The Emergence of Monkeypox in The U.S.
What is monkeypox?
The monkeypox virus (MPXV) is a rare infectious disease that has emerged in the past two decades. Originating in animals, MPXV was then transmitted to humans, thus classifying it as a viral zoonosis. The virus is now primarily spread through close contact between humans. MPXV primarily affects the Democratic Republic of Congo and the Central African Republic (1). However, in the wake of the COVID-19 pandemic, there are public health concerns regarding its recent emergence in the United States.
Rising Numbers of Monkeypox Cases in the United States
As of June 8 2022, World Health Organization (WHO) experts have reported 1285 laboratory-confirmed cases from 28 countries where monkeypox is not common (5). Of the 1285 confirmed cases, 40 were found in the United States. There is no treatment available yet for those who have contracted the disease. WHO experts acknowledge that the number of confirmed cases is an underestimate of the true number of infected individuals due to limited surveillance, lack of rapid diagnostics, and early recognition of infection in Africa (5). The WHO’s current risk assessment of monkeypox is classified as moderate as of June 10 2022, considering that this is the first time that many monkeypox cases have been reported from multiple countries simultaneously (5). Monkeypox is related to smallpox, as both viruses are classified as belonging to the Orthopoxvirus genus. These similarities in viral structure allow the commonly administered smallpox vaccine to provide some cross-immunity against MPXV. It is important to note that monkeypox is in no way related to the COVID-19 virus or chicken pox virus.
Symptoms
MPXV presents similarly to influenza in early stages and smallpox in later stages in humans. It manifests in a host as mild symptoms such as fever, headache, exhaustion, and muscle aches. More severe symptoms patients experience include adenopathy (swelling of the glands and lymph nodes), and maculopapular rash of the face, hands, genitals, and soles of the feet. Monkeypox virus poses the greatest threat to women who are breastfeeding, immunocompromised individuals, and healthcare workers lacking proper PPE. MPXV can be spread to other parts of the body if blisters formed during infection are scratched. For example, scratching lesions and then proceeding to rub the eyes could result, in extreme cases, in vision damage (5).
Transmission
According to the Centers for Disease Control and Prevention (CDC), the incubation period for monkeypox is usually 7 to 14 days but can range from 5 upwards to 21 days. Transmission of MPXV is suspected to travel through close person-to-person contact including the exchange of bodily fluids, respiratory droplets, lesions, and sharing of contaminated materials such as clothes or bedding. Those infected by MPXV remain infectious until their lesions heal, which may result in scabbing and scarring. A small number of people were reported to be asymptomatic.
Is this cause for concern for the average U.S. Citizen?
According to previous data, there is a 5% mortality rate in those infected by MPXV, though most can recover without treatment. The current emergent strain, however, appears to be less severe with a mortality rate of only 1% (4), compared to a 1.2% mortality rate displayed in Americans who contracted COVID-19 (3). Though this mortality rate appears to be negligible, in large population sizes such as the United States, it is necessary to treat all infectious diseases with caution. For example, though COVID-19 has a 1.2% mortality rate among Americans, The New York Times and Our World in Data reported a staggering 1.01 million confirmed COVID-19-related deaths across the United States as of June 16, 2022.
MPXV Vaccine Stockpile
The United States has taken preemptive measures as a precaution against bioterrorism. There is currently a national stockpile of 36,600 Jynneos vaccines produced by the manufacturer Bavarian Nordic available. Bavarian Nordic, a Denmark-based biotechnology company, holds 1 million US-owned doses and has the manufacturing capabilities of producing another 16.4 million vaccines upon request by the federal government.
Though the potential of another public health emergency may seem daunting to Americans, there is relief in knowing there is a stockpile of monkeypox vaccinations readily available. However, it is imperative that we continue to social distance, wear a mask, limit unnecessary travel, and exercise caution in order to aid the federal government’s preemptive measures. Up-to-date news regarding the monkeypox virus should be sourced from reliable sources, such as the WHO, CDC, or any other fact-based health reporting source to prevent the spread of misinformation as Americans, and the world, learn more about the monkeypox virus.
Citations
Berthet, N., Descorps-Declère, S., Besombes, C., Curaudeau, M., Nkili Meyong, A. A., Selekon, B., Labouba, I., Gonofio, E. C., Ouilibona, R. S., Simo Tchetgna, H. D., Feher, M., Fontanet, A., Kazanji, M., Manuguerra, J.-C., Hassanin, A., Gessain, A., & Nakoune, E. (2021, June 22). Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018. Nature News. Retrieved June 16, 2022, from https://www.nature.com/articles/s41598-021-92315-8
Kozlov, M. (2022, May 20). Monkeypox Goes Global: Why scientists are on alert. Nature News. Retrieved June 17, 2022, from https://www.nature.com/articles/d41586-022-01421-8 Mortality analyses. Johns Hopkins Coronavirus Resource Center. (n.d.). Retrieved June 16, 2022, from https://coronavirus.jhu.edu/data/mortality
Null. (2022, June 6). Monkeypox: What you need to know about this rare virus. news. Retrieved June 16, 2022, from https://health.ucdavis.edu/news/headlines/monkeypox-what-you-need-to-know-about-this-rare-virus-/2022/05
Spencekimball. (2022, June 6). U.S. has more than 36,000 Jynneos monkeypox vaccine doses immediately available in National Stockpile. CNBC. Retrieved June 16, 2022, from https://www.cnbc.com/amp/2022/06/06/us-has-36000-doses-of-jynneos-monkeypox-vaccine-immediately-available-in-national-stockpile.html
World Health Organization. (n.d.). Multi-country Monkeypox Outbreak: Situation update. World Health Organization. Retrieved June 16, 2022, from https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON392
