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What is The Monkeypox outbreak of 2022?
The monkeypox outbreak of 2022 has been one of the most requested topics of discussion as of late for the Lunch and Learn Community. Even as we continue to battle the up and down news cycle of Covid-19 I think it is very interesting to see how many people are very concerned about a disease that as early as April of this month they probably never gave it any thought. Let's talk about this year's Monkeypox outbreak to get some context of where we started and how we quickly we got there.
In May of 2022 the World Health Organization reported a man who was traveling from Nigeria was diagnosed in the United Kingdom, a location that clearly was not prepared to recognize and deal with a monkeypox infection. Since the initial report of that lone traveler being diagnosed we now have a total reported cases worldwide of 18,861 cases at the time of me writing this blog with 3,591 cases being right here in the United States.
Lets talk about monkeypox and try to answer all the questions I have gotten over the past few weeks
What is the Monkeypox Virus?
Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as smallpox. Monkeypox is endemic to Central and West Africa. It was first discovered in monkeys even thought the animal hosts typically include a range of rodents and non-human primates. There are two different strains, the West African clade, which produces less severe illness and is responsible for the 2022 outbreak and the Congo Basin strain which has been shown to kill up to 10% of those infected.
Signs and Symptoms of MonkeyPox Virus Infection?
Now the signs and symptoms that are commonly associated with a monkeypox infection include fevers, headaches, muscle aches, backache, swollen lymph nodes, chills and exhaustion. Now of course what has people worried about this disease in particular is the characteristic rash associated with it that can include begin as flat, macular in characteristic but then becomes large pus filled blisters that crust and scab over time.
The signs and symptoms typically happen over three phases:
The Incubation period typically last 1-2 weeks where you are no symptomatic at all, and you are not contagious.
The prodrome period is typically a 1-2 day period where you get many of the symptoms noted above excluding the rash.
The rash period is when the lesions will develop and can occur anywhere from your inside the mouth, hands, feet, genitals or anus.
How does the monkeypox virus spread?
This has probably been the biggest point of contention since the start of this year's outbreak. Because of the origin of the cases being largely centered around gay pride events and with the predominance of men who have become infected the negative attachment of this disease only to gay men has persisted throughout many media channels and some of the general public.
They typical route of spread of this disease includes direct contact with the infectious rash, scabs, or body fluids, through respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex and even touching items (such as clothing or linens) that previously touched the infectious rash or body fluids. There have also been cases where pregnant people can spread the virus to their fetus through the placenta. One thing that we have not seen is any research to show spread via semen or vaginal fluids.
Unfortunately due to the early nature of the presentation of this outbreak and anchor bias amongst the general public this will continue to be a tough stigma to break.
How to prevent the spread of the monkeypox virus
For the route of avoiding this disease alot of the answers are going to be self explanatory but more easier said than done. First we must look to avoid close, skin-to-skin contact with people who have the rash as we know that is when they are contagious. Avoid handling any clothes, towels or bedding of those affected and most importantly to remember to wash your hands with often with soap and water often and use and alcohol-based hand sanitizer.
Now when you check out the CDC they have compiled a list of the products that will work to kill the monkeypox virus and the database is kind of cumbersome to navigate so I complied a list of products that you may easily recognize. Because when you try to narrow down the options on just the residential products its over 300. I will separate it by the active ingredients and you will see that many of your favorite products make the list. Now some of these products we have to be careful because we don't want kids to have access to these products.
- Hydrochloric acid
- Hydrogen peroxide ( especially to keep this category away from children)
- Quaternary ammonium
- Sodium hypochlorite
- Citric Acid
How is monkeypox diagnosed?
Because all health care professionals are now on high alert they are going to be your best bet to get adequately diagnosed. Of course like I would tell my residents, the history is everything so its important to let your health care professional know if you have been or have risk of being exposed to someone who may have it. Typically your health care professional can order blood test which are as reliable or send the samples off to the lab for polymerase chain reaction (PCR) testing which is far more diagnostic.
The differential diagnosis that your health care professionals will have to rule out includes other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies.
What are the treatment options for a monkeypox virus infection?
Now the thing about the monkeypox virus infections is that there are no treatments specifically for monkeypox virus infections. What typically occurs from a clinical standpoint is the infection will last approximately 2- 4 weeks and resolve on its own.
Fortunately for this outbreak the predominant strain has been the West African Clade and at the time of my writing we have not seen any cases of death but we most be very careful as school is beginning to start in session for many across the United States and we typically see the more severe cases occur more commonly among children because of the extent of viral exposure and nature of complications.
Are there vaccines available for monkeypox?
After the many “heated” discussions I have had over the past year and a half from covid-19 vaccine discussions I have been quite surprised at the number of people asking about a Monkeypox vaccine. What I always educate those who ask me is that because the monkeypox virus is closely related to the virus that causes smallpox that we actually use a smallpox vaccine to protect people from getting monkeypox
Because we were able to essentially eradicate smallpox globally many of us have never needed to even get vaccinated against smallpox with the US stopping routine vaccination in 1972. That being said we do have two options available for small pox vaccination known as ACAM2000 & JYNEEO.
The JYNNEO vaccine is the most commonly used for preventing monkeypox infection is during this outbreak as it was recently FDA approved in June 2022. It requires two shots that you have to take 28 days apart and you must be 18 years or older. More details about the vaccine can be found here.
Can the United States handle a Monkeypox outbreak?
I have been going back and forth with my thoughts on this one. I know we have the infrastructure to handle such a a task but being that I remember vividly how people acted and continue to act during this pandemic I am not so sure.
Check out my Real Physician Reacts episode where I expound on my reasoning. – Are we prepared for a monkeypox outbreak?