Monkeypox is a serious virus that is popping up in unusual places, but public health experts don’t expect another deadly plague layered on top of the coronavirus, which spreads far more easily.
The Centers for Disease Control and Prevention wants Americans to be on the lookout for rashes and other signs of monkeypox as Massachusetts treats a patient who recently traveled to Canada.
The U.S. case follows clusters in countries that don’t typically see cases — Canada, Portugal, Spain, Sweden, Italy and the U.K. — so officials are trying to determine if there is a link.
Some monkeypox strains have been known to cause death in as many as one in 10 cases, though current cases are believed to be of a less lethal kind that causes death in fewer than 1% of cases.
“I wouldn’t expect we’d have mortality with this illness, this outbreak, but these are bothersome and serious infections,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “It’s not going to spread widely, it requires close personal contact.”
The virus can spread through body fluids, monkeypox sores, or shared items such as clothing and bedding that have been contaminated by a person with monkeypox. It can also spread through respiratory droplets, though not as efficiently as COVID-19.
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“It’s much less contagious than COVID19 or influenza,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
The disease is marked by fever, headache and swollen lymph nodes and causes a notable rash that can spread all over the body.
“It starts as just a red blotch and then becomes a bit of a blister, and then that blister becomes firm and rubbery. And it fills with puss. It gets kind of yellowy and hard and it takes time for these blisters to be resolved,” Dr. Schaffner said. “You can be left with a scar — the ‘pox.’”
Federal officials said people who see symptoms of monkeypox, including unusual rashes, should contact their doctors. They said men who have sex with other men may be at higher risk now, based on trends in the latest cases.
“Many of these global reports of monkeypox cases are occurring within sexual networks. However, healthcare providers should be alert to any rash that has features typical of monkeypox. We’re asking the public to contact their healthcare provider if they have a new rash and are concerned about monkeypox,” Inger Damon, a poxvirus expert and director of the CDC’s Division of High-Consequence Pathogens and Pathology.
The virus was discovered in 1958 in monkeys, hence the name, though rodents in Africa are most likely to carry it. Persons who come into contact with the rodents, often children, may catch it and spread it to other people through close contact.
The first human outbreak was detected in the Democratic Republic of Congo in the 1970s and most cases reported since then have occurred in central and western African countries.
The virus reemerged in Nigeria in 2017. There have been more than 450 reported cases in Nigeria since then and at least eight cases that were exported to other countries.
There are antiviral drugs that can be used to treat monkeypox.
Monkeypox is related to smallpox, meaning the vaccine for the latter can be protective, though the world hasn’t been vaccinated for smallpox in some time.
“One thing worth remembering — we expect cross-protection against monkeypox from smallpox vaccination, but younger people are not vaccinated, and immunity has been waning in older people for decades,” tweeted Bill Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health.
U.K. officials said they are offering the smallpox vaccine to persons who are considered higher-risk contacts of known cases.
The technique, known as “ring” vaccination, has been successful in combatting diseases like Ebola.
In the U.S., officials are conducting contact tracing while the Massachusetts patient is in stable condition at Massachusetts General Hospital.
“The patient is doing well, safely in isolation, in our unit,” said Dr. Paul Biddinger, director of the hospital’s Center for Disaster Medicine.
Dr. Adalja said there will likely be more cases in the U.S. but the threat to the general public is “low and the smallpox vaccine and antivirals are always the backstop, if needed.”