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The Villages
Thursday, December 1, 2022

Monkeypox is spreading faster than expected

Dr. Gabe Mirkin

The World Health Organization (WHO) reports that monkeypox is spreading faster than early reports stated. The increased spread is due to the virus’s 50 DNA mutations from 2018 to 2022, or up to 12 times the expected number of mutations (Nature Medicine, June 24, 2022). This could lead to 100,000 cases worldwide by August, 2022 and 500,000 to one million cases by the end of September. A monkeypox vaccine is now being made in Denmark, and the company is expected to send about two million doses to the United States by the end of 2022.

Transmission and Symptoms
Monkeypox usually starts out as a relatively mild viral infection, with a 6-16 day incubation period. The virus can be transmitted through the air or on objects, so:
• Avoid direct contact with skin lesions and materials used by patients (clothing, bedding, and towels)
• Avoid infected patients. If you must be exposed, wear a mask and protective clothing
• Do not touch anything that may have been touched by an infected individual.

Symptoms include sore throat, fever, headaches, swellings, back pain, swollen lymph nodes, aching muscles, and fatigue and weakness. In a few days, the fever and symptoms decrease and a rash spreads first across the face, then to the rest of the body, most prominently on the palms of the hands and soles of the feet. The crusted blisters then take two to three weeks to heal. Complications can include pneumonia, brain infection (encephalitis) or eye infections. Estimates of the death rate range from 1-11 percent, and the WHO says the current range is around 3-6 percent (WHO Fact Sheet, May 19, 2022). Monkeypox is of particular concern for:
• the immuno-compromised
• pregnant women
• young children
Special tests are needed to make a diagnosis of monkeypox, because the rashes caused by chickenpox, measles, scabies and syphilis can appear in the same way. See my earlier report on What You Should Know About Monkeypox

There is currently no specific antiviral treatment for monkeypox, but those with severe disease, immunocompromised patients, children younger than eight years, and pregnant women should probably receive anti-viral medication (tecovirimat or brincidofovir). Intravenous vaccinia immune globulin (VIGIV) may be considered. Doctors should contact the CDC Emergency Operations Center.

My Recommendations
Anyone who develops a rash with blisters should check with their doctor immediately. Stay away from people who have a rash, particularly if it has blisters. If they are suffering from monkeypox, the virus can spread to you through the air or by touching them or anything they touch.

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

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