The World Health Organization said June 25 that monkeypox wasn’t yet a public health emergency of international concern. More than 4,000 cases have been reported worldwide, with about 250 in the U.S. And with public health officials unable to follow all chains of transmission, they’re likely undercounting cases. Everyone should be aware of its symptoms, how it spreads, and the risks of it getting worse.
But monkeypox could become endemic in the U.S. and around the world if it continues to spread unchecked.
Q: How does monkeypox spread?
Monkeypox is a viral infection, a close cousin of smallpox. But it causes a much milder disease.
It is transmitted through close contact, including sex, kissing, and massage — any kind of contact of the penis, vagina, anus, mouth, throat, or even skin. In the current outbreak, monkeypox has primarily been transmitted sexually.
Condoms and dental dams will reduce but won’t prevent all transmission because they protect only against transmission to and from the skin and mucosal surfaces that are covered by those devices. It’s important to know that the virus can enter broken skin and penetrate mucous membranes, like in the eyes, nose, mouth, genitalia, and anus. Scientists don’t know whether monkeypox can be transmitted through semen or vaginal fluid.
Monkeypox can be transmitted through respiratory droplets or “sprays” within a few feet, but this is not thought to be a particularly efficient mode of transmission. Whether monkeypox could be transmitted through aerosols, as covid-19 is, is unknown, but it hasn’t been documented so far.
It is not known whether monkeypox can be transmitted when someone doesn’t have symptoms.
Q: What are the common symptoms of monkeypox?
Symptoms of monkeypox may develop up to 21 days after exposure and can include fevers and chills, swollen lymph nodes, rash, and headaches.
It is not known whether monkeypox always shows any or all of those symptoms.
Experts currently think monkeypox, like smallpox, will always cause at least some of these symptoms, but that belief is based on pre-1980 science, before there were more sophisticated diagnostic tests.
Q: What does the monkeypox rash look like?
The monkeypox rash usually starts with red spots and then evolves into fluid-filled and then pus-filled bumps that may look like blisters or pimples. The bumps then open into sores and scab over. People with monkeypox should be considered infectious until after the sores scab over and fall off. Monkeypox sores are painful. The rash was often seen on palms and soles in the past, but many people in this outbreak have experienced external and internal lesions of the mouth, genitalia, and anus. People may also experience rectal pain or the sensation of needing to have a bowel movement when their bowels are empty.
Q: How do I get tested for monkeypox?
If you have symptoms of monkeypox, including oral, genital, or anal lesions, go to your nearest sexual health clinic for testing. A medical professional should swab any suspicious lesion for testing. There’s also emerging evidence that throat swabs may be useful in screening for monkeypox, but health officials in the U.S. are so far not recommending them.
People consult about monkeypox vaccination at a clinic in New York City on June 24, 2022.
Liao Pan/China News Service via Getty Images
Q: Is there a vaccine for monkeypox?
Yes. Two vaccines are effective in preventing monkeypox: the Jynneos vaccine and the ACAM2000 vaccine. The FDA has approved the Jynneos vaccine for preventing monkeypox and smallpox among people 18 and older. The ACAM2000 is FDA-approved to prevent smallpox. The U.S. is currently using only the Jynneos vaccine because it’s safer and has fewer side effects.
The Jynneos vaccine is safe. It has been tested in thousands of people, including people who are immunocompromised or have skin conditions. Common side effects of the Jynneos vaccine are similar to those of other vaccines and include fevers, fatigue, swollen glands, and irritation at the injection site.
The Jynneos vaccine is effective in preventing monkeypox disease up to four days after exposure and may reduce the severity of symptoms if given up to 14 days after exposure.
Q: Can I be vaccinated against monkeypox?
The Centers for Disease Control and Prevention currently recommends vaccination against smallpox and monkeypox only for those at heightened risk: people who have had close contact with someone with monkeypox, as well as some health care workers, laboratory staffers, first responders, and members of the military who might come into contact with the affected.
Supplies of the Jynneos vaccine are limited. As of June 14, the strategic national stockpile held more than 72,000 doses. The U.S. government purchased 500,000 more doses this month, bringing the total number of doses bought to almost 2 million.
The New York City Department of Health and Mental Hygiene has started offering the Jynneos vaccine to gay and bisexual men, other men who have sex with men, and trans women who are age 18 and older and have had multiple or anonymous sex partners in the past 14 days. Other big cities, including San Francisco, are expected to do the same.
Q: What are other ways to lower the risk of monkeypox transmission?
The best way is to educate yourself and your sex partners about monkeypox. If you’re worried you might have monkeypox, get tested at a sexual health clinic. Many emergency rooms, urgent care centers, and other health care facilities may not be up to date on monkeypox. The CDC link to find the nearest sexual health clinic is https://gettested.cdc.gov/.
Abstain from sex if you or your partner has monkeypox. And remember that condoms and dental dams can reduce but not eliminate the risk of transmission. The CDC also warns about the risk of going to raves or other parties where lots of people are wearing little clothing and of saunas and sex clubs. It has other suggestions like washing sex toys and bedding.
Q: Is there a treatment for monkeypox?
There is no proven, safe treatment specifically for monkeypox. Most cases of monkeypox are mild and improve without treatment over a couple of weeks. Medications like acetaminophen and ibuprofen can be used to reduce fevers and muscle aches, and medications like acetaminophen, ibuprofen, and opioids may be used for pain. In rare cases, some patients —such as immunocompromised people, pregnant women, a fetus or newborn, women who are breastfeeding, young children, and people with severe skin diseases — will develop more severe illness and may require more specific treatment. Doctors are trying experimental therapies like cidofovir, brincidofovir, tecovirimat, and vaccinia immune globulin. If administered early in the course of infection, the Jynneos and ACAM2000 vaccines may also help reduce the severity of disease.
Q: What misinformation is circulating about monkeypox?
Conspiracy theories about monkeypox abound. Monkeypox is not a hoax. Monkeypox is real. Covid vaccines can’t give you monkeypox. Monkeypox was not invented by Bill Gates or pharmaceutical companies. Monkeypox didn’t come from a lab in China or Ukraine. Migrants crossing the U.S.-Mexico border haven’t brought monkeypox into the U.S. Monkeypox isn’t a ploy to allow for mail-in ballots during elections. There is no need for a monkeypox vaccine mandate or lockdowns due to monkeypox.
Dr. Céline Gounder, an internist, epidemiologist and infectious disease specialist, is Senior Fellow and Editor-at-Large for Public Health at Kaiser Health News.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
