Monkey Pox: Facts, Fictions and Unknowns So Far

CDC: US Case Count: 10,392 Total confirmed monkeypox/orthopoxvirus cases as of August 10, 2022

This electron microscopic (EM) image depicted a monkeypox virion, obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was a thin section image from of a human skin sample. On the left were mature, oval-shaped virus particles, and on the right were the crescents, and spherical particles of immature virions.

As monkeypox cases mount and the disease spreads, some people might have déjà vu — here comes another potentially life-disrupting virus. Although monkeypox first surfaced more than six decades ago, public health officials say this outbreak is different because of unprecedented case counts and the spread associated with sexual activity.

The disease was first discovered in monkeys kept for research at the Statens Serum Institut in Copenhagen, Denmark, in 1958. The first human case was reported in 1970 in the Democratic Republic of Congo. 

As The Washington Post reported, the monkeypox virus is from the Orthopoxvirus genus, which includes the variola virus that causes smallpox. Monkeypox is zoonotic, meaning it spreads from animals to humans.

FILE – People line up at a monkeypox vaccination site on Thursday, July 28, 2022, in Encino, Calif. California’s public health officer said they are pressing for more vaccine and closely monitoring the spread of the monkeypox virus. (AP Photo/Marcio Jose Sanchez, File)

Although monkeypox and smallpox have similar symptoms, monkeypox is generally milder and much less likely to cause death, Healthline reported.

Human-to-human monkeypox transmission has now been reported in more than 70 countries; since May 17, more than 6,600 monkeypox cases have been identified in the United States. On Aug. 4, the Biden administration declared monkeypox a public health emergency, a move that can increase funding for health agencies responding to the outbreak and accelerate vaccine distribution. 

The Rash: Monkeypox spreads through close contact, according to the CDC. This includes direct contact with monkeypox rash, scabs or bodily fluids from someone infected with the virus; touching objects, fabrics and surfaces that someone with monkeypox has used; and contact with respiratory secretions from someone who is infected.

Someone who is pregnant can spread the virus to the fetus through the placenta. People can also get monkeypox from infected animals. 

“In short, it’s a virus,” said Andy Seale, an adviser with the WHO and an expert on global HIV, hepatitis and sexually transmitted infections. “Viruses can affect anybody,” he said, and are often spread in more than one way. 

Seale added that current monkeypox cases seem to be “most efficiently transmitted through sexual contact.” Because the virus “found its way into networks” of men who have sex with other men, those men are the most affected. (The sexual networks of men who have sex with men includes people who identify as gay, bisexual, pansexual, transgender and nonbinary.) They stress it is not a sexually transmitted disease but can be spread more efficiently between sexual partners.

  • Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
    • Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
    • Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
    • Contact with respiratory secretions.
  • This direct contact can happen during intimate contact, including:
    • Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
    • Hugging, massage, and kissing.
    • Prolonged face-to-face contact.
    • Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.
  • A pregnant person can spread the virus to their fetus through the placenta.

It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

Scientists are still researching:

  • If the virus can be spread when someone has no symptoms
  • How often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions.
  • Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces. and Politifact and Science

Vaccine protection

The preferred vaccine to protect against monkeypox is JYNNEOS, which is a two-dose vaccine. It takes 14 days after getting the second dose of JYNNEOS for its immune protection to reach its maximum.

The ACAM2000 vaccine may be an alternative to JYNNEOS. ACAM2000 is a single-dose vaccine, and it takes four weeks after vaccination for its immune protection to reach its maximum. However, it has the potential for more side effects and adverse events than JYNNEOS. It is not recommended for people with severely weakened immune systems and several other conditions.

People should take precautions to reduce their exposure to monkeypox until immune protection from vaccines has reached its maximum. Consult your healthcare provider to see if you should get vaccinated against monkeypox, and if you should receive ACAM2000 instead of JYNNEOS.

See the Science and CDC links for vaccine and anti-viral medication efficacy and availability.