By Sandee LaMotte, CNN
An extremely rare disease called monkeypox, a much less serious cousin of smallpox, is spreading around the world. More than 250 cases have been reported in at least 16 countries, according to the World Health Organization. Experts say it is transmitted by close and prolonged contact with an infected person.
“Countries that now report smallpox are countries that do not normally have smallpox outbreaks,” Rosamund Lewis, head of the smallpox secretariat of the WHO emergency program, told a news conference at the United Nations. in Geneva.
Smallpox is endemic near the rainforests of Central and West Africa, but has been seen getting closer to urban areas, according to the WHO.
“This is an emerging disease. It’s been emerging for the last 20 or 30 years, (so) it’s not unknown, it’s very well described,” Lewis told reporters. “The risk to the general public, therefore, seems to be low, because we know that the main modes of transmission have been those described in the past.”
In the United States, in 2022, the first case of monkeypox was diagnosed in a patient hospitalized in Massachusetts who had recently traveled to Canada on private transportation. In 2021, two people traveling from Nigeria to the United States were diagnosed with the disease, according to the Centers for Disease Control and Prevention.
Cases in parts of the world other than Africa are often related to international travel or smallpox-infected imported animals, the CDC said.
Several cases of monkeypox reported in the UK have been among people who had no known trips or contacts with other people, but there is no reason to be alarmed, US Surgeon General Dr Vivek Murthy said on Thursday. to CNN’s “New Day.”
“Right now, we don’t want people to worry,” Murthy said. “These numbers are still small; we want (people) to be aware of the (symptoms) and, if they have any concerns, contact their doctor. “
What are the initial symptoms of monkeypox?
There is an incubation period of about seven to 14 days, the CDC said. The initial symptoms are usually flu, such as fever, chills, exhaustion, headache and muscle weakness, followed by swelling in the lymph nodes, which help the body fight infections and disease.
“One feature that distinguishes monkeypox infection from smallpox infection is the development of swollen lymph nodes,” the CDC said.
This is followed by a rash on the face and body, including the mouth and palms of the hands and soles of the feet.
Painful and high warts are pearly and full of fluid, often surrounded by red circles. The injuries eventually build up and resolve within two to three weeks, the CDC said.
In the current outbreak, there appear to be a greater number of cases causing rashes in the groin area of patients, according to the WHO and the CDC.
“In some cases, during the early stages of the disease, the rash has been mainly in the genital and perianal area,” Dr. John Brooks, medical director of the CDC’s HIV / AIDS Prevention Division, said Monday. a press conference.
“In some cases, it has caused anal or genital lesions that look like other diseases such as herpes, chickenpox or syphilis,” he said.
A “significant fraction of cases” have been observed in the current outbreak of gay and bisexual men, “but in no way is the current risk of exposure to monkeypox smallpox exclusively to the U.S. gay and bisexual community. , any, can be developed [and] spread the monkey’s smallpox, “Brooks said.
In general, monkeypox risk is moderate for people with multiple sexual partners and low for the general population, according to a rapid risk assessment report released Monday by the European Center for the Prevention and Control of Diseases.
However, monkeypox is not considered a sexually transmitted disease.
How is the monkey’s smallpox spread?
Experts say close contact with an infected person is required for the spread of the monkeypox virus.
The infection can develop after exposure to “broken skin, mucous membranes, respiratory droplets, infected body fluids or even contact with contaminated clothing,” said Neil Mabbott, a senior professor of immunopathology at the University of Edinburgh Veterinary School in Scotland. .
“Once the lesions have healed, the scabs (which can carry infectious viruses) can spill as dust, which could be inhaled,” said Dr. Michael Skinner, who is part of the medical school’s medical school. Imperial College infectious diseases. London, in a statement.
Transmission between people can occur through large respiratory drops, and because these drops usually travel only a few feet, “prolonged face-to-face contact is required,” the CDC said. According to the WHO, this causes health workers and members of the household to care for or live with someone who is actively infected.
Smallpox, which was eradicated worldwide in 1980, also spread mainly through direct and prolonged face-to-face contact between people, as well as objects contaminated with infected liquids, such as bedding or clothing.
“Patients with smallpox became infected as soon as they developed sores and spread the virus through cough drops or sneezing. They remained contagious until their injuries were resolved,” said Dr. Paritosh Prasad, director of the unit. of Highly Infectious Diseases at Rochester University Medical Center in New York.
However, according to available historical information, monkeypox appears to be less contagious than smallpox, Prasad said.
“Monkeypox can be a serious infection, as mortality rates for this type of monkeypox virus have been around 1% in other outbreaks. They are often found in low-income settings with a limited access to healthcare, “said Michael Head, a senior researcher in global health at the University of Southampton in the United Kingdom. There are no deaths from the current outbreak.
However, in the developed world, “it would be very unusual to see more than a handful of cases in any outbreak, and we will not see levels of transmission in the style (Covid),” Head said in a statement.
According to the CDC, common household disinfectants can kill the monkeypox virus.
How is monkeypox treated?
There are no specific medications available to treat the symptoms of monkeypox, so “treatment is usually supportive,” Jimmy Whitworth, a professor of international public health at the London School of Hygiene & Tropical Medicine, said in a statement. press release.
“However, there is a vaccine available that can be given to prevent the development of disease,” Whitworth said.
In the US, a two-dose vaccine called Jynneos is currently licensed to prevent monkeypox and can also be used for smallpox. The vaccine has been stored by the US government in case of recurrence of the eradicated disease.
“Right now, we have more than 1,000 doses available and we expect that level to rise very rapidly in the coming weeks as the company provides us with more doses,” said Dr. Jennifer McQuiston, deputy director of the High Consequences Pathogens Division. and Pathology within the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, he told reporters during a call Monday.
“We hope to maximize the distribution of the vaccine to those we know will benefit,” McQuiston said. “These are people who have had contact with known smallpox patients, health care workers, very close personal contact, and in particular those who may be at high risk for serious illness.”
Where did the monkey’s smallpox come from?
Monkeypox received its name in 1958 when “two outbreaks of smallpox-like disease occurred in monkey colonies preserved for research,” the CDC said.
However, the main carrier of the monkey’s smallpox is still unknown, although “it is suspected that African rodents play a role in transmission,” the agency said.
The first known case of smallpox in humans was “recorded in 1970 in the Democratic Republic of the Congo during a period of intense effort to eliminate smallpox,” the CDC said. Since then, most cases have been concentrated in 11 African countries, with several outbreaks in the US and Europe related to travel or imports from endemic countries.
An outbreak occurred in the United States in 2003 after forty-seven people from six states (Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin) became ill from contact with their prairie dogs, the CDC.
“The pets became infected after being housed near small mammals imported from Ghana,” the CDC said. “This is the first time human smallpox has been reported outside Africa.”
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CNN’s Jacqueline Howard, Nadia Kounang, Jen Christensen, Michael Nedelman, Paula Newton, John Bonifield, Naomi Thomas, Alex Hardie, and Benjamin Brown contributed to this report.