Monkeypox - Updating our knowledge
Over 25000 cases of Monkepox have been detected across the world since May 2022. For a rare disease that requires close contact to spread, these numbers, which continue to rise, are unusual.
As we continue to understand this outbreak of Monkeypox – which the WHO has designated as a Public Health Emergency of International Concern, I thought of doing a quick set of posts on Monkeypox.
Let’s start with the key question
How can I get Monkeypox?
How can I get Monkeypox?
From Infected Humans1,2
Requires close physical contact – direct contact with skin lesions or scabs, respiratory secretions, recently contaminated objects (particularly relevant in household or healthcare settings) or sexual contact3,4.
From Infected Animals1,2
Many animals are known to get infected with the Monkeypox virus, including many different rodents, squirrels and monkeys. Humans can get infected by direct contact with blood, secretions or lesions of infected animals.
The virus enters the body through broken skin (including microabrasions
that are not visible), via mucous membranes and via the respiratory
In the current outbreak, with cases reported from May 2022 onwards3, sexual contact is emerging as a possible mode of spread of the virus4. This was not appreciated as an important mode of spread before. In a study published in Lancet Infectious Diseases on August 02, 2022, researchers were able to isolate/grow the virus from the semen of two infected individuals5. They detected the genetic material (DNA) of the virus in the semen in 11/14 cases. This suggests that the virus is present in semen and could be infectious5.
So, early evidence suggests that we may have to update our knowledge on the spread of this virus and include sexual transmission as a mode of spread for this virus, in addition to the other modes of transmission all of which require close/intimate contact including mother-child (via placenta or close contact)6, respiratory droplets in close proximity and from contaminated objects.
A related question- Will everyone in the world get Monkeypox?
This is probably something that comes to mind given our experience with COVID-19. There are several key differences between Monkeypox virus and the SARS-CoV-2, both from the standpoint of transmission as well as preparedness. I’ll cover these in my next post.
Links to information on Monkeypox:
Fact sheet from WHO: https://www.who.int/news-room/fact-sheets/detail/monkeypox
Countries reporting cases: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
A course from WHO based on previous outbreaks – aimed at public health professionals, policy-makers and health workers
1. https://www.gov.uk/guidance/monkeypox#transmission Accessed on Aug 04, 2022
2. https://www.who.int/news-room/fact-sheets/detail/monkeypox Accessed on Aug 04, 2022
3. Thornhill, John P et al. “Monkeypox Virus Infection in Humans across 16 Countries – April-June 2022.” The New England journal of medicine, 10.1056/NEJMoa2207323. 21 Jul. 2022, doi:10.1056/NEJMoa2207323
4. Antinori, Andrea et al. “Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022.” Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin vol. 27,22 (2022): 2200421. doi:10.2807/1560-7917.ES.2022.27.22.22004
5. Lapa, Daniele et al., “Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding” The Lancet Infectious Diseases. doi: 10.1016/S1473-3099(22)00513-8
6. Mbala, Placide K et al. “Maternal and Fetal Outcomes Among Pregnant Women With Human Monkeypox Infection in the Democratic Republic of Congo.” The Journal of infectious diseases vol. 216,7 (2017): 824-828. doi:10.1093/infdis/jix260