Monkeypox

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Mary D. Nettleman, MD, MS, MACP
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Monkeypox Symptoms, Signs, and Transmission

What are the clinical features of monkeypox?

In humans, monkeypox is similar to smallpox, although it is often milder. Unlike smallpox, monkeypox causes lymph nodes to swell (lymphadenopathy). The incubation period for monkeypox is about 12 days (range 7 to 17 days). The illness begins with fever, headache, muscle aches, backache, swollen lymph nodes, a general feeling of discomfort, and exhaustion. Within 1 to 3 days (sometimes longer) after the appearance of fever, the patient develops a papular rash (i.e., raised bumps), often first on the face but sometimes initially on other parts of the body. The lesions usually develop through several stages before crusting and falling off.

How long does monkeypox last?

The illness typically lasts for 2 to 4 weeks.

Is monkeypox fatal?

Studies of human monkeypox in rural central and west Africa ? where people live in remote areas and are medically underserved ? have reported case-fatality ratios of 1% to 10%.

How do people get monkeypox?

Monkeypox can spread to humans from an infected animal through an animal bite or direct contact with the animal?s lesions or body fluids. The disease also can be spread from person to person, although it is much less infectious than smallpox. The virus is thought to be transmitted by respiratory droplets during direct and prolonged face-to-face contact. In addition, it is possible monkeypox can be spread by direct contact with body fluids of an infected person or with virus-contaminated objects, such as bedding or clothing.

SOURCE: CDC

Monkeypox facts

  • Monkeypox is a viral disease that produces pox lesions on the skin and is closely related to smallpox but is not nearly as deadly as smallpox was.
  • The history of monkeypox is new (1958), and the first human cases were diagnosed and differentiated from smallpox in the early 1970s.
  • Monkeypox virus causes monkeypox. The majority of cases are transmitted from animals (rodents) to humans by direct contact. Person-to-person transfer, probably by droplets, can occur infrequently.
  • Risk factors for monkeypox include close association with African animals (usually rodents) that have the disease or caring for a patient who has monkeypox.
  • During the first few days, symptoms are nonspecific and include fever, nausea, and malaise. After about four to seven days, lesions (pustules, papules) develop on the face and trunk that ulcerate, crust over, and begin to clear up after about 14-21 days, and lymph nodes enlarge. There may be some scarring.
  • The diagnosis of monkeypox is often made presumptively in Africa by the patient's history and the exam that shows the pox lesions, however, a definitive diagnosis is made by PCR, ELISA, or Western blotting tests that are usually done by the CDC or some state labs. Definitive diagnosis is important to rule out other possible infectious agents like smallpox.
  • Treatment may consist of immediate vaccination with smallpox vaccine because monkeypox is so closely related to smallpox. Treatment with an antiviral drug or human immune globulin has been done.
  • In general, the prognosis for monkeypox is good to excellent as most patients recover. The prognosis may decrease in immunocompromised patients, and patients with other problems such as malnutrition or lung disease may have a poorer prognosis.
  • Monkeypox is preventable as long as people avoid direct contact with infected animals and people. Vaccination against smallpox seems to afford about an 85% chance of avoiding the infection. There is no commercially available vaccine specifically for monkeypox.
  • Research is ongoing to study antivirals, genetics, and rapid tests for monkeypox.
Medically Reviewed by a Doctor on 2/8/2016
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