks in countries that don’t normally report monkeypox, including Portugal, Spain and the United Kingdom.

Monkeypox is endemic in Central Africa, said Lewis, who noted that cases are being reported in the Central African Republic, Democratic Republic of the Congo, Nigeria and Cameroon. WHO estimates thousands of cases occur in the region annually.

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Health officials are urging people who suspect they may have monkeypox to see a physician and get tested. “Many of these global reports of monkeypox cases are occurring within sexual networks. However, healthcare providers should be alert to any rash that has features typical of monkeypox. We’re asking the public to contact their healthcare provider if they have a new rash and are concerned about monkeypox,” Inger Damon, M.D., director of CDC’s Division of High-Consequence Pathogens and Pathology, said in a statement.

The European Centre for Disease Prevention and Control recommended all suspected cases be isolated and that high-risk contacts be offered a smallpox vaccine. The U.K. is offering high-risk contacts the smallpox vaccine and recommending anyone who might be infected to isolate until they recover. The U.S. has 1,000 doses of a vaccine approved for the prevention of monkeypox and smallpox, plus more than 100 million doses of an older-generation smallpox vaccine in a government stockpile, the Associated Press reported.

What is Monkeypox?

A relative of smallpox and cowpox, the monkeypox virus was first discovered in 1958, when two outbreaks of a poxlike disease occurred in colonies of monkeys kept for research, according to the Center for Genome Sciences at the U.S. Army Medical Research Institute of Infectious Diseases. The first human case was recorded in 1970 in the Democratic Republic of the Congo (DRC).

The largest U.S. outbreak of monkeypox occurred in 2003, when 47 cases were reported in the Midwest among individuals who became ill after having contact with pet prairie dogs that had been housed near a shipment of small mammals from Ghana. Tests confirmed that among those mammals, two African giant pouched rats, nine dormice and three rope squirrels were infected with monkeypox virus, according to the Centers for Disease Control and Prevention (CDC).

What are the symptoms?

Monkeypox symptoms typically begin about a week or two after infection, according to the CDC.

Early symptoms include:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion

Soon after experiencing a fever (typically within one to three days, but sometimes longer), people infected with monkeypox develop a rash, often beginning on the face, then spreading to other parts of the body. As with smallpox, pimples form that become pus-filled and leave pockmarks upon healing. Most infections last two to four weeks.

How does it spread?

You can get the virus through exposure to an infected animal or person. “Animal-to-human transmission may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding,” the CDC reports.

Human-to-human transmission is thought to occur primarily through large respiratory droplets inhaled during prolonged face-to-face contact. “Other human-to-human methods of transmission include direct contact with body fluids or lesion material and indirect contact with lesion material, such as through contaminated clothing or linens,” according to the CDC. However, the latest outbreak “has been transmitted primarily by close skin-to-skin contact,” according to the WHO’s Lewis.

Am I at risk?

Unless you are traveling outside the U.S. or come in direct contact with an infected person, you are at little risk of developing monkeypox, according to health officials.

Still, there are things you can do to reduce your risk if you plan to travel in west and central Africa, according to the United Kingdom’s National Health Service:

  • Wash your hands regularly with soap and water or an alcohol-based hand sanitizer.
  • Eat only meat that has been thoroughly cooked.
  • Don’t go near wild or stray animals, either alive or dead, or animals that appear sick.
  • Don’t touch meat from wild game.
  • Avoid people who are sick or who may have monkeypox, and don’t share beddings or towels with them.

Peter Urban is a contributing writer and editor who focuses on health news. Urban spent two decades working as a correspondent in Washington, D.C., for daily newspapers in Connecticut, Massachusetts, Ohio, California and Arkansas, including a stint as Washington bureau chief for the Las Vegas Review Journal. His freelance work has appeared in Scientific American, Bloomberg Government, and