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What do I need to know about monkeypox now?

A Penn State infectious disease expert offers answers to your most pressing questions

Suresh Kuchipudi, the Huck Chair in Emerging Infectious Diseases at Penn State and an expert on emerging and zoonotic viruses, explains what is known about monkeypox and how to protect yourself. Credit: Getty Images | kontekbrothersAll Rights Reserved.

UNIVERSITY PARK, Pa. — More than 10,000 cases of monkeypox have been reported in the United States since May, triggering the U.S. Department of Health and Human Services to declare the outbreak a public-health emergency. As the fall semester begins, many are wondering if they should be concerned about monkeypox. Suresh Kuchipudi, the Huck Chair in Emerging Infectious Diseases at Penn State and an expert on emerging and zoonotic viruses, explains what is known about monkeypox and how to protect yourself.

What is monkeypox?

Monkeypox is a disease caused by the monkeypox virus. It belongs to the same family of viruses as smallpox, but although the symptoms of monkeypox are similar to smallpox, the disease is milder and rarely fatal. It is not related to chickenpox. The monkeypox virus was first reported in Denmark in the 1950s in monkeys kept for research and is believed to have circulated primarily in rodents and nonhuman primates in Africa prior to the recent outbreak.

How easily does monkeypox spread?

Monkeypox spreads through direct contact with infectious lesions and bodily fluids and through respiratory droplets during close face-to-face contact, such as kissing and cuddling. Additional transmission can occur from touching objects and surfaces that have been used by a person with monkeypox. However, it’s premature for people to be overly concerned about touching things like doorknobs and desks. New data suggest that in shared spaces like offices and classrooms, people with monkeypox do not leave behind enough live virus to infect others, suggesting that environmental contamination is not a major source of transmission. Instead, sexual activity is currently the primary driver of the outbreak.

How long does a person with monkeypox remain infectious?

After exposure, the incubation period — when the virus initially begins to replicate in the body — lasts for one to two weeks. During this time, patients are not infectious. However, after symptoms appear, patients can be infectious for two to four weeks. Symptoms include fever, chills, headache, muscle ache, rash, and clear- or pus-filled sores.

Can monkeypox cause scars?

Yes, as with many inflammatory skin conditions, the lesions caused by monkeypox can sometimes result in scarring or discoloration.

Are college students at greater risk than the general population?

No. Monkeypox spreads through direct contact with the infectious lesions or respiratory droplets, and occasionally by touching contaminated surfaces. Anyone who is exposed in these ways can become infected.

How can I protect myself from monkeypox?

Talk to potential partners about monkeypox before becoming physically intimate. Avoid close, skin-to-skin and face-to-face contact with people with monkeypox until their symptoms have fully resolved. Avoid touching bedding, towels, and clothing with people who have monkeypox. Wash hands frequently with soap and water or use an alcohol-based hand sanitizer after exposure to people who are sick with the virus. 

What should I do if I think I have monkeypox?

People with an active rash or other symptoms should call their doctor and self-isolate at home. Penn State has provided more specific guidance for students.

Should parents be concerned about monkeypox in schools?

In the U.S., fewer than a dozen cases have been reported in children. At this time, monkeypox is not a significant threat in schools; however, the longer the virus circulates in the larger population, the greater the chances it could evolve to become more transmissible and spread within schools.

Can pets spread monkeypox?

Recently, the first case of a dog with confirmed monkeypox virus infection was reported. The infection is believed to have been acquired through human transmission. It is unknown whether pets can spread the virus back to humans or to other pets.

How does monkeypox compare to COVID-19?

Monkeypox is much less contagious than COVID-19. While the reproduction number (RO) — or the number of people that one person can infect — is currently around 1.5 for COVID-19, it is less than one for monkeypox.

Another difference is that SARS-CoV-2, the virus that causes COVID-19, is an RNA virus, whereas the monkeypox virus is a DNA virus. DNA viruses are more stable and produce fewer mutations than RNA viruses, so the monkeypox virus will likely evolve more slowly than the SARS-CoV-2 virus. Two variants of monkeypox have been identified by the Centers for Disease Control and Prevention in the current outbreak. These variants share common ancestors with strains that have circulated in Nigeria since 2017, and likely arose from two separate spillover events from animals to people, followed by close person-to-person contact.

Are experts worried about monkeypox?

Currently, the overall risk to the general population remains low. However, the biggest concern my colleagues and I have is that the virus could evolve to become more transmissible, more severe, or both. The more the virus continues to spread and circulate within humans, the more opportunities it will have to mutate. Likewise, the longer it circulates in humans, the more likely it is to spill over into domestic and wild animals and establish viral reservoirs that could repeatedly re-infect humans.

Last Updated August 22, 2022

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