Monkeypox Explained: Treatment, Transmission, Rash Symptoms

Monkeypox, also known as mpox, is a viral disease that has recently gained global attention due to its rapid spread and potential health risks. This comprehensive guide will provide you with essential information about monkeypox, including its symptoms, transmission, treatment, and the latest developments in vaccination. We will also explore the first signs of infection and address the question of whether monkeypox is deadly. By the conclusion of this article, you’ll gain a clearer insight into this growing health issue and learn ways to safeguard yourself and your loved ones.

What is Monkeypox?

Monkeypox is a viral illness caused by the monkeypox virus, which belongs to the Orthopoxvirus genus in the Poxviridae family. This virus is closely related to the smallpox virus, but it typically causes milder symptoms. The disease was first discovered in 1958 in monkeys kept for research, and the first reported human case was in 1970 in the Democratic Republic of the Congo.

Symptoms of Monkeypox

Monkeypox, now known as mpox, presents a variety of symptoms that can be categorized into two main phases. The symptoms typically begin within 3 to 17 days after exposure to the virus, with most cases showing symptoms within a week. The duration of the illness usually lasts between 2 to 4 weeks.

Initial Symptoms

The first symptoms of mpox often resemble flu-like conditions and may include:

Fever
Chills
Headache
Muscle aches
Back pain
Fatigue
Sore throat
Swollen lymph nodes (this is a distinguishing feature from smallpox and chickenpox) .

Rash Development

Following the onset of fever, a rash typically develops within 1 to 4 days. The rash progresses through several stages:

Papules: Small, raised bumps appear.
Vesicles: These bumps turn into blister-like lesions filled with fluid.
Pustules: The vesicles then become pus-filled.
Crusting: Eventually, the lesions dry out, crust over, and fall off.

The rash can appear on various parts of the body, including the face, hands, feet, chest, and near the genital area. It may be painful or itchy and can vary in number from a few lesions to hundreds .

Complications

While most individuals recover without treatment, complications can arise, especially in those with weakened immune systems or young children. Serious complications include secondary infections, pneumonia, and, in rare cases, death. The mortality rate for mpox is generally low, ranging from 0% to 11%, with higher risk in children and immunocompromised individuals .

Modes of Monkeypox Transmission

Monkeypox can be transmitted through several modes:

Animal-to-Human Transmission

Direct contact or exposure with infected animals, most commonly through bodily fluids like saliva, respiratory excretions, or exudate from cutaneous or mucosal lesions
Viral shedding via feces can also be an exposure source

Human-to-Human Transmission

Respiratory droplets during prolonged face-to-face contact
Direct contact with skin lesions, body fluids, or contaminated materials like clothing or linens of an infected individual
Possible transmission through semen or vaginal fluids, still under investigation
Unlikely to occur during short periods of shared airspace

Environmental Transmission

Touching contaminated objects or surfaces like bedding or dishes used by an infected person

The current monkeypox outbreak appears to be concentrated in men who have sex with men, with some cases associated with unexpected anal and genital lesions. However, anyone who has close contact with an infectious person can get monkeypox, regardless of their sexual orientation or gender identity.

Monkeypox does not persist in the air and is not spread through brief encounters in shared airspace. Long-range (airborne) transmission has not been reported. The virus follows a similar infectious pathway to smallpox, with the oropharyngeal or respiratory mucosa as the site of inoculation in human-to-human transmission.

Human-to-dog transmission has been reported in one case, where a dog tested positive for monkeypox after close contact with its infected owners. However, more research is needed to understand the role of pets in monkeypox transmission.

Human monkeypox infections have been associated with contact with wild animals, though identifying the exact source can be challenging in regions where household rodent infestations and hunting or preparing bushmeat are common.

Human-to-human transmission is considered less common than animal-to-human, but it remains the primary driver of the current outbreak in non-endemic countries.

Treatment of Monkeypox

Currently, there is no treatment specifically approved for monkeypox virus (MPXV) infections. For most patients with intact immune systems, supportive care and pain control are sufficient for recovery without medical treatment.However, some patients may experience severe manifestations of monkeypox, such as ocular infections, neurologic complications, myopericarditis, complications from mucosal lesions, or uncontrolled viral spread due to immunocompromise. These patients may require more intensive treatment.

Available Therapeutics

The following treatments are available under expanded access or compassionate use protocols:Tecovirimat (TPOXX)

FDA-approved for treatment of smallpox, also used for monkeypox under expanded access
Primarily available through the Study of Tecovirimat for Mpox (STOMP) clinical trial

Brincidofovir (Tembexa)