Going Viral

What is monkeypox?

Monkeypox is a rare disease caused by the monkeypox virus. Its symptoms are similar to smallpox, but the disease is less contagious and less severe.

The monkeypox virus is a member of the genus Orthopoxvirus. It is closely related to the variola virus that causes human smallpox, as well as the vaccinia virus used in smallpox vaccines, and the cowpox virus. Since smallpox was deemed to be globally eradicated in 1980, monkeypox has become the most important orthopoxviral disease in terms of public health.

Where does monkeypox come from?

The virus is called “monkeypox” because it was first discovered in colonies of research monkeys in 1958. In addition to monkeys and apes, more recent information indicates that African rodents, such as squirrels and rats, can also carry the virus.

The monkeypox virus usually occurs in Central and West Africa. International travel and the importation of animals have led to the presence of cases of human and animal monkeypox in countries outside of Africa.

The first cases of human monkeypox reported outside of Africa were diagnosed in the United States in 2003. Those cases were traced to contact with pet prairie dogs that had previously been kept near small rodents that were imported from Ghana.

Most recently, in May 2022, multiple cases of human monkeypox began to surface. Outbreaks occurred in several non-African countries, including the United States. Case counts escalated in just a few weeks to involve at least 75 countries. This prompted the World Health Organization to declare monkeypox a global emergency on July 23, 2022.

What are the symptoms of monkeypox in people?

For humans, monkeypox symptoms may start 5 to 21 days following exposure. The time between exposure and the development of symptoms is called the incubation period.

Monkeypox symptoms last for two to four weeks. They include fever, chills, skin rash, headache, sore muscles, fatigue and swollen lymph nodes.

First you come down with a fever, and then a skin rash develops approximately one to four days later. The monkeypox rash first appears on the face, hands or feet, then spreads to other parts of the body.

The monkeypox rash goes through several stages. Flat, round spots turn into blisters. Then the blisters fill with pus, scab over and fall off over a period of two to four weeks.

Monkeypox is contagious while symptoms are present. This is from the time the fever starts until the rash and all the scabs heal. Even if you do not know anyone with monkeypox, if you develop a new rash or any other monkeypox symptoms, you should seek medical attention right away.

How does the monkeypox virus spread?

The monkeypox virus spreads through close contact with an infected animal or person. It can also be transmitted when a person handles materials such as bedding that have been in contact with someone who has monkeypox.

The virus spreads from person to person through direct contact with rashes, scabs or body fluids of a person infected with monkeypox. Another way it is transmitted is by extended close contact, which would be more than four hours, with respiratory droplets from an infected person. A fetus can contract the monkeypox virus from an infected mother.

Monkeypox spreads from animal to person through animal bites or scratches, wild game that is cooked for food, or products made of infected animals. It can also be spread by coming in direct contact with the body fluids or rashes of animals with monkeypox.

Can a dog get monkeypox from a human?

Dogs are susceptible to monkeypox, and other pets may be as well. Virus transmission from infected people to pets may occur through close contact like hugging, kissing, licking and sharing beds. To keep pets safe, people with symptoms of monkeypox, especially if they have pox-like skin sores, should avoid contact with animals.

Rabbits and mice, but not guinea pigs and hamsters, have been found to develop signs of monkeypox following exposure to the virus. Whether cats are susceptible is unclear. However, given the available evidence concerning other orthopoxviruses, it is assumed cats might catch monkeypox, so it would be wise to take measures to prevent infection.

How is monkeypox diagnosed?

Laboratory testing of people and animals with suspected monkeypox is important to confirm the presence of the viral infection and prevent and control outbreaks. The best specimens to submit for testing are swabs from the sores on the skin.

To maximize the chance of virus detection, several samples are recommended from different body locations and stages of the sores. Laboratories are finding it helpful in interpreting the results if the times when the fever and rash were first noticed and the stage of the patient’s rash at the time of the sample collection are included with the samples.

Is there a treatment for monkeypox?

There is no specific treatment for people or animals with monkeypox. The Center for Disease Control (CDC) has made available the antiviral drug tecovirimat (TPOXX) for human use. Supportive care such as electrolyte fluids and pain medications can be provided to relieve dehydration, fever and pain. Antibiotics are rarely necessary, but may be indicated for patients with secondary bacterial infections.

Some smallpox vaccines can prevent monkeypox in people, including the ACAM2000 and Jynneos vaccines. These vaccines are used to prevent monkeypox because smallpox and monkeypox are caused by related viruses.

People who have been exposed to monkeypox or people who are at high risk of being exposed, such as lab personnel, should consider getting vaccinated. At this time, the CDC does not recommend vaccines for the general public.

What are the signs of monkeypox in dogs?

The symptoms of monkeypox in dogs are similar to other common infectious diseases. These include fever, cough, reddened eyes, runny nose, lethargy and decreased appetite. If your dog shows these signs, but has not been exposed to anyone with monkeypox, the cause is likely to be something else.

If your dog develops at least two of these signs — or a pimple- or blister-like rash within 21 days after exposure to someone with monkeypox — you should contact your veterinarian immediately. He or she will advise you on the next steps, including how to get your dog tested to confirm infection.

In cases where you suspect your dog may have monkeypox, or a monkeypox viral infection is confirmed, you should keep your dog separate from other animals and minimize contact with people for at least 21 days after symptoms appear or until he has fully recovered. This is especially important for people who are immunocompromised, younger than eight years of age, pregnant, or have a history of eczema or atopic dermatitis.

As of yet, there is not a vaccine against orthopoxvirus approved for use in animals in the United States.

On August 1, 2022, monkeypox was deemed a nationally notifiable condition. States are required to report confirmed or probable monkeypox cases to the CDC within 24 hours. Veterinarians who suspect an animal has monkeypox are advised to have the animal tested and to contact their state veterinarian or public health officials so they can investigate the source of the infection and take measures to contain it.