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What is monkeypox, how does it spread, tips to stay safe: 14 questions answered

UAE authority publishes WHO’s Q&A on the viral zoonotic disease, prevention methods

With 12 countries reporting over 90 confirmed cases of the viral zoonotic disease monkeypox, the UAE’s health ministry has reassured the public that the country is fully prepared to deal with its spread.

The Ministry of Health and Prevention (MoHAP) is currently studying and evaluating the seriousness of the disease locally, with healthcare facilities asked to report any suspected cases.

The Abu Dhabi Public Health Centre has, on its website, published the World Health Organisation’s Q&A about the virus that causes the disease, its symptoms, how it spreads and how people can stay safe from it.

1. What is monkeypox?

It is a zoonotic viral disease, which means it can spread from animals to humans. It can also spread between people.

2. Where is monkeypox typically found?

It is commonly found in Central and West Africa, where there are tropical rainforests where animals that may carry the virus typically live. People with monkeypox are occasionally identified in other countries outside these two endemic regions following travel from there.

3. What are its symptoms?

Symptoms typically include a fever, intense headache, muscle aches, back pain, low energy, swollen lymph nodes and a skin rash or lesions. The rash usually begins within one to three days of the start of a fever.

Lesions can be flat or slightly raised, filled with clear or yellowish fluid, and then crust, dry up and fall off. The number of lesions on one person can range from a few to several thousand. The rash tends to be concentrated on the face, palms of the hands and soles of the feet. They can also be found on the mouth, genitals, and eyes.

Symptoms typically last between two to four weeks and go away on their own without treatment. If you think you have symptoms that could be monkeypox, seek advice from your health care provider. Also, let them know if you have had close contact with someone who has suspected or confirmed monkeypox.

4. Can people die from the disease?

In most cases, the symptoms of monkeypox go away on their own within a few weeks, but in some individuals, they can lead to medical complications and even death. Newborns, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.

Complications from severe cases of monkeypox include skin infections, pneumonia, confusion, and eye infections which can lead to loss of vision. Around three to six per cent of reported cases have led to death in endemic countries in recent times, often in children or persons who may have other health conditions. It is important to note that this may be an overestimate because surveillance in endemic countries is limited.

5. How does it spread from animals to humans?

Monkeypox can spread to people when they come into physical contact with an infected animal. Animal hosts include rodents and primates.

The risk of catching monkeypox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood).

In endemic countries where animals carry monkeypox, any foods containing animal meat or parts should be cooked thoroughly before eating.

6. How does it spread from person to person?

People with monkeypox are infectious while they have symptoms (normally for between two and four weeks).

You can catch monkeypox through close physical contact with someone who has symptoms. The rash, bodily fluids (such as fluid, pus or blood from skin lesions) and scabs are particularly infectious. Clothing, bedding, towels or objects like utensils and dishes that have been contaminated with the virus from contact with an infected person can also infect others.

Ulcers, lesions or sores in the mouth can also be infectious, meaning the virus can spread through saliva. People who closely interact with an infectious person, including health workers, household members and sexual partners, are therefore at greater risk for infection.

The virus can also spread from someone who is pregnant to the foetus from the placenta, or from an infected parent to child during or after birth through skin-to-skin contact.

It is not clear whether people who do not have symptoms can spread the disease.

7. How can I protect myself and others?

You can reduce your risk by limiting contact with people who have suspected or confirmed monkeypox.

If you do need to have physical contact with someone who has monkeypox because you are a health worker or live together, encourage the infected person to self-isolate and cover any skin lesions if they can (for example, by wearing clothing over the rash).

When you are physically close to them, they should wear a medical mask, especially if they are coughing or have lesions in their mouth. You should wear one also. Avoid skin-to-skin contact whenever possible and use disposable gloves if you have any direct contact with lesions. Wear a mask when handling any clothes or bedding if the person cannot do it themselves.

Regularly clean your hands with soap and water or an alcohol-based hand rub, especially after contact with the person who is infected, their clothes, bed sheets, towels and other items or surfaces they have touched or that might have come into contact with their rash or respiratory secretions (for example, utensils, dishes).  Wash the person’s clothes, towels and bedsheets and eating utensils with warm water and detergent.  Clean and disinfect any contaminated surfaces and dispose of contaminated waste (for example, dressings) appropriately.

8. Can children get the virus?

Children are typically more prone to have severe symptoms than adolescents and adults. The virus can also be passed to a foetus or to a newborn through birth or early physical contact.

9. What should I do if I think I may have been infected?

If you think you have symptoms or have been in close contact with someone with monkeypox, contact your health worker for advice, testing and medical care. If possible, self-isolate and avoid close contact with others. Clean hands regularly and take the steps listed above to protect others from infection.

10. Is there a vaccine against monkeypox?

There are several vaccines available for the prevention of smallpox that also provide some protection against monkeypox.

A newer vaccine that was developed for smallpox (MVA-BN – also known as Imvamune, Imvanex or Jynneos) was approved in 2019 for use in preventing monkeypox and is not yet widely available. WHO is working with the manufacturer to improve access.

People who have been vaccinated against smallpox in the past will also have some protection against monkeypox. The original smallpox vaccines are no longer available to the general public, and people below the age of 40 – 50 years are unlikely to have been immunised since vaccination against smallpox ended in 1980 after it became the first disease to be eradicated. Some laboratory personnel or health workers may have been vaccinated with a more recent smallpox vaccine.

11. Is there a treatment for it?

Monkeypox symptoms often resolve on their own without the need for treatment.

It is important to take care of the rash by letting it dry if possible or covering it with a moist dressing to protect the area if needed. Avoid touching any sores in the mouth or eyes. Mouth rinses and eye drops can be used as long as cortisone-containing products are avoided.

Vaccinia immune globulin (VIG) may be recommended for severe cases. An antiviral that was developed to treat smallpox (tecovirimat, commercialised as TPOXX) was also approved for the treatment of monkeypox in January 2022.

12. Where in the world is there currently a risk of the virus?

Since 1970, human cases of monkeypox have been reported in 11 African countries – Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Côte d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan.

Cases occasionally occur in non-endemic countries. These are typically reported in persons who have travelled to endemic countries. One outbreak was caused by contact with animals who had been infected by other imported small mammals.

In May 2022, multiple cases of monkeypox are being identified in several non-endemic countries. This is not typical of past patterns of monkeypox. WHO is working with all affected countries to enhance surveillance and provide guidance on how to stop the spread and how to care for those infected.

13. Is there a risk of this becoming a larger outbreak?

Monkeypox is not typically considered to be very contagious because it requires close physical contact with someone who is infectious (for example, skin to skin) to spread between people. The risk to the general public is low.

WHO is responding to this outbreak as a high priority to avoid further spread; for many years, it has considered monkeypox a priority pathogen. The cases we are currently seeing are not typical for outbreaks of monkeypox because there is no reported travel from endemic countries or to animals exported from endemic countries. Identifying how the virus is spreading and protecting more people from becoming infected is a priority for WHO. Raising awareness about this new situation will help to stop further transmission.

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14. Why is this disease called ‘monkeypox’?

The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. It was only later detected in humans in 1970.