Need to Know: Monkeypox

Monkeypox is a viral infection. It is an Orthopoxvirus, the same genus as smallpox. The main reservoirs are thought to be wild mammals, such as African rodents, but people are sometimes infected when they are exposed to these animals or their meat. Person-to-person spread is less common, but possible. The virus enters the body through broken skin, respiratory tract or mucous membranes (i.e., eyes, nose, mouth).

People infected with monkeypox may first experience nonspecific symptoms like fever, headache, feeling tired, swollen glands, and muscle pains, and later to go on to develop a characteristic vesicular rash (pox). Lesions progress from flat to raised lesions, and eventually fluid filled lesions called vesicles, which scab over. The time from exposure to onset of symptoms is around 10 days (can be five to 21 days). Symptoms usually last about two to four weeks. A person is contagious when they develop symptoms and until they scab over and begin to heal. Most people will recover from monkeypox, but some people may require hospitalization. The mortality rate ranges from 1% to 11%, depending on the variant.

A vaccine for smallpox (JYNNEOS™) provides protection against monkeypox. JYNNEOS™ is approved by the U.S. Food and Drug Administration but is not routinely recommended or available in the U.S. on the private market. Another smallpox vaccine, ACAM2000, is also available for people at high risk for smallpox infection. Most people in the U.S. born after 1971 are not vaccinated against smallpox, because smallpox was eliminated from the U.S. due to vaccination prior to this and eradicated from the world by 1980.

There are anti-viral and immune therapy treatments that can be used to treat people with certain high-risk conditions or severe cases of monkeypox. Supportive care should be provided as needed. Infected people should work closely with their health care provider.

The current monkeypox outbreak was first detected in the United Kingdom on April 29, 2022. At the time of this post, fifteen countries, including the U.S. and Canada, have confirmed or suspected monkeypox cases. This has raised concern for a few reasons, considering the cases are in countries (i.e., U.K., Spain, Portugal, Canada, U.S.) that don’t normally report monkeypox, and the precise risk factors for exposure are unclear for some cases. Typically, cases in countries like the U.S. that do not have natural animal reservoirs for the virus, cases occur in people who recently traveled to these locations or are exposed to imported animals. Currently, men who have sex with men have been disproportionally identified as individuals who have been diagnosed with monkeypox.

This virus is different than the virus that causes COVID-19, and unlikely to cause a pandemic-level amount of spread. It is not known to be routinely transmitted through aerosols and typically requires direct animal-to-person or person-to-person contact to spread. Mortality rates are low when infected people have proper medical care.

People who may have symptoms of monkeypox should contact their health care provider. This includes anyone who recently traveled to countries where monkeypox has been identified, those who had contact with someone diagnosed with monkeypox or had intimate contact with someone at high risk. People should continue to practice safe health practices that will reduce the spread of this and many other infectious illnesses.

The NDDoH is closely monitoring the current outbreak and will provide additional information to the public and health care providers as information becomes available. The NDDoH is ready to conduct case investigations, contact tracing, and facilitate treatment and vaccination, if recommended.


News releases:
North Dakota Department of Health identifies monkeypox case (July 20, 2022)

Additional resources:
Monkeypox Vaccine Providers | Department of Health (nd.gov)
Monkeypox (MPV/MPX/MPXV) | Department of Health (nd.gov)
Monkeypox | Poxvirus | CDC
Monkeypox cases confirmed in England – latest updates – GOV.UK
Massachusetts public health officials confirm case of monkeypox | Mass.gov

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