Monkeypox: what it is, how it is spread, who is at risk and how to protect yourself

What is monkeypox?
It is a disease caused by a virus known as monkeypox. It is a zoonotic viral disease, which means it can be transmitted from animals to humans. It can also spread from person to person. Interestingly, the disease is so named because it was detected in several apes in a laboratory in 1958. However, most animals susceptible to contracting the disease and then infecting people are rodents, such as Gambian giant rats, dormouse or prairie dogs.

Where is it typically found?
Monkeypox is commonly found in the rainforests of central and western Africa, where animals that may carry the virus live, and is endemic. On some occasions, it can also be found in people outside those African regions who could have been infected after visiting them.

What are the symptoms?
Symptoms usually include fever, severe headache, muscle aches, back pain, low energy, swollen lymph nodes, and a rash or lesions on the skin.

The rash usually begins on the first day or three of the onset of the fever. Lesions may be flat or slightly raised, filled with clear or yellowish fluid, then crust over, dry up, and fall off. The number of injuries to a person varies from a few to several thousand. The rash tends to occur on the face, palms of the hands, and soles of the feet. They can also be found in the mouth, genitals, and eyes.

Symptoms usually last two to four weeks and go away on their own without treatment. If you think your symptoms could be related to monkeypox, contact your doctor immediately. If you had close contact with someone who has these symptoms or suspect that there is a possibility of being infected, notify your doctor.

Can people die from monkeypox?
In most cases, smallpox symptoms go away on their own within a few weeks, but in some people they can lead to medical complications and even death. Newborns, children, and people with immune deficiencies may be at risk of more severe symptoms and death from the disease.

Complications of severe cases include skin infections, pneumonia, confusion, and eye infections that can lead to vision loss. Between 3% and 6% of the identified cases where monkeypox is endemic have resulted in deaths. Many of these cases are children or people who may have other health conditions. It must be taken into account that these figures could be an overestimate because the accounting of cases in endemic countries is limited.

How is monkeypox transmitted from animals to humans?
This condition can be spread to people when they come into physical contact with an infected animal. Animals that host this virus can include rodents or primates. The risk of contracting the disease from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including contact with their flesh and blood). It is crucial to stress that any food containing meat or animal parts must be cooked, especially in countries where monkeypox is endemic.

How does it spread from person to person?
People who have the disease are contagious for as long as they have symptoms (usually for the first two to four weeks). You can get this condition through physical contact with someone who has symptoms. Rashes, bodily fluids (such as fluid, pus, or blood from skin lesions), and scabs are particularly infectious. Contact with objects that have been in contact with the infected person such as clothing, bedding, towels or objects such as eating utensils can also represent a source of infection.

Ulcers, lesions or sores can also be infectious since the virus can spread through saliva. Therefore, we will have a high risk of infection if we live with infected people in our home or if we do so with sexual partners. Also people who work in the health sector are more exposed.

The virus can also be transmitted from a pregnant woman to the fetus through the placenta, or through contact from an infected parent with the child during or after delivery through skin-to-skin contact.

However, it is not clear whether people who are asymptomatic can transmit the disease.

Who is at risk of contracting it?
Anyone who comes into physical contact with someone with symptoms or an infected animal is most at risk of infection. People who have been vaccinated against smallpox are likely to have some protection against infection. In 1980 smallpox became the first human disease to be eradicated, so vaccination against this disease was stopped. Therefore, the youngest are more likely to contract it. However, people who have been vaccinated against smallpox should also take precautions to protect themselves and others.

Newborns, children, and people with underlying immunodeficiencies may experience more severe symptoms and a higher risk of death. Likewise, health workers are at high risk of contagion due to their prolonged exposure to the virus.

How can I protect myself and others?
You can reduce the risk of contagion by limiting contact with people who suspect they have the disease or are confirmed cases.

If you need to have physical contact with someone with this condition because you are a healthcare worker or you live together, encourage the infected person to isolate themselves and cover any skin breaks if they can (for example, by wearing clothing over the rash). You will need to wear a medical mask when you are physically around them, especially if they are coughing or have mouth sores. Avoid skin-to-skin contact and if you have any direct contact, wear disposable gloves. Wear a mask if you have to touch an infected person’s clothing or bedding.

Wash your hands frequently with soap and water or use an alcohol-based hand rub, especially after coming in contact with the infected person, or with their clothing (including sheets and towels) or other items or surfaces you have touched or that may have come in contact with your rash or respiratory secretions (for example, utensils or dishes).

Wash the infected person’s clothing, towels, sheets, and eating utensils with warm water and detergent. Clean and disinfect any contaminated surfaces and dispose of contaminated waste (such as dressings) appropriately.

Can children get monkeypox?
Children can get it and are often more likely to have severe symptoms than adolescents and adults. The virus can also be transmitted from the woman to the fetus or newborn during birth or by physical contact.

What should I do if I suspect that I have been infected?
Contact your doctor immediately for medical advice, testing and care if you think you have symptoms or have been in contact with someone who is infected. If possible, isolate yourself and avoid close contact with other people. Wash your hands frequently and follow the steps listed above to protect others from contagion. Your healthcare worker will take a sample for testing so you can receive appropriate care.

Is there a vaccine?
There are several vaccines available for the prevention of smallpox that also provide some protection. A smallpox vaccine (MVA-BN, also known as Imvamune, Imvanex, or Jynneos) was recently developed and was approved in 2019 for use in preventing monkeypox and is not yet widely available. WHO is working with the vaccine producer to improve its access. People who have been vaccinated against smallpox in the past will also have some protection.

Is there any treatment?
The symptoms often go away on their own without the need for treatment. It is important to care for the rash by letting it dry if possible or covering it with a moist bandage if necessary to protect the area. Avoid touching any sores in your mouth or eyes. Mouthwashes and eye drops can be used as long as cortisone-containing products are avoided. For severe cases, vaccinia immune globulin (VIG), an antiviral that was developed to treat smallpox (tecovirimat, marketed as TPOXX) that was also approved for the treatment of monkeypox in January 2022, may be recommended.

In which part of the world is there currently a higher risk?
Since 1970, human cases of monkeypox have been located in 11 African countries: Benin, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Côte d’Ivoire, Liberia, Nigeria, Republic of the Congo, Sierra Leone, and Sudan. South.

The cases that occur sporadically in non-endemic countries are from people who became infected while traveling to endemic countries. One outbreak was caused by contact with animals imported to the people with whom they lived.

In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. This is not usual in previous patterns of the disease. WHO is working with all affected countries to improve surveillance and provide guidance on how to stop the spread and how to care for infected people.

What do we know about the outbreak identified in several countries in May 2022?
Several countries where this type of smallpox is not endemic reported cases in May 2022. As of May 19, 2022, cases were reported in more than 10 countries in non-endemic areas. Additional cases are being investigated.

With the exception of a few cases detected in travelers visiting endemic countries, cases in non-endemic areas that are not linked to travel from endemic countries are rare. At present (as of May 2022), there is no clear link between reported cases and travel from endemic countries and no link to infected animals.

We understand that this outbreak is concerning to many, especially those whose loved ones have been affected. The most important thing at this time is that there is greater awareness of monkeypox among people who are most at risk of infection and that we offer advice on how to limit further spread between people. It is also important for public health workers to be able to identify and care for patients. It is critical to understand that no one who is affected by the virus should be stigmatized.

The World Health Organization is working to support Member States with surveillance, preparedness and outbreak response activities in affected countries.

Studies are also underway in affected countries to determine the source of infection for each identified case and to provide medical care and limit further spread.

Is there a risk of it becoming a bigger outbreak?
Monkeypox is generally not considered highly contagious because it requires close physical contact with someone who is contagious (for example, skin-to-skin). The risk to the public is low. WHO is responding to this outbreak as a high priority to prevent further spread; monkeypox has been considered a priority pathogen for many years. The cases we are currently seeing are not typical because there is no information on travel from endemic countries or animals exported from endemic countries. Identifying how the virus is spreading and protecting more people from becoming infected is a priority for the UN agency. Raising awareness about this new situation will help stop further transmission.

Is monkeypox a sexually transmitted infection?
The condition can spread from one person to another through close physical contact, including sexual contact. However, it is currently unknown whether it can be spread by sexually transmitted routes (for example, through semen or vaginal fluids). However, direct skin-to-skin contact with lesions during sexual activities can spread the virus.

Rashes may occasionally appear on the genitals and in the mouth, probably contributing to transmission during sexual contact. Therefore, mouth-to-skin contact could cause transmission when there are lesions in one of these parts.

The rashes can also resemble some sexually transmitted diseases, such as herpes and syphilis. This may explain why several of the cases in the current outbreak have been identified among men seeking care at sexual health clinics.

The risk of becoming infected is not limited to sexually active people or men who have sex with men. Anyone who has close physical contact with someone who is contagious is at risk. Anyone who has symptoms that could be monkeypox should seek the advice of a health worker immediately.

What is the World Health Organization’s response to stigmatizing messages circulating online related to disease?
We have seen messages that stigmatize certain groups of people around this outbreak. We want to make it very clear that this is unacceptable.

First, anyone who has close physical contact of any kind with someone with monkeypox is at risk, regardless of who they are, what they do, who they choose to have sex with or any other factor. Second, it is unacceptable to stigmatize people for a disease. The stigma is likely to only make things worse and prevent us from ending this outbreak as quickly as possible. We need to stick together to support anyone who has been infected or who is helping care for people who are unwell. We know how to stop the spread and how we can protect ourselves and others. Stigma and discrimination are never acceptable. We are all in this together.