Q&A: CDC disease detective answers questions about monkeypox
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After 40 years without a reported case, monkeypox reemerged in Nigeria in 2017. Since then, 218 cases have been confirmed in Nigeria, and eight cases have been reported in travelers from the country.
Of those eight cases, two occurred in travelers to the U.S. this year, initiating an effort to trace airline passengers and anyone else who may have come in contact with the patients. The second case was confirmed on Nov. 16 in a patient who was being isolated in Maryland.
According to the CDC, it can take up to 21 days after infection for symptoms of monkeypox to develop. The first U.S. case this year was reported in July in Texas. The CDC said no additional cases were identified in the more than 200 people who had possible contact with that patient.
We spoke with Faisal Minhaj, PharmD, a CDC Epidemic Intelligence Officer in the National Center for Emerging and Zoonotic Infectious Diseases, to answer some lingering questions about monkeypox.
Healio: What is monkeypox?
Minhaj: Monkeypox virus is in the same genus of viruses as variola virus — which caused smallpox — but causes a milder infection. Most infections last 2 to 4 weeks. The mortality rate can be as high as 11% in individuals who did not have a prior smallpox vaccination.
There are two primary strains — West African and Congo Basin. The West African strain, which has been associated with the outbreak in Nigeria, causes fewer fatalities, and most of the deaths from it have occurred in individuals with underlying health conditions.
Healio: Where does monkeypox come from?
Minhaj: The virus is found in West and Central Africa. It is thought that small mammals, including rodents, play a role in spreading the virus to people and other forest animals like monkeys.
Interestingly, the name monkeypox is a bit of a misnomer because monkeys are not typically where the virus is found. However, the first identified case of monkeypox was in a monkey. So, the disease has been called monkeypox ever since.
Healio: Is there concern for spread in the U.S.?
Minhaj: Monkeypox has been reported in nine countries in West and Central Africa since 1970. Monkeypox also caused a large outbreak in 2003 in the U.S. after the virus spread from imported African wild mammals that were housed alongside with prairie dogs. The prairie dogs became infected and were then adopted as pets across multiple states.
Since 2017, there have been eight instances of travel-associated infections in travelers from Nigeria to four non-African countries, including the two cases to the U.S. this year.
The CDC has been collaborating with our health partners in the U.S. and in Nigeria to prevent monkeypox by collaborating with Nigerian partners to identify which wild animals carry the virus, helping to improve identification of infections in people, and interviewing community members about their interactions with local wildlife — including products from animals — to understand potential exposures to the virus. These actions help to control disease where it is endemic to decrease the likelihood of spread to other countries.
Healio: How contagious is monkeypox?
Minhaj: People can get monkeypox when they are bitten or scratched by an animal, preparing wild game while cooking, having contact with an infected animal’s body fluids or sores, or through contaminated household surfaces or animal bedding. Monkeypox virus can also spread between people through respiratory droplets or through contact with body fluids, monkeypox sores, or items — such as clothing and bedding — that have been contaminated with fluids or sores of an infected person. The West African strain is less transmissible than the strain found in Central Africa.
Healio: Are there any vaccines for monkeypox available or in development?
Minhaj: Previous smallpox vaccination can be protective against monkeypox. The CDC is coordinating clinical trials in the Democratic Republic of Congo to assess whether the smallpox vaccine, Jynneos, may help protect health care workers from contracting monkeypox infections from their patients.
References:
CDC. Monkeypox in the United States. https://www.cdc.gov/poxvirus/monkeypox/outbreak/us-outbreaks.html. Accessed Dec. 8, 2021.
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