Category: infections, vaccination, and hygiene

Questions and answers about monkeypox

Predominant symptoms of monkeypox include fever, rash ,enlarged lymph nodes, muscle aches, and chills. Most patients with monkeypox have a mild illness. Symptom onset is 7-13 days after exposure, but can be as long as 3 weeks.

updated October 1, 2022

Several poxviruses infect humans, ranging from the deadly smallpox to the contagious but not serious molluscum contagiosum. Now more than 30 countries, including the United States are experiencing an outbreak of monkeypox, which the World Health Organization is calling a”a public health emergency of international concern.”

What is monkeypox?

Monkeypox, an orthopoxvirus, was first isolated in the late 1950s from a colony of sick monkeys in Copenhagen Denmark. The virus is related to the variola, smallpox, and vaccinia, coxpox, viruses. The first known human case was found in the Democratic Republic of the Congo in 1970.

Where is monkeypox found?

Since routine smallpox immunization ended, most cases have occurred in Central and West Africa. Sporadic cases have been reported in several non-endemic countries, typically in returning travelers.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2–4 weeks

Centers for Disease Control and Prevention
As of September 13, 2022 there are 59,000 global cases and 22,000 United States cases of monkeypox.
worldwide cases of monkeypox as of SEPTEMBER 13, 2022

How does it spread?

The virus is typically acquired through contact with an infected animal’s bodily fluids or through a bite.

Human-to-human transmission can also occur through close contact with infectious skin lesions. Direct contact with lesions that contain the virus can easily transmit the disease .

Transmission can also occur through large respiratory droplets, and prolonged face-to-face contact (eg, within 6 feet for ≥3 hours in the absence of personal protection equipment [PPE]).

What are the symptoms of monkeypox?

Onset of monkeypox infection is 5 days to 3 weeks after exposure.

Predominant symptoms of monkeypox include

  • fever,
  • rash,
  • enlarged lymph nodes,
  • sore throat,
  • muscle aches,
  • chills,
  • headache

The rash is similar to that of smallpox or chickenpox. The illness usually lasts 2 to 4 weeks.

How do doctors diagnose monkeypox?

Doctors usually suspect monkeypox based on symptoms, especially a suspicious rash. Testing is done on specimens collected by swabbing monkeypox lesions, but should only be obtained by professionals wearing appropriate PPE.

CDC is working with state and local health officials to identify people who may have been in contact with individuals who have tested positive for monkeypox, so they can monitor their health.

CDC website
This electron microscopic (EM) image depicted a monkeypox virion, obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was a thin section image from of a human skin sample. On the left were mature, oval-shaped virus particles, and on the right were the crescents, and spherical particles of immature virions.

This electron microscopic (EM) image depicted a monkeypox virion, obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was a thin section image from of a human skin sample. On the left were mature, oval-shaped virus particles, and on the right were the crescents, and spherical particles of immature virions. credit CDC, Cynthia S. Goldsmith, Russell Regnery

What treatments are available?

Most patients have mild disease and recover with home supportive care, similar to influenza, COVID, and other viral infections. For the seriously ill patient, medically supervised supportive care is necessary until recovery.

The antiviral agents, tecovirimat and brincidofovir, approved for treatment of smallpox in the United States, work for monkeypox in animals and are likely to work in humans.

Can monkeypox be prevented?

When a rash is present, persons with suspected monkeypox should be considered infectious and be isolated until all scabs separate and results of testing are negative.  

Detailed information on infection control precautions to reduce transmission of monkeypox in the home is on the CDC website.

Persons with close contact with an infected animal or person should be monitored for symptoms for 21 days after their last exposure .

Detailed information on the approach to monitoring after an exposure can be found on the CDC website.

Is there a vaccine?

The JYNNEOS vaccine is approved for prevention of smallpox and monkeypox. It is the primary vaccine being used during this outbreak in the U.S.

The ACAM2000 vaccine is an alternative to JYNNEOS. It is also approved to help protect against smallpox and monkeypox.

Facts about JYNNEOS vaccine 2 dose vaccine, maximum immunity 14 days after dose 2

Is monkeypox fatal?

In Central Africa, the fatality rate is approximately 10 percent, generally in the second week of illness.

In the 2003 outbreak in the United States, none of the 34 confirmed cases died, although a few became seriously ill, requiring hospitalization.

Exploring the HEART of international health

a world globe with crossed bandaids

Dr Aletha

cover image by Jerney Furman

Fighting COVID-19 in 2021-it’s not over yet

In this post, I’m offering a graphic review of COVID-19 and what we can still do to prevent infections IN ADDITION TO getting vaccinated. Until we achieve wide spread immunity through vaccination the risk of infection and death are still present and still just as real.

IMPORTANT NOTE: This post was written and published 9 months ago and much has been learned and changed since. However, the basics have not changed and are perhaps more important than ever. I hope seeing this again will remind you of what’s important and prompt you to carefully follow reputable sources for updates.

This time a year ago, no one in the United States, or even anywhere in the world, knew about a novel coronavirus, except a handful of physicians and scientists. Perhaps not even they knew we were facing a viral pandemic that would turn our lives upside down.

That unknown virus, SARS-CoV-2, has sickened 90 million people world wide and caused almost 2 million deaths. In the United States it has infected 22 million people, killing 370,000.

UPDATE: as of September 5,2021 there have been

221 million worldwide cases with with 4.5 million global deaths

40 million U.S.A. cases with 650,000 deaths

In the United States, the healthcare systems in many places, including our most populous states, are overwhelmed with COVID-19 patients, so much so that it impairs their ability to care for them and other patients. Cases are at an all time high across the entire country.

illustration showing the coronavirus which causes COVID-19
a model of the structure of the SARS_CoV-2

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.

Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. In this view, the protein particles E, S, and M, also located on the outer surface of the particle, have all been labeled as well.

A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). CDC/ Alissa Eckert, MS; Dan Higgins, MAMS, public domain.

Finally, a vaccine for SARS-CoV-2

There is hope for an end to this nightmare now that two vaccines are available and being dispensed. I feel fortunate to have received my first dose of the Pfizer-BiONTech vaccine but I know for many others it will be weeks if not months before they will be vaccinated.

Dr. Aletha inspecting her arm after a COVID-19 shot
Three days after my first vaccination the soreness in my arm is almost gone, and I had no redness or swelling.

Let’s review COVID-19

In this post, I’m offering a graphic review of COVID-19 and what we can still do to prevent infections IN ADDITION TO getting vaccinated. Until we achieve wide spread immunity through vaccination the risk of infection and death are still present and still just as real.

Please note I am not addressing management of COVID-19 in this post. Your best source of information for treatment of symptomatic COVD-19 is from a physician familiar with your symptoms and underlying health.

The timeline of a COVID-19 infection-from exposure to immunity

Other common symptoms include
  • headache
  • muscle and/or joint aches
  • nasal congestion and drainage
  • sore throat
  • nausea/vomiting/diarrhea
  • loss of taste or smell-this almost always means you are infected
  • fatigue
  • there may be no symptoms at all

Steps to prevent infection from coronavirus-

Wash your hands, Wear a mask, Watch your distance

Practice social distancing and wear a mask.
What to do if you think you have COVID-19 or have been exposed
You should also contact your physician for advice, especially if you have chronic medical conditions which might make you at greater risk of severe disease.

Base your actions on FACTS, not FEAR

MANAGE ANXIETY-DON'T BE AFRAID-BE SMART

Learn about the vaccines from Dr. Gupta and Dr. Fauci

Throughout the pandemic, I have depended on the reports from Dr. Sanjay Gupta, neurosurgeon and medical correspondent for CNN. I don’t miss his daily podcasts called Coronavirus: Fact vs Fiction.

In this episode, Dr. Gupta interviewed Dr. Anthony Fauci about the coronavirus vaccine. I suggest you listen to this 12 minute podcast, as well as the others in this series.

A Q&A on vaccines with Dr. Anthony Fauci

exploring the HEART of controlling a pandemic

Dr. Aletha