Monkeypox: the History and the Current Outbreak

With cases of Monkeypox on the rise in New York City, and throughout the region, it’s important to be educated about the disease and be on the lookout for potential signs and symptoms. Read on below for a brief history on the disease, symptoms and transmission, treatment, and where we are right now in the region.

Let’s begin with a brief history.  First of all, there is no specific association with monkeys.  The name comes from its original isolation in a group of monkeys in Africa, but the reservoir for it is in rodents, specifically rodents in Central and West Africa.

What are the symptoms?  There is often a 7-14 day incubation period.  When symptoms begin, patients typically experience  flu-like symptoms including fever, chills, headache, muscle aches, and generalized fatigue.  Patients may also have lymphadenopathy (swollen lymph nodes) in the neck, armpits or groin.  After a few days of symptoms, the characteristic rash begins developing on the skin of the patient’s body.  .

Whereas historically, monkeypox presents w/ lesions on head and neck, spreading to the trunk and then to palms and soles of feet.  This outbreak is a little different, with lesions often beginning in the genital areas and in the mouth.

The lesions often appear as pimples or blisters and can develop into pustules or vesicles.  Anogenital symptoms can be quite painful and uncomfortable. Lesions in the mouth may make it painful to eat or drink leading to dehydration.

Thankfully, the disease is usually self-limited and gets better without any specific therapy. Supportive care including medications to address symptoms such as itching, nausea, vomiting, and body aches. It is important to isolate from the time of prodromal (flu-like) symptoms through all lesions being crusted over.  Transmission can occur during sex or other intimate activites including hugging, kissing, sharing clothing, bedding, towels used by someone with monkeypox.  It can also be spread through respiratory droplets or oral fluids, but is NOT thought to be airborne.

If you believe you might have monkeypox or been in close contact with someone who has been diagnosed, contact a medical professional or the health department.  There is now testing available through both public health laboratories and private laboratories like Quest labs.  Samples can be collected at healthcare facilities, doctors’ offices as well as in-home medical services like Care2U. There is also a vaccine available and which can be effective if given within 4 days of an exposure.

There is no FDA approved treatment yet for Monkeypox, but there is a medication called tecovirimat  that was developed and approved for smallpox.  Supplies are limited and controlled by the federal government, but certain high risk patients may qualify.