What to Know About Monkeypox

What to Know About Monkeypox

Claremont Colonic Monkeypox
Total cases reported worldwide remain low but have begun to rise sharply, and they likely represent an underestimate, experts say.
The rare monkeypox virus, usually confined mostly to Central and West Africa, has spread in unusual ways this year, and among populations that have not been vulnerable in the past.

President Biden has said that “everybody should be concerned about” the rise in cases. The transmissions have created some alarm among officials and infectious disease experts, while a Covid-weary world is on high alert for new outbreaks.

From the beginning of the year until June 27, there were 3,413 confirmed cases worldwide and one death, in Nigeria, according to the World Health Organization. Cases have been concentrated among gay men. The U.S. has begun a vaccination campaign, although critics have protested that it is too limited to be effective.

Here’s what to know about monkeypox and the risks it poses.

What is monkeypox?

Monkeypox is a virus endemic in parts of Central and West Africa. It is similar to but less severe than smallpox, which is caused by a related virus, according to the Centers for Disease Control and Prevention.

It was discovered in 1958, after outbreaks occurred in monkeys kept for research, the C.D.C. said.

While there remains debate among scientists about how exactly to describe the sexual transmissibility of monkeypox, sexual contact does appear to be a driver of the virus’s current spread.

What are the symptoms of monkeypox?

Monkeypox creates a rash that starts with flat red marks that become raised and filled with pus. Infected people will also have a fever and body aches.

Symptoms typically appear in six to 13 days but can take as long as three weeks after exposure. They can last for two to four weeks, with severe cases occurring more commonly among children, according to the World Health Organization.

The C.D.C. says there is “no proven, safe treatment” for monkeypox but the Food and Drug Administration has approved the use of smallpox vaccines and antiviral treatments to control outbreaks.

How infectious is it?

Typically, it does not lead to major outbreaks — in most years there are just a handful of cases outside Africa, if any. The most severe outbreak in the United States came in 2003, when dozens of cases were linked to exposure to infected prairie dogs and other pets. It was the first time there had been a monkeypox outbreak outside of Africa, according to the World Health Organization.

In Africa, 11 countries have reported cases since 1970, when the first human case was identified in a 9-year-old boy in the Democratic Republic of Congo. Nigeria has experienced a large outbreak, with more than 500 suspected cases and 200 confirmed cases since 2017, the W.H.O. said.

“Most cases presented with lesions on the genitalia or peri-genital area, indicating that transmission likely occurs during close physical contact during sexual activities,” the European Center for Disease Prevention and Control said in May.

How many cases have there been this year, and where have they been?

The monkeypox outbreak has been concentrated in Europe, with 86 percent of total cases, the W.H.O. says. There have been just over 300 confirmed cases in the U.S. as of late June, according to the Centers for Disease Control and Prevention.

Cases have appeared in several countries without any known source of infection, which suggests undetected community spread. Genetic analysis indicates that monkeypox has been quietly circulating since 2018.

The first confirmed case in the U.S. was diagnosed in Massachusetts on May 18 in a man who had recently traveled to Canada. As of June 28, New York City had reported 55 cases.

Europe has been hit harder. Britain leads the world with 793 cases; Germany comes in at second, with 521; and Spain is just behind, with 520, the W.H.O. said.

Experts say these figures do not fully reflect the reality of monkeypox’s spread. “It’s pretty clear to me and I think many others that the epidemic is far larger in magnitude than what our official case counts suggest it is,” Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response, told The New York Times.

The W.H.O. has emphasized that while monkeypox may infect anyone, it is being identified particularly in communities of men who have sex with men.

How is the current outbreak different?

This is the first time that chains of transmission were reported in Europe without links to West or Central Africa, according to the European Center for Disease Prevention and Control. The agency also said this year’s cases included the first that have been reported among men who have sex with men.

Should I be worried?

The likelihood of the virus being spread during sexual contact is high, but the risk of transmission from other forms of close contact is low, the European Center for Disease Prevention and Control said.

The symptoms are typically mild, and most people recover within weeks, but the virus has had a fatality rate of about 3.3 percent in Nigeria, with children, young adults and immunocompromised people most susceptible.

Federal health officials announced on June 28 that clinics nationwide will provide vaccinations against monkeypox to anyone who might have been exposed. Officials estimate that 1.6 million doses will be made available by the end of the year.

In a guest essay in The New York Times, Dr. Varma, who is also a professor at Weill Cornell Medical School, warned that the nation was repeating mistakes it made responding to the coronavirus, like “limited access to testing, contact tracing, vaccination and isolation support, and scant data from public health officials about how and where people are being infected.”

A previous outbreak of monkeypox in the U.S. in 2003 appeared to end after infecting only 71 Americans. But Dr. Varma wrote that he and other experts fear that monkeypox could now wind up becoming an entrenched sexually transmitted infection like syphilis and H.I.V.

Contributors: Daniel Victor and Alex Traub – NYTimes.com

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