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Monkeypox Is Not Like COVID-19

If the thought of another contagious disease originating from overseas and apparently spreading in the U.S. has you experiencing a déjà vu case of “Oh, no, here we go again,” that’s understandable. After what we’ve been through in the last two years with the SARS-CoV-2 coronavirus, the last thing we want to hear about is the possibility of another pandemic.

But our primary care doctors in Delray Beach want to reassure you that the recent news about monkeypox is no cause for alarm. Not only is this virus different from COVID-19, but we already have an effective vaccine for this disease that has been around for over fifty years.

The beginning

According to the Centers for Disease Control and Prevention (CDC), monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research; thus the name “monkeypox” arose.

The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in humans in other central and western African countries.

Rarely, it has been seen outside of these areas when owners of imported pets, particularly rodents, infect their owners.

Recently, however, it has been found the U.S., including Massachusetts, New York City, Utah, and Florida. The World Health Organization (WHO) reports more than 160 cases have been found in more than 16 countries, including Canada, Spain, Israel, France, and Switzerland.

These, however, are not as severe as the strain that continues to plague the Democratic Republic of Congo. There, doctors have reported at least 1,200 cases and 57 deaths since January of this year, because the strain circulating there has a fatality rate of around 10 percent.

The strain that is currently being found outside that area has a fatality rate around one percent.


Similarities and differences

Although the WHO classifies monkeypox, like the coronavirus, as a zoonotic virus, meaning it passed from animals to humans, there are many reasons why it is not like COVID-19.

First, unlike the stealth infections of the coronavirus, it’s very apparent when a person is infected with monkeypox. They develop fever, headache or body aches, swollen lymph nodes, chills, and exhaustion. These symptoms are similar to those of smallpox, a cousin of monkeypox, with one difference:

“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the CDC says.

Within one to three days after the fever begins, the patient develops a rash, often beginning on the face, then spreading to other parts of the body. This rash then turns to painful fluid-filled lesions (pox) that then crust or scab over and eventually fall off.

And, unlike the largely airborne transmission of SARS-CoV-2 through aerosols that linger in the air, the monkeypox virus can only be spread through close contact with an infected person, animal, or materials such as bedding that are contaminated with the virus, or possibly from respiratory droplets in close proximity to an infected person.

Finally, monkeypox appears at this time to be far less transmissible than COVID-19. One study found that just three percent of those in close contact with an infected person will develop monkeypox.


Why now?

No one is sure why we’ve seen an uptick in cases outside of Africa in the last few weeks, although experts believe it began at two separate raves (dance parties) in Spain and Belgium.

Dr. David Heymann, who formerly headed the WHO’s emergencies department, told the Associated Press (AP) that the agency suspects it spread there through close sexual contact among attendees. Public health authorities in Madrid have also linked the infections in Spain to an outbreak at a sauna there.

“We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified transmission,” he told the AP.

NBC News points out that this is not the first time the U.S. has seen an outbreak of monkeypox. In 2003, the U.S. identified 47 cases among people who had been in contact with infected pet prairie dogs. No one died in that outbreak.

Another reason we’re seeing it here might be the fact that the U.S. stopped vaccinating the public for smallpox in 1972. The smallpox vaccine was also 85 percent effective at preventing monkeypox, but now the general population no longer has this protection.


Should you worry?

Our primary care doctors don’t believe you have to worry about getting monkeypox at this time. We would, however, like you to be aware of the possibility, and the fact that it has been detected in Florida, among other states.

Because this outbreak is so unusual, particularly the fact that cases haven’t been traced to travel, the CDC is preparing for additional cases in the U.S.

“We are telling people this is an emerging issue,” Agam Rao, a medical officer at the CDC, told NBC News.

“As an emerging issue, we are asking people to keep it top of mind at the moment,” she said.

Still, according to Tom Inglesby, of the Johns Hopkins Center for Health Security, outbreaks of monkeypox in the past have usually been small, with numbers in the single digits.

“So I think the risk to the general public at this point, from the information we have, is very, very low,” he told The Washington Post.

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