U.S. Declares Monkeypox a Public Health Emergency

Cases are rising across the country. Learn what it is, how it spreads, and how serious it really is.

man getting vaccinated

Updated on August 4, 2022.

The Biden Administration has declared monkeypox a public health emergency. The strategic move triggers a set of measures to help curb the spread of the viral infection, including enabling federal agencies to fast-track drugs and other therapies, easing access to treatments, freeing up emergency funding for states and local health departments, and hiring additional staff to help contain the outbreak.

It's also a clear message that taking steps to stop the spread of Monkeypox must be a priority.

Since the global Monkeypox outbreak began in May 2022, at least 26,208 people have been infected in 87 countries. The vast majority of those affected live in areas where the virus is not usually found, including the United States where there have been 6,617 confirmed infections across 48 states as of August 3, according to the Centers for Disease Control and Prevention (CDC). U.S. cases are rising exponentially, doubling each week since the beginning of July.

Some 98 precent of monkeypox cases have involved men who are gay, bisexual, or have sex with men, the World Health Organization (WHO) reported in a July 27 briefing. But monkeypox is not targeting people based on their sexual preferences. Anyone can become infected if they are exposed—including kids.

Already, several children have developed monkeypox, the WHO points out, including two in the United States. The children were infected mainly through household contacts.

“I am concerned about sustained transmission because it would suggest that the virus is establishing itself and it could move into high-risk groups including children, the immunocompromised and pregnant women,” said WHO Director-General Tedros Adhanom Ghebreyesus in a June 29 media briefing.

The worrisome trend also prompted the global agency to declare the escalating monkeypox outbreak a Public Health Emergency of International Concern (PHEIC) on July 23.

So, what now? What does this all mean?

Debunking monkeypox misconceptions

For the past few years, we’ve all gotten a crash course in virology and epidemiology. Like it or not, COVID has taught us lessons in how bundles of genetic material can infect human cells, spread, and wreak havoc on the body in the process.

Now, we’re confronted with another outbreak—monkeypox. This time the infectious agent isn’t new. It was first identified in monkeys about 64 years ago, and the first human case was confirmed in 1970. But it is raising alarms given how quickly—and where—it appears to be spreading.

Still, for most people, the risk for infection remains low. Monkeypox is rare. Some Americans may not have even heard of it before the current outbreak. That’s because the virus is typically found in central and west Africa.

The fact that an increasing number of cases are being reported in the United States and other countries where it is not usually found, such as the UK, France, Canada, and Australia, is cause for concern. Scientists point out however, that the west African strain of monkeypox, which is less severe that the Congo strain, is the one that is involved in this latest outbreak.

Can monkeypox kill you? It’s possible but highly unlikely—especially if you live in a country with adequate healthcare resources. The less serious strain in circulation may result in death in about 1 percent of those infected. Outcomes may depend on variables, including a person’s health history, but most people recover fully on their own in two to four weeks

If you are exposed to the virus, the vaccine used to eradicate smallpox could help protect against monkeypox. (No, monkeypox isn’t the same thing as smallpox. In this family of viruses, monkeypox is a less harmful cousin of smallpox.) In fact, one reason why monkeypox cases may be popping up is that routine smallpox vaccinations ended in 1972. So, immunity among the population may be waning.

The U.S. Food and Drug Administration (FDA) approved the JYNNEOS vaccine for the prevention of both smallpox and monkeypox among adults at high risk for infection. Observational studies suggest the vaccine is about 85 percent effective against monkeypox. Immunization can help prevent infections within four days of exposure. Being vaccinated could also result in a milder monkeypox infection.

The two-dose vaccine is included in the U.S. Strategic National Stockpile, but it is currently in short supply.

Some countries, including parts of the U.S., have begun rationing its use, withholding the second dose which is usually given four weeks after the first shot. U.S. health and regulatory officials have warned against this strategy, noting that one dose will not provide adequate protection over time.

Know the symptoms—and avoid exposure

If we’ve learned anything from COVID, it’s that we can’t always predict how a virus will behave. But the more we know about it, the better off we all are. Fortunately, scientists already know a lot about monkeypox. Understanding the virus and how it spreads can help you protect yourself and others.

Unlike COVID which can spread even before someone knows they’re infected, monkeypox takes longer to become transmissible (usually about one to two weeks) and most people are symptomatic by the time this happens. As a result, preventative steps can be taken to stop its spread.

The early warning signs of monkeypox infection include fever, chills, headache, backpain, muscle aches and fatigue. The virus also causes swelling in the lymph nodes.

Usually within a few days (sometime longer), people also develop a rash. It may start on the face then spread to other parts of the body.

At first, the lesions will be flat. But over the course of a few weeks, they will become raised, blister, and fill with puss before scabbing up and falling off. Monkeypox can spread from the time that symptoms start until the rash is fully healed and new skin has formed.

How can you get it?

Direct contact with these sores and body fluids as well as contaminated materials, such as bedding, towels, or other fabrics and textiles can spread the infection to others. It also can be spread through respiratory droplets during prolonged, face-to-face contact. This includes intimate contact between people, such as during sex, or while kissing, cuddling, or touching parts of the body with monkeypox sores.

Monkeypox does not spread through casual conversations, or simply walking near or passing by someone out on the street or in a store. You also don’t get infected by casually touching everyday objects, like doorknobs, the CDC points out.

The virus can, however, cross a pregnant person’s placenta, infecting a fetus. And it can spread from infected animals to people through exposure to contaminated animal products, bites, scratches or by handling wild game.

Researchers are still working to understand if the infection can be spread through contact with semen or vaginal fluids.

Being mindful about possible exposure and taking steps to protect yourself and others can help prevent more infections from happening. Aside from avoiding close contact with infected people, animals, or contaminated materials, it’s important to continue to practice excellent hand hygiene. Wash your hands well and often with soap and water for at least 20 seconds. If you do not have access to soap and water, use a hand sanitizer with an alcohol content of at least 60 percent.

Avoid sharing cups and utensils with people who are infected. Those with monkeypox should isolate themselves within their household to avoid contaminating common spaces, such as upholstered seating and blankets. If possible, those infected should not share a bathroom with other people until their infection has resolved.  

What else is being done?

As cases continue to rise, the U.S. Department of Health and Human Services (HHS) announced plans to expand a national immunization strategy that would provide more vaccines and more tests to high-risk groups in states with the greatest number of confirmed infections. The strategy will make 296,000 doses of the smallpox/monkeypox vaccine available over the coming weeks, with an additional 750,000 doses expected in the summer and 500,000 doses in the fall.

Health officials are also asking healthcare providers to continue to look for rashes that could indicate possible monkeypox infections. Similarly, anyone with a rash that resembles monkeypox should talk to their provider. Even though most people will recover fully without treatment, those at higher risk for severe cases include:

  • People with serious diseases or weakened immune systems
  • Children younger than 8-years old
  • Pregnant people or those who are breastfeeding
  • Those with a history of certain skin conditions, including severe acne, eczema, burns, impetigo, varicella zoster (chickenpox), herpes simplex, and psoriasis.

People at greater risk for complicated or serious monkeypox infections may be treated with an antiviral medication or VIGIV (vaccinia immune globulin intravenous).

The antiviral drug, TPOXX, which is FDA-approved for the treatment of smallpox. In certain cases, the CDC says it may be prescribed for people with monkeypox who are at high risk for severe infections. During the current outbreak, the FDA has streamlined the process by which healthcare providers can request this drug to treat people with monkeypox, making it easier to obtain.

Article sources open article sources

Centers for Disease Control and Prevention. 2022 Monkeypox and Orthopoxvirus Outbreak Global Map. Jul 29, 2022.
Centers for Disease Control and Prevention. 2022 U.S. Map & Case Count. Jul 29, 2022.
Centers for Disease Control and Prevention. U.S. Monkeypox Case Trends Reported to CDC. Jul 27, 2022.
World Health Organization. WHO press conference on monkeypox, COVID-19 and other global health issues. Jul 27, 2022.
World Health Organization. WHO Director-General's opening remarks at the media briefing. Jun 29, 2022.
Centers for Disease Control and Prevention. Update for Clinicians on Monkeypox in People with HIV, Children and Adolescents, and People who are Pregnant or Breastfeeding. Jul 30, 2022.
Centers for Disease Control and Prevention. Traveler’s Health: Monkeypox in Multiple Countries. Jun 7, 2022.
Centers for Disease Control and Prevention. Monkeypox and Smallpox Vaccine Guidance. Jun 2, 2022.
Nature. Monkeypox vaccination begins — can the global outbreaks be contained? Jun 8, 2022.
Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Guidance for Tecovirimat Use Under Expanded Access Investigational New Drug Protocol during 2022 U.S. Monkeypox Cases. Jul 26, 2022.
UNCHealth. Do You Have to Worry About Monkeypox? 6 Questions and Answers. May 25, 2022
World Health Organization. Monkeypox. May 19, 2022.
UCSF. How Dangerous Is Monkeypox? May 26, 2022.
Centers for Disease Control and Prevention. Monkeypox: Prevention. Jun 9, 2022.
Centers for Disease Control and Prevention. Monkeypox: Transmission. Jun 9, 2022.
Centers for Disease Control and Prevention. U.S. Monkeypox Outbreak 2022: Situation Summary. Jun 14, 2022.
Centers for Disease Control and Prevention. Interim Clinical Guidance for the Treatment of Monkeypox. Jun 10, 2022.
U.S. Department of Health and Human Services. HHS Announces Enhanced Strategy to Vaccinate and Protect At-Risk Individuals from the Current Monkeypox Outbreak. June 28, 2022.

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