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MSU infectious disease expert explains monkeypox outbreak

Colorized electron microscopic image of a monkeypox virion
Colorized electron microscopic image of a monkeypox virion

Monkeypox has become the biggest medical story in the news since COVID. But what is it exactly? And how dangerous might it be?

Monkeypox comes from the same family of viruses as smallpox. Michigan State University infectious disease expert Dr. Peter Gulick says the first case of monkeypox in animals was detected in the 1950s, and the first human case emerged in 1970. It can transmit from animal to human, human to human, and human to animal.

There have been small outbreaks over the years. In recent months, more than 10,000 cases have been reported around the world. Of those, about 1,000 were in the United States, but at this time fewer than a dozen cases have been reported in Michigan.

Dr. Gulick says the numbers could be misleading because not much testing is being done. Of the cases we know about, most have been among men who have sex with men, but he stresses that monkeypox should not be thought of as a gay disease.

The main method of spread is close contact.

“Close contact with any part of your body, body fluids, even respiratory secretions can transmit the disease. But again, I want to emphasize that the respiratory spread is very, very minimal. It’s not like COVID, even close to it as far as that.”

Considering the rate of spread we’re seeing, Dr. Gulick says anyone who tests positive for monkeypox should isolate immediately. Once exposed, he says monkeypox can present in a variety of ways.

“Number one, it can present itself with just local outbreaks of a rash,” Gulick said. “And the rash is, again, a kind of unique rash that can be confused with the chicken pox rash, a herpes rash, those kind of rashes.”

The patient can suffer from flu-like achiness and fever. There are a couple of oral medications that can help.

The rash can appear as flat marks on the skin which can then become little bumps that can break open and scab over. The rash can be extremely painful and itchy, and might even become disfiguring.

Dr. Gulick says immunocompromised people may be at risk for a more systemic infection.

“There’s been descriptions of people getting encephalitis from it spread to other organs of the body where it can be deadly. But, in the majority of cases, no, it’s pretty much localized and eventually just clears up over a matter of several days or a couple weeks.”

A couple of vaccines could prove to be helpful in the fight against monkeypox. One is widely available to fight smallpox, but it uses a live virus that’s risky to give to someone with a compromised immune system.

Dr. Gulick says another vaccine is being developed to more specifically target monkeypox. It would require two shots administered a month apart. Experts are now trying to determine who should get it.

“If you had a known exposure to somebody with monkeypox, or you started to maybe develop symptoms or so within four to 14 days of either exposure or symptoms, they’re saying that this vaccine might be warranted to give,” Gulick said.

Dr. Gulick says this second vaccine may not prevent monkeypox, but would reduce the severity of symptoms. The supply is limited, but the U.S. is ramping up production. The best source of information is your local health department.

Scott Pohl is a general assignment news reporter and produces news features and interviews. He is also an alternate local host on NPR's "Morning Edition."
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