Monkeypox: What to Know

Monkeypox was declared a public health emergency by the World Health Organization (WHO) on July 23, 2022. This is a decision undertaken by the WHO if a disease outbreak is an extraordinary event, when it constitutes a public health risk to other states through international spread, and when a coordinated international response is potentially required. At the time of this blog post being written, the global case count will likely be more than 30,000 cases, contributing to the significant attention from governments and the media. So what does this have to do with dermatology in Florida? Read on to learn more.

Monkeypox is a zoonotic virus related to smallpox. Sporadic outbreaks have historically been reported in Africa, typically originating from contact with wildlife, particularly rodents. Transmission of monkeypox occurs through large respiratory droplets that require prolonged face-to-face contact, direct contact with skin lesions, and possibly through contaminated objects. 

Typically, symptoms will start to develop one to two weeks after an individual has been infected. Nonspecific symptoms then begin to emerge, such as fever, swollen lymph nodes, muscle aches, etc. Due to their nonspecific nature, an infected individual may attribute these symptoms to the flu or viral cold. In the emergence of the current outbreak, some patients may produce only mild symptoms, which are commonly ignored, suggesting that individuals may not be aware at all until the appearance of the hallmark feature: a painful rash.

The current global outbreak has demonstrated changes in monkeypox’s behavior. Men have disproportionately been affected. A UK case series reported only 62 percent with a fever and 56 percent reported swollen lymph nodes. In the past, these two features were considered to be near absolutes in disease presentation. Headache (27 percent), fatigue or exhaustion (41 percent), and muscle aches (31 percent) were also very common among those infected. Painful skin lesions were present in 97 percent of the cases, with 58 percent presenting as fluid-filled lesions, and only 32 percent presenting with more than 10 lesions.

We have certainly not heard the end of monkeypox—however, given its mode of transmission, there is reason for optimism that the current outbreak will ultimately be held under control. 

If anyone is suspicious of a recent illness that coincides with an outbreak of a rash, please contact Skin Wellness Physicians at 239-732-0044 right away for an appointment.

Dr. Daniel Wasserman

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