will county — Is monkeypox the next pandemic?
Probably not, said Dr. Jonathan Pinsky, medical director of infection control at Edward Hospital in Naperville.
Pinsky actually treated some of the nine patients involved in a small Midwest outbreak of monkeypox in 2003 that included Illinois. Pinsky’s patients were hospitalized and only required supportive treatment, he said. They all recovered.
So, why shouldn’t people worry?
First of all, monkeypox isn’t new. It’s very rare and unlikely to cause large outbreaks, Pinsky said.
Sporadic cases of monkeypox have been around since 1958, so infectious disease experts understand it.
Furthermore, monkeypox is endemic in Africa and mostly confined to people with direct contact with animals, Pinsky said.
Pinsky said the cases he treated in 2003 were linked to a prairie dog colony that were sold as pets. The prairie dogs likely were infected by a rat that was imported from the Gambia in Africa.
No person-to-person transmission was reported in those patients, he said.
“Those patients all had exposure to the infected prairie dog,” Pinsky said.
Since then, no cases have been reported in prairie dogs or people with prairie dogs as pets, he said.
While person-to-person spread of monkeypox is possible, monkeypox really “doesn’t spread very efficiently,” Pinsky said.
Therefore, monkeypox is very unlikely to cause an epidemic – or even a pandemic.
“You need to get in moderately close contact with someone who is actively infected and has lesions,” Pinsky said. “It’s pretty obvious if someone has it.”
People typically get a rash “all over” that starts from the trunk and spreads to the arms. The cases in the news right now are a bit different.
“In theses cases, some rashes are confined to the genitals,” Pinsky said. “So these are atypical presentations. All these patients have relatively mild illness.”
Pinsky attributed the mild illness to the person-to-person transmission in the current outbreak, resulting in “not a lot of viral exposure as compared to animal exposure.”
“The atypical cases described currently are predominantly in men who have sex with men,” Pinsky said. “And they may be linked to someone who traveled from Africa. It’s still under investigation. But it’s possible these cases may be related to close sexual contact.”
Pinsky stressed that monkeypox is not a sexually transmitted disease. People must have contact with the lesions or respiratory secretions of someone who is sick.
How much contact?
“Well, really, really close contact,” Pinsky said. “It’s not airborne.”
Edward Hospital said monkeypox symptoms include fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion and a sore throat. Most symptoms in the early days are very nonspecific, Pinsky said.
But monkeypox also creates a very specific rash that develops into blisters and pustules – just like chickenpox, herpes, shingles and syphilis have their own specific clinical signs, Pinsky said.
The rash appears one to three days after symptoms develop, Pinsky said.
If doctors suspect monkeypox, they’ll ask if the patients have a history of exposure with someone who is actively infected, he said.
If someone is exposed, the smallpox vaccine can prevent infection, Pinsky said. The smallpox vaccine is not available publicly, but the U.S. has a small supply and can quickly deploy it if necessary, Pinsky said.
Antivirals also are available to treat severe illness, Pinsky said. None of the patients Pinsky treated in 2003 received antivirals, he said.
But considering monkeypox only has resulted in “a handful of cases,” the odds are extremely small that the general public should worry about monkeypox, he said.
Instead, Pinsky advised people to be concerned about COVID-19 and make sure they get vaccinated.
Five things you should know about monkeypox
- It’s not new and very rare.
- It’s spread mostly by animals in Africa.
- Monkeypox causes a very specific rash.
- People typically have mild illness and completely recover.
- Antivirals can treat people with severe illness.