Monkeypox is rare, but knowledge is key

Perspective, action are important as case counts grow.

July 14, 2022 at 10:35PM
A medical laboratory technician prepares to test for monkeypox at a microbiology laboratory in Madrid, Spain. (Pablo Blazquez Dominguez, TNS/The Minnesota Star Tribune)

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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With cases of monkeypox now topping 10,000 globally, the World Health Organization will meet next week and reconsider whether this viral disease's latest outbreak is a "global health emergency."

That label is considered the agency's highest-level alert. While the WHO decided against using it in late June, ongoing cases in locations where infections aren't usually found have generated alarm. "I continue to be concerned by the scale and spread of the virus across the world," Director-General Tedros Adhanom Ghebreyesus said in a recent Reuters news report.

Among the COVID-19 pandemic's lessons is the importance of reliable information and clear communication. While public health agencies lead in stopping outbreaks, the reality is that infection control requires public collaboration.

That involves understanding how the virus spreads, who's at risk and what to do. To help inform Minnesotans, the Star Tribune Editorial Board contacted the state Department of Health (MDH) and compiled information from other agencies to provide a factual foundation.

Here's some essential information:

  • Monkeypox is a viral infection that can cause a flu-like illness and characteristic rash. The pathogen that causes this infection is an Orthopoxvirus, "the same genus as the virus that causes smallpox," according to MDH, though it is "less severe." The rash can develop into fluid-filled bumps that eventually scab over. The illness can last three to four weeks.
  • Monkeypox is a bit of a misnomer. It doesn't mainly occur in monkeys. Rodents are the likeliest source, but the virus can leap to other species, including humans. Those who are infected can transmit it to other people. Before now, monkeypox infections have mainly occurred in some African countries. In the 2022 outbreak, "Spain, the United Kingdom, Germany, and the United States have reported the most cases," according to CIDRAP News, a Minnesota-based infectious disease news service.
  • Severe illness can occur, but perspective is crucial. Global health officials list the case fatality ratio at 3-6%, which may reflect a lack of access to medical care in countries where monkeypox is endemic. The WHO said no deaths had been reported in the 2022 outbreak outside of Africa. In addition, the current outbreak appears to be caused by a monkeypox "clade," or strain, less likely to cause severe illness.
  • Two critical things to know about the rash: As more people are infected, we are learning that the rash can be "very, very painful," though, in others, it might not be very noticeable, state health officials said. In addition, people remain infectious until scabs heal and healthy new skin appears. People should be off work and take other precautions until they heal.
  • How monkeypox spreads in humans: "Direct contact with body fluids or skin lesions (i.e., skin-to-skin contact) is the most common mode of human-to-human transmission," state health officials advise. "Transmission via respiratory particles can also occur but usually require prolonged face-to-face contact." To be even clearer: Sexual activity provides a setting where this contact can occur, facilitating viral spread. Transmission can also occur if someone wears or uses an infected person's clothing, bedding or towels. While anyone can get monkeypox, risk increases with "multiple or anonymous sex partners," according to the U.S. Centers for Disease Control.
  • Time frame from exposure to symptoms: Twelve days is often when people start feeling sick after becoming infected, but symptoms could appear anywhere from five days to 21 days afterward.
  • A vaccine and antivirals are available in Minnesota. See a provider promptly if you've been exposed. Health officials said the vaccine could "actually stop the disease" if given within four days of exposure. It can still mitigate the illness if given up to 14 days later. Prescription drugs such as TPOXX (tecovirimat) may also be beneficial.

As of Thursday, 10 cases have been confirmed in Minnesota. No one has required hospital care for the illness. All those infected have traveled, and none of the cases are linked epidemiologically.

The Minnesota Department of Health asks health care providers to call 651-201-5414 if they suspect a patient has monkeypox.

With more knowledge and a serious approach to the illness, Minnesotans and the medical community can help keep monkeypox in check.

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