How much should people worry about contracting monkeypox? Should everyone be trying to get the vaccine? Who are the groups most at risk, and what actions should they take? How exactly is monkeypox spread and how can people prevent from trying to get it? What are common symptoms to look out for?
CNN: How is monkeypox spread? Is it as transmissible as Covid-19, another disease that we know very well by now?
Dr. Leana Wen: Monkeypox is not spread like Covid-19. As we know by now, Covid-19 is highly transmissible and can be spread through microscopic aerosols. That means you could be infected by someone who you’re having a casual conversation with or even someone who happens to be in the same conference room or restaurant as you.
Monkeypox is primarily spread through prolonged, direct, skin-to-skin contact. Most cases thus far have been linked to sexual activity though this is not considered a sexually transmitted infection. Rather, individuals can spread monkeypox through intimate contact, such as kissing, hugging, cuddling and sexual intercourse.
CNN: What kinds of symptoms do patients with monkeypox have?
Wen: People who contract monkeypox often first start developing fever, headache, muscles aches and overall fatigue — similar to many other viral illnesses. Many people also have lymph node swelling. They then develop a rash that progresses into blisters, pimples or sores. The lesions can be all over the body or only in one part. It could be localized to just the anal or genital area, on the face, inside the mouth, or any other part of the body.
Clinicians seeing patients with a fever and new rash should have a low threshold for testing for monkeypox, especially if the patient is in a high-risk group for contracting monkeypox. Importantly, the recent study also found that 29% of people diagnosed with monkeypox had a sexually transmitted infection. To me, this means that just because a patient is diagnosed with one thing doesn’t mean they can’t have another, too, and patients in high-risk groups who have new lesions need to get tested to rule out monkeypox.
CNN: What started monkeypox, and how widespread is it in the United States?
Wen: Monkeypox is a virus that is in the same family as the smallpox virus. It was first discovered in 1958 in monkeys, hence the name, though its usual animal hosts are rodents and other small mammals. It first appeared in humans in 1970 in east Africa. It has been endemic in countries in sub-Saharan Africa, with outbreaks sometimes occurring when infected travelers bring back the disease to their home countries. There was a big outbreak in the United States in 2003 due to imported rodents.
CNN: Who are the individuals in the high-risk groups for contracting monkeypox?
CNN: Has anyone died from monkeypox?
CNN: How much should people worry about monkeypox?
Wen: Because of the way that monkeypox is spread, it is not yet a concern for most Americans. However, individuals who are gay, bisexual and other men who have sex with men, who have intimate contact with multiple or anonymous people, are at high risk.
CNN: Should everyone try to get the monkeypox vaccine?
Wen: No. First of all, the monkeypox vaccine is extremely limited right now. About 300,000 doses of the two-dose vaccine have been delivered thus far, much less than the 1.5 million people the CDC says are eligible.
Soon, I hope there will be enough vaccine so that people in high-risk groups are able to access it. But given the way that monkeypox is spread, most Americans are not likely to contract it, and a mass vaccination campaign targeting the general population is probably not going to be recommended any time soon.
CNN: Is monkeypox going to be yet another virus that will be endemic in the United States?
Wen: I really hope not. It is still possible to contain monkeypox through testing and vaccination. I hope that the WHO’s declaration of a global health emergency will spur more countries, including ours, to put every effort to try to prevent monkeypox from taking hold and becoming endemic here.
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