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.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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