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The Villages
Wednesday, August 17, 2022

What you should know about monkeypox

Dr. Gabe Mirkin

So far, the monkeypox virus does not appear to be likely to cause an epidemic or to be any more dangerous than chicken pox. There is evidence that it can be spread from humans-to-humans, rather than from most cases previously of animal-to-human transmission, so there is concern that this recent monkeypox virus has changed to become more transmissible.

All of the 47 proven cases of monkeypox that occurred in 2003 in North America were traced to contact with pet prairie dogs that were housed near animals imported from Ghana. African rodents may have been the original source of recent cases. The CDC reports that the main source of human-to-human transmission in recent cases occur from:
• large respiratory droplets
• direct contact with body fluids or lesions
• contact with contaminated clothing or bedding

As of May 20, 2022, almost 200 suspected cases have been detected in 12 Western countries including the U.S. (Massachusetts and New York), U.K., Spain, Portugal, France, Canada, Sweden and Italy (MedPage Today, May 20, 2022). Most cases have occurred in people who had not recently traveled to countries in which monkeypox outbreaks are more common, or in people who have contact with wild animals. Previously, monkeypox outbreaks were reported mainly in rainforest regions of Western and Central Africa, and from exposure to wild animals.

Monkeypox Diagnosis and Treatment
The monkeypox virus belongs to the same family of viruses as smallpox, vaccinia (which is used in the smallpox vaccine), and cowpox.
Incubation: The incubation period from exposure to symptoms for monkeypox is 7 to 14 days, but on occasion can take up to 21 days.
Symptoms: Symptoms can start like the flu with fever, muscle aches, and fatigue and cause the lymph nodes to enlarge. Then, after one to four days, a rash with blisters can form often on the face and spread to the rest of the body. The disease usually clears in 2 to 4 weeks.
Death Rate: Less than one percent.
Treatments: There is no proven effective treatment for monkeypox.
• The live-virus smallpox vaccine (Imvamune or Imvanex) helps to prevent monkeypox.
Routine smallpox vaccination programs were stopped in 1972, but people who received that vaccination 50 years ago may still be protected.
• No medication has been proven to be effective to treat monkeypox, but cidofovir and brincidofovir may help.
• The FDA has approved tecovirimat (Tpoxx) pills and injections to treat smallpox and they may help in treating monkeypox.
• Vaccinia immune globulin can also help.

My Recommendations
Stay away from people who have a rash, particularly if it includes blisters. If a person is suffering from monkeypox, the virus can spread to you:
• through the air,
• by touching an infected person, or
• by handling anything that they touch.
Anyone who develops a rash with blisters should check with their doctor immediately.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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