August 22, 2022
6 min. read

How Concerned Should I Be About Monkeypox?


Good to Know:

  • The World Health Organization (WHO) General-Director declared monkeypox a Public Health Emergency of International Concern. President Biden made a similar declaration for the U.S. on August 4th.
  • Monkeypox is a virus similar to smallpox. Most people will experience symptoms for 2-4 weeks, then recover.
  • While there is a monkeypox vaccine, the WHO does not believe widespread vaccinations are necessary at this time.

It’s been about one month since the World Health Organization declared monkeypox a public health emergency of international concern, and President Biden’s declaration was made even more recently on August 4th. In the midst of the ongoing COVID-19 pandemic, it can be concerning to hear this news; however, monkeypox as a public health concern is very different from COVID-19.

With that in mind, it’s still important to practice caution against contracting and spreading the disease. Here’s what you need to know to keep yourself and your family safe.

Quick Statistics: The Centers for Disease Control and Prevention are monitoring the number of monkeypox cases throughout the U.S. As of August 18, 2022, there have been roughly 14,100 cases. 

What is monkeypox?

Monkeypox is a virus similar to smallpox; both belong to a family of viruses called orthopoxviruses. However, smallpox is more contagious and more dangerous. Smallpox was also eradicated in the 1980s with the help of vaccines. In 2008, one study suggested that, if introduced to an unvaccinated population, monkeypox might become an epidemic.

Fast Facts: The name “monkeypox” came from where the disease was first observed in colonies of monkeys used for research back in 1958.

This is not the first time monkeypox has been introduced to the United States: in 2003, a small outbreak occurred with 47 cases in six states. Right now, there are more than 39,000 cases worldwide, many of which have not reported a history of monkeypox. This includes many cases appearing in Europe, Australia, and North and South America.

Monkeypox signs & symptoms

According to the WHO, the most common symptoms of monkeypox to look out for include:

  • Fatigue or low energy
  • Fever
  • Headache
  • Muscle aches
  • Swollen lymph nodes

The WHO calls this phase of the monkeypox virus the initial invasive period, and it typically lasts 0-5 days. Then, 1 to 3 days after the fever, skin lesions will start to appear. These lesions can appear anywhere on the body.

There seems to be a pattern that most cases of monkeypox follow with skin lesions. Usually, lesions will start as red, flat bumps against the skin. Then, one or two days later, the bumps will raise and harden, then in another couple of days the lesions will fill with a clear fluid, like blisters. After this stage, the blisters will become pustules (filled with pus), which last about 5-7 days. The final stage is when the skin lesions become scabs, which eventually fall off. The scabs stay on the skin for about one to two weeks, according to the Cleveland Clinic.

Fast Facts: Some patients have shown subtler signs of monkeypox rash, with some reporting only a single lesion. If you’re concerned about monkeypox and notice a rash or skin lesion, and you’re unsure how you got it, talk to your healthcare provider to rule out monkeypox.

How is monkeypox spread?

Monkeypox is spread by close contact with someone who has monkeypox symptoms. This includes skin-to-skin, face-to-face, and sexual contact; it also includes touching infected clothing, bedding, or other objects, although this seems to be less common. 

It seems that the most common way monkeypox is spread is through contact with skin lesions. Monkeypox remains contagious until lesions scab over and fall off, and new skin has already formed. Until then, any direct contact, including intimate contact, may spread monkeypox.

Fast Facts: Monkeypox is a DNA virus, and DNA virus mutations don’t occur as quickly as they do in RNA viruses. Examples of RNA viruses include influenza and SARS-COV-2, or COVID-19. 

While it is possible to spread monkeypox through respiratory droplets (i.e., coughing or sneezing), the Mayo Clinic stated this requires sustained exposure within 6 feet of a person with the virus for at least 3 hours. This means that, as far as we know, monkeypox does not spread as quickly as COVID-19. The people who are at the highest risk of contracting monkeypox this way are healthcare workers or household members who live with someone with the virus.

Who is at risk for monkeypox?

Anyone can contract monkeypox if exposed to the virus. Currently, in the U.S., the majority of cases appear to be in gay and bisexual men. The WHO is still learning why this is, but we do know the virus can be transmitted in other ways besides intimate contact. We also know that gay or bisexual men are not the only group of people who can contract monkeypox; there are numerous cases of patients who do not fit these criteria. In fact, in Africa where the virus is endemic (regularly occurring at a manageable rate), monkeypox is most common in children under the age of 15. It’s essential that, when we discuss monkeypox cases, we reduce stigma and treat all patients with dignity.

As of August 3rd, the number of pediatric cases of monkeypox within the U.S. has been less than %0.1, according to the American Academy of Pediatrics. Children under the age of 8, children with eczema or other skin conditions, and children with autoimmune conditions do have a higher risk of contracting monkeypox. Even still, it appears the risk of children developing monkeypox remains relatively low. 

How contagious is monkeypox?

Currently, experts believe the likelihood of contracting monkeypox is relatively low. Because it requires direct contact (such as face-to-face or skin-to-skin contact), this monkeypox outbreak is not as contagious as other conditions. By monitoring the number and severity of monkeypox cases, the WHO, CDC, and other healthcare providers can help prevent a widespread pandemic and keep cases of monkeypox to a minimum.

Is monkeypox fatal?

As far as we are aware, the fatality rate of monkeypox is very low and no one has died from the current outbreak in the United States. Roughly 99% of patients infected with monkeypox are expected to survive. Most will recover in 2-4 weeks without the need for treatment. So far, the most common complication from monkeypox is scarring from skin lesions. However, children under 8 years old, people with compromised immune systems, and pregnant or breastfeeding people have a higher risk of the infection being fatal.

Is there a monkeypox vaccine?

There is, but the WHO doesn’t believe that widespread vaccination is necessary at the moment. For now, limiting intimate contact with others, regularly cleaning clothing and objects, and asking others if they’ve shown symptoms before sexual contact can help reduce the spread of monkeypox.

Also, if you’ve already had your smallpox vaccine, you may have some protection as well. Both the WHO and the Mayo Clinic report that those who have already been vaccinated against smallpox report less severe symptoms if they contract monkeypox. Tecovirimat, also called TPOXX, is the vaccine given for smallpox. It’s being used with the CDC’s expanded access Investigational New Drug protocol to test its efficacy as a treatment against monkeypox. Under the CDC’s protocol, your healthcare provider may have access to tecovirimat if you or a loved one contract monkeypox.

What to do if you get monkeypox

  • Isolate yourself for at least three weeks to minimize the spread of monkeypox
  • Contact your healthcare provider and follow their medical advice
  • Avoid close contact with others, including sexual contact
  • Avoid touching and wear a mask if close contact is needed
  • If you have lesions, keep your skin uncovered, clean, and dry
  • Avoid scratching your skin

We are still learning about this current outbreak of monkeypox. But we are also seeing that treatment is available and that symptoms can be managed. Also, all patients in the U.S. have been able to recover. We’ll continue to learn more about the outbreak, but for now, take precautionary measures to stay safe and healthy, and you and your loved ones should be able to avoid the virus. If you do experience symptoms, let your healthcare provider know your concerns.


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