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Monkeypox symptoms and how to avoid infection?

On July 23, 2022, WHO declared that the recent monkeypox outbreak is a public health emergency of international concern (PHEIC).

This decision came after reporting more than 16,000 cases within 75 countries and territories, along with five deaths. This decision also will raise the international priority level on monkeypox response.


Monkeypox is a rare zoonotic virus (it transfers from animals to humans).

Despite being named “monkeypox, various species of monkeys, giant-pouched rats, African dormice, and certain types of squirrels can carry and transfer monkeypox to humans.

The disease belongs to the variola family of viruses, which also includes smallpox. Because of that, Monkeypox symptoms are mostly similar to smallpox symptoms but milder.

In 1958, researchers discovered the first cases of monkeypox during two outbreaks in monkeys being kept for research.

In 1970, researchers recorded the first human case of the disease in the Democratic Republic of the Congo. Since then, 11 African countries have reported monkeypox cases.

In 2003, The first monkeypox outbreak outside of Africa occurred in the United States. Scientists linked this incident to prairie dogs infected with monkeypox.

How does someone become infected with monkeypox?

Transfer of the virus from an animal to a human occurs through:

  • bitting or scratching by an infected animal
  • eating meat or using products from an animal with monkeypox
  • coming into contact with an infected animal’s body fluids.

Once a human with monkeypox, they can transfer the virus to another human through:

  • respiratory secretions during prolonged close, personal, often skin-to-skin contact.
  • intimate physical contact, including kissing and sexual intercourse and through
    • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
    • Hugging, massage, and kissing.

Having multiple or anonymous sex partners may increase the chances for monkeypox infection, so limiting sex partners may reduce the possibility of infection.

  • direct contacting with the infectious rash, scabs or body fluids from a person with monkeypox.
  • touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by a person with monkeypox.
  • pregnant women can transfer the virus to their fetus through the placenta

A recently study found that, between April and June 2022, 98% of monkeypox cases were gay or bisexual men, and 95% of monkeypox cases occurred through sexual transmission.

Monkeypox symptoms

If a person becomes infected with monkeypox, the incubation period before they begin to experience symptoms lasts from 5 to 21 days.

Most people experience two sets of monkeypox symptoms. The first sets occur for about 5 days and include:

  • fever
  • headaches
  • swollen lymph nodes
  • muscle aches and/or back pain
  • respiratory symptoms like sore throat, nasal congestion, or cough
  • chills 
  • exhaustion 
  • low energy.

A few days after fever, a rash normally appears. The rash looks similar to pimples or blisters and can appear on many parts of the body, including:

  • face
  • chest
  • palms of the hands
  • soles of the feet
  • inside the mouth
  • genitals and/ or anus.

Symptoms normally last between two to four weeks. Monkeypox currently has a fatality rate of 3% to 6%.

  • You may experience all or only a few of the symptoms of monkeypox.
  • Some people have experienced a rash before (or without) flu-like symptoms.
  • The rash will go through stages, including scabs, before healing.
  • The rash may also be inside the body, including the mouth, vagina, or anus.
  • Monkeypox can be transferred from the time symptoms start until the rash has healed, all scabs have fallen off, and a new layer of skin has formed. This can take several weeks.

Monkeypox treatment 

Monkeypox treatment normally depends on symptoms and some antiviral drugs.

Tecovirimat (TPOXX) is an antiviral drug developed for the treatment of smallpox and related diseases. Also it is approved for the treatment of monkeypox the European Medicines Agency (EMA) and the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom.

In the United States, the Food and Drug Administration (FDA) approved Tecovirimat for the treatment of smallpox, but not currently monkeypox till now.

Monkeypox prevention

Two vaccines are currently available for monkeypox.

  • JYNNEOS vaccine

The FDA approved the JYNNEOS vaccine — (also known as Imvamune or Imvanex) — for preventing smallpox and monkeypox.

JYNNEOS contains a live Vaccinia virus that doesn't replicate efficiently in human cells.

The JYNNEOS vaccine includes two shots (0.5 mL) subcutaneous (under the skin), and people considered fully vaccinated after about 2 weeks from the second shot.

JYNNEOS is safe to administer to people with HIV and eczema or other exfoliative skin conditions.

  • ACAM2000

The second vaccine, ACAM2000, is approved to prevent smallpox in the U.S. and has an expanded access for monkeypox.

ACAM2000 contains a live Vaccinia virus that is replication competent.

The ACAM2000 vaccine includes only one percutaneous dose via multiple puncture technique with a bifurcated needle, and people considered fully vaccinated about 4 weeks after. 

This vaccine shouldn't be used in people who have specific health conditions, such as a weakened immune system, skin conditions like eczema or other exfoliative skin conditions, or pregnancy.

While vaccination is important, it may not be the complete solution.

Vaccination alone may not work unless supported by other measures — including also capacity to diagnose and treat early.

Medical professionals suggest people take the following steps to help prevent the spread of monkeypox:

  • avoid intimate and skin-to-skin contact with a person who has a rash similar to that of monkeypox
  • try not to touch bedding, clothing, or other materials that may have touched a person with monkeypox
  • wash hands frequently with soap and water
  • in certain African regions, keep away from known animal carriers of monkeypox, and do not touch sick or dead animals.


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