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Monkeypox: What is it? How Does it Spread?

On July 23, 2022, the World Health Organization (WHO) declared the monkeypox outbreak a global public health emergency.

WHO Director General Tedros Adhanom Ghebreyesus stated, “We have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little, and which meets the criteria in the international health regulations.”

A global emergency is the WHO’s highest level of alert, declared in response to “an extraordinary event which is determined to constitute a public health risk through the international spread of disease and to potentially require a coordinated international response.”

As of this writing, Canada has confirmed 681 cases of monkeypox across five provinces, including British Columbia, Alberta, Saskatchewan, Ontario, and Quebec.   

In response to the WHO’s declaration, the Government of Canada said in a statement that it will “continue to work closely with international, provincial and territorial health partners to gather information on this evolving outbreak and to assess the possible risk of exposure of the monkeypox virus in Canada.”

What is Monkeypox?

Monkeypox is caused by the monkeypox virus, which is part of the same family of viruses as the variola virus, which causes smallpox. 

It was first discovered in 1958 after two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research – it was first identified in humans in 1970, in a 9-month-old boy living in the Democratic Republic of the Congo.  

It is typically found in remote parts of central and west African countries, near tropical rainforests. According to the WHO, there have been more than 1,200 cases of monkeypox in these regions since the start of 2022.

Monkeypox is not related to chickenpox.

How does Monkeypox Spread?

Monkeypox is spread through large respiratory droplets, close or direct contact with the infectious rash, scabs, or body fluids, and from touching or sharing items (e.g., clothing, bedding, razors, toothbrushes) that previously touched the infectious rash. Pregnant people can also spread the virus to their fetus through the placenta.  

It’s also possible to contract the virus from infected animals, either from scratches or bites, or by preparing meat from an infected animal. There is no clear evidence of monkeypox being spread via sexual transmission through seminal or vaginal fluids.

Monkeypox Symptoms

Monkeypox symptoms are similar to smallpox symptoms, but are typically milder and rarely fatal. Most people develop symptoms 5 to 21 days after exposure, with symptoms lasting from 2 to 4 weeks depending on severity.  

Early symptoms include:

  • fever
  • chills
  • swollen lymph nodes
  • headache
  • muscle pain
  • joint pain
  • back pain
  • exhaustion

A painful rash that looks similar to pimples or blisters typically develops within 1 to 3 days after onset of symptoms. It commonly appears on the face, inside the mouth, as well as the hands, feet, chest, genitals, or anus. The rash lasts an average of 14 to 28 days and will go through various stages, starting as flat lesions, then raised lesions, vesicles, and then pustules. At the later stages, ulcers will form that eventually scab over and fall off. Some lesions may cause scarring.

The virus will usually self-resolve within 2-4 weeks, however in severe cases, it can cause complications including: 

  • bacterial superinfection
  • corneal infection (may lead to vision loss)
  • sepsis
  • pneumonia
  • encephalitis
  • death

In recent cases, case fatality ratio has been around 3 to 6 percent.

Treatment for Monkeypox

Currently, there is no official treatment for monkeypox, however some existing antiviral medications including TPOXX (tecovirimat monohydrate) and IMVAMUNE may be useful in some instances.

Staying Safe

For now, your best bet is reducing your risk of contracting the virus. The Government of Canada advises taking the following steps:

  • stay home and limit contact with others if you have symptoms. 
  • avoid close physical contact, including sexual contact, with someone who is infected with or may have been exposed to the monkeypox virus
  • maintain good hand hygiene and respiratory etiquette, including covering coughs and sneezes with the bend of your arm or wearing a well-fitting mask
  • clean and disinfect high-touch surfaces and objects in your home, especially after having visitors

If you suspect you have the virus, seek medical treatment as soon as possible. 

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