Mpox: What You Need To Know

The world is still in the grip of the COVID-19 pandemic, which has killed more than 6 million people globally. But while governments continue to wage a battle against the novel coronavirus, another infectious disease called mpox has raised alarm bells among health care workers.

As with any disease that crosses international borders, there are questions about transmissibility, symptoms, and how to protect yourself. Here are a few common questions about mpox.

What is mpox and where did it come from?

Mpox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of Central and West Africa. Mpox virus is part of the same family of viruses as variola, the virus that causes smallpox, and is rarely fatal. It is not related to the chickenpox virus. Symptoms include a rash with blisters on the face, hands, feet, eyes, mouth, or genitals; fever; swollen lymph nodes; headaches; muscle aches; and low energy. It typically takes two to four weeks for the virus to run its course.

Mpox is formerly known as monkeypox, which derived its name from the first detection of this virus in macaques in the 1950s. It’s believed that African rodents and primates carry the virus and transmit it to people who are exposed to these animals or consume raw meat. Prior to the current global outbreak, mpox had mostly been reported in people living in central and western African countries or those who traveled there.

The first human case of mpox was recorded in 1970 in West Africa and is endemic in the region, meaning that it continues to circulate among the general population.

The current global outbreak in non-endemic countries started in May 2022, when cases of mpox began being reported by people who had traveled to Europe and North America, where mpox cases had not previously been seen. It also marked the first time that clusters of mpox cases have been reported in different geographical areas. Many of the initial patients in the 2022 outbreak participated in large festivals and other activities where close, personal, skin-to-skin contact likely occurred.

“We don’t need to panic over mpox as it is not as severe as COVID-19. We do need to take necessary precautions to minimize risks and further transmission,” said Dr. Nagesh N. Borse, Project HOPE’s Deputy Chief Health Officer.

Mpox virus transmission occurs after prolonged person-to-person contact with lesions, bodily fluids, respiratory droplets, and contaminated materials such as bedding. The case fatality ratio is very low (3-6%), however, it does affect a person’s quality of life for up to four weeks of sores that are painful and itchy. Severe cases may occur more commonly among children and are related to the extent of virus exposure, patient health status, and nature of complications. Underlying immune deficiencies like HIV/AIDS may lead to worse outcomes.

How many people are currently infected with the mpox virus?

In non-endemic countries, more than 45,000 cases and 12 deaths were reported in the first eight months of 2022, according to Centers for Disease Control and Prevention global data. Cases have been reported in more than 100 countries, with the majority of cases in Europe and the United States.

As of the last week of August, according to the CDC, the U.S. now has the highest number of mpox cases in the world at nearly 17,000.

Who is most at risk for mpox?

Mpox can spread through close or skin-to-skin contact such as through a rash or scabs of an infected person, or through oral, vaginal, or anal sex. It can also be spread through clothing, bedding, towels, or contact with surfaces or respiratory secretions by someone with mpox. Many of the initial mpox cases were reported among gay, bisexual, and other men who have sex with men, although many of the new cases are among women and children.

Is an mpox vaccine available to the public?

Thanks to years of ongoing research, a vaccine for mpox was quickly made available. But while the United States, Canada, Western Europe, and other developed countries have received shipments, many countries in the global South that have current outbreaks have not been able to secure any doses of the vaccine.

Most countries, including the U.S., are turning to the JYNNEOS vaccine, produced by Bavarian Nordic. However, because of the shortage of vaccines, the World Health Organization is currently recommending that only people who are at a higher risk of exposure, like health workers and those with multiple sex partners, get vaccinated. The two-dose vaccine is administered over 28 days. People who have been exposed to the virus are also urged to get vaccinated, ideally within four days of first exposure and up to 14 days if they are no symptoms. Receiving a vaccine after exposure has been shown to reduce the likelihood of infection.

How worried should you be about mpox?

The CDC has a list of precautions you can take to protect yourself from mpox. Those who are concerned about catching mpox should avoid close skin-to-skin contact with people who have a rash that looks like mpox, along with surfaces and bedding used by anyone who has had it.

At the beginning of the 2022 mpox outbreak, a vast majority of cases were transmitted via male-to-male transmission. However, cases have also been reported in women and children. As the HIV, Ebola, and COVID-19 epidemics have shown, the stigma around a disease can negatively impact the ability to detect, prevent and treat infectious diseases.

“Stigma can lead to poor health-seeking behavior, leading to poor testing and reporting, which results in an inaccurate understanding of the severity of spread and potentially underestimating the resource need to control the spread,” Dr. Borse said. “As a result, it may cause delays in bringing the right treatment options to those communities in need.”

That’s why early engagement of communities and health systems is crucial to minimizing disinformation, improving public awareness, and changing attitudes and behaviors, all of which help minimize further spread, said Dr. Borse.

It’s not just the gay community that has been stigmatized by mpox. In Brazil, there have been a number of attacks on monkeys even though the disease is spread by rodents. The World Health Organization has also decided that subsequent variants will not reference geographic locations to avoid stigmatizing people from certain countries or parts of the world.