Monkeypox Symptoms and 7 Other Facts from Epidemiologists

Updated: Jul. 28, 2022

Here's what to know about monkeypox after the World Health Organization declared it a public health emergency of international concern.

Monkeypox symptoms can seem flu-like

On July 23, the World Health Organization (WHO) declared the global outbreak of monkeypox a public health emergency of international concern, citing over 16,000 reported cases and five deaths across 75 countries and territories. With the Centers for Disease Control and Prevention (CDC) reporting about 5,000 of those cases in the U.S. so far, here’s what you need to know about monkeypox and how you can protect yourself.

The CDC suggests an individual who’s been exposed to the virus may see the following monkeypox symptoms appear anywhere between five and 21 days after exposure:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • Sore throat, nasal congestion or a cough

The CDC adds, “Within one to three days (sometimes longer) after the appearance of fever, the patient develops a rash.”

“It’s the rash that helps distinguish monkeypox from other things,” explains Daniel Bausch, MD, the president of the American Society of Tropical Medicine & Hygiene and director for emerging threats and global health security at FIND, the global alliance for diagnostics. The rash can be comprised of fluid- and pus-filled lesions that often begin on the face and spread to other parts of the body.

The CDC says that in general a case of monkeypox usually lasts two to four weeks.

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Monkeypox is not a new virus

This is a new outbreak of a known virus, explains Anne Rimoin, chair of infectious diseases and public health at the University of California, Los Angeles.

First discovered in 1958 in monkeys, the virus was identified in humans in 1970 in the Democratic Republic of the Congo. Since then, infections have been reported in humans in other central and western African countries, according to the CDC.

There have been other outbreaks in the U.S. over the years, including a 2003 outbreak linked to infected prairie dogs that had been imported as pets.

Monkeypox doesn’t spread as easily as COVID-19

In past outbreaks, monkeypox spread primarily from animals to humans, and less often from person to person. However, according to the CDC, transmission of monkeypox between humans is possible through:

  • Direct contact with bodily fluids, or with infectious rashes or scabs
  • Intimate physical contact, such as kissing, cuddling or sex
  • Touching items, such as clothes or sheets, that were previously exposed to fluids or a rash

The CDC also says pregnant people can spread the virus to their fetus through the placenta.

Still, while concern over monkeypox is rising, it is not as contagious as COVID-19, as transmission requires close contact with someone who is symptomatic.

“This is not a disease that is easily spread,” Dr. Bausch says. “This will not be the next pandemic.”

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Monkeypox is rarely lethal

Hannah Newman, director of epidemiology at Lenox Hill Hospital in New York City says the mortality rate associated with the current strain is thought to be about one percent. “That being said, anyone experiencing an unusual rash or lesion and has risk factors (or had sexual encounters with someone who has) should seek care immediately,” she says.

Men who have sex with men may be at heightened risk

In his statement announcing the declaration of a public health emergency, WHO Director-General Tedros Adhanom Ghebreyesus wrote, “Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners.”

During a press conference on July 27, Dr Tedros recommended that gay and bisexual men limit their number of sexual partners to prevent transmission and protect themselves. He also encouraged countries to engage with their LGBTQ+ communities so they can spread awareness and take care of those who are infected.

It’s important to understand, though, that the illness can be spread between anyone of any orientation. Dr. Tedros emphasized in his July 23 announcement, “Stigma and discrimination can be as dangerous as any virus.”

Monkeypox is a cousin of smallpox

Monkeypox is a milder version of smallpox, which means that we have a vaccine and treatments, says Bausch. “There is fairly good evidence that the smallpox vaccine is protective against monkeypox,” he says.

In fact, according to the CDC there are two vaccines licensed by the U.S. Food and Drug Administration (FDA) to prevent monkeypox infection. One, JYNNEOS, currently has a limited supply in the U.S., though the CDC reports that is expected to change in the coming weeks. The other, ACAM2000, should not be used for people with a weakened immune system, certain skin conditions such as eczema or for people who are pregnant. There also are antiviral drugs for smallpox that could be used to treat severe cases of monkeypox.

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