What is monkeypox
and is it a cause for concern?

On 23rd July of this year, the global monkeypox outbreak was declared a public health emergency of international concern by the World Health Organisation (WHO).

According to WHO, the risk to the general public is “moderate” globally and “high” in Europe, and there is a clear risk of further international spread at this time.

Monkeypox can be severe in children, pregnant women or people whose immune systems are compromised due to illness or specific treatments. While countries in Europe have been hardest hit, cases have also been reported in the US, Canada, Australia, Nigeria, Israel, Brazil and Mexico among others.

The symptoms of monkeypox are similar to but milder than the symptoms of smallpox, with the main difference being that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not.

The defining symptom of monkeypox is a distinctive itchy rash that later turns to blisters. The rash, which can be very itchy or painful, changes and goes through a number of different stages before finally forming a scab, which later falls off. The lesions can cause scarring.

The rash, often beginning on the face, spreads to other parts of the body, mainly the palms of the hands and soles of the feet. It usually appears two to four days after the other symptoms. 

The early signs of monkeypox include flu-like symptoms such as:

• Fever
• Chills
• Headaches
• Backache
• Muscle aches
• Fatigue
• Swollen lymph nodes

According to the Centers for Disease Control and Prevention, the incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.

According to the World Health Organisation, the monkeypox outbreak has been largely among men who have sex with men. However, experts have stressed that anyone can get monkeypox as it is usually spread through close contact with an infected person or animal via large respiratory droplets or by skin-to-skin contact.

It can also be spread indirectly through contact with contaminated clothing or bedding used by someone with the rash. 

A vaccine has been recently approved for preventing monkeypox. Many years of research have led to development of newer and safer vaccines for smallpox, which may also be useful for monkeypox. One of these has been approved for prevention of monkeypox.

Only people who are at risk (for example someone who has been a close contact of someone who has monkeypox) are being considered for vaccination, and mass vaccination is not being recommended at this time. Some countries have, or are developing, policies to offer vaccines to people who may be at risk such as laboratory personnel, rapid response teams and healthcare workers. 

Symptoms normally resolve on their own without the need for treatment and most people fully recover in two to four weeks. If needed, medication for pain and fever can be used to relieve some symptoms.  It is important for anyone with monkeypox to stay hydrated, eat well, and get enough sleep.

Anti-viral drugs used to treat smallpox can be used to treat anyone who becomes severely ill with monkeypox. People who suspect they have monkeypox should isolate and seek medical care.