On July 23, the World Health Organization (WHO) declared monkeypox a public health emergency. Since the historically rare infection has spread rapidly after being detected in the United Kingdom, misinformation about its contraction has also spread.
The way monkeypox attacks the immune system is distinct and cannot be compared to other viruses like chickenpox. “As far as the immune system is concerned, in most other viral infections, the human body generates Cytokines that are able to counter the virus,” states Dr. Manoj Gandhi, Senior Medical Director at ThermoFisher Scientific and Symptomatic Testing Solutions. “However, monkeypox seems to have specific genes that prevent the activation of these Cytokines and inhibits our immune system.” Simply put, the monkeypox virus attacks a specific protein that fights infection. With that protein being weak, the virus can infiltrate and cripple our immune system.
The most apparent symptom of monkeypox is a rash. “It generally starts in the face and spreads to the entire body. It can be mistaken for an STI,” Dr. Manoj elaborates. Other symptoms include fever, headache, chills, and exhaustion. Even though it is not comparable to many viruses, an underlying similarity to COVID-19 is that it can be contracted through contact.
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Before 2022, monkeypox cases were primarily reported in Central and West Africa, resulting in two different variants, a Central African variant and West African variant. If it was contracted by someone who was not a resident of Africa, their case was linked to their international travel or imported animals. The CDC website states that in 1958, the first case was discovered in monkeys, hence the virus’ name. The CDC website also mentions that there is no documentation of a human contracting the virus until 1970. “Prior to the first cases that were identified among humans, it was spread animal to animal, and then human to animal, and then subsequently, animal to human. At this point, particularly in the United States, it is spread human to human,” confirms Dr. Jessie Kimborough Marshall, the Medical Director for Centene Corporation and an Adjunct Clinical Assistant Professor at the University of Michigan.
According to the press conference held by WHO on July 27, there are now over 18,000 cases across 78 countries. Seventy percent of cases are reported in Europe and twenty-five percent from the Americas. As of July 29, the United States has 4,907 confirmed cases. Public health officials believe the reported numbers are inaccurate because of under-testing and under-reported symptoms, but the outbreak will not be treated the same as COVID-19.
The United States has had a relaxed approach to containing the virus, and concerns have surfaced. The first case in the U.S. was reported in May of 2022 and spread from there.
Unlike COVID-19, monkeypox is not respiratory. “You cannot contract it from droplets or smaller respiratory particles coming from the mouth,” says Dr. Jessie. It is less contagious; therefore, public health control measures will not be as extreme. Dr. Jessie says the U.S is primarily dealing with the less aggressive variant. “As far as the outbreak that the U.S. is experiencing, it is the West African type, which is less severe,” she says. Hospitalizations are at 10%, and five deaths were reported worldwide. The hospitalizations are from extreme pain caused by the virus and no casualties were reported in the United States. Those statistics suggest that the virus has a lower impact than COVID-19; therefore, a different approach will be taken to contain the virus. But that does not insinuate the virus should not be taken seriously.
Anyone can be at risk of contracting the virus. Monkeypox is spread from skin-to-skin contact, close proximity, or sharing materials but mainly from sexual activity, as seen in reports. Since 98% of cases reported to WHO are from men who have had sex with other men, it breeds the misconception that monkeypox is an LGBTQIA+- only virus. That is not true.
“The lack of awareness and thinking this is somebody else’s problem, not mine, is not the first time we’ve seen this occur with emerging viruses that have gone into pandemic levels like HIV,” Dr. Jessie says. The stigma around the virus is dangerous. “The truth of the matter is that anyone who is in close contact with a person who has monkeypox is probably at risk of getting it,” Dr. Manoj adds. That also eliminates the misinterpretation that monkeypox is an STI. “People have this other misconception that it is sexually transmitted. It is not an STI. You just need to be in close proximity/ physical contact with that person. It would be unfair to say this is a disease only specific to the LGBTQIA+ community,” he validates.
Eliminating the spread by increased awareness and testing are the next steps. Any rash should be tested and treated as if it could be monkeypox. If you are experiencing any symptoms, it is suggested that you take a PCR test to determine if you contracted the virus. Even though the World Health Organization does not recommend mass vaccination for monkeypox, a vaccine has been approved in the United States, Canada, and European Union and is available for those at high risk of contraction.