The number of Americans infected with monkeypox, now known as mpox, has surpassed 29,000 with the CDC reporting a large increase in the the fall in confirmed cases since the start of the current outbreak in the United States.

And with that news comes updates on vaccines, treatments, and Novant Health’s response to keeping the community healthy.

Dr. David Priest, Novant Health chief safety, quality, and epidemiology office stresses that the virus is not a sexually transmitted infection, and anyone can contract it.

More than 680 cases have been diagnosed in North Carolina, with the largest number reported in Mecklenburg County.

Priest said most of the cases have been mild and did not require hospitalization. Still, he said, monkeypox can be very painful. Answers to common questions follow.

What is monkeypox?

The monkeypox virus belongs to the same family of viruses as smallpox. The symptoms are similar to smallpox, but generally milder.

Monkeypox is usually found in several central and west African countries and is transmitted from animals to humans. Some of the cases discovered in May, the start of the outbreak, are linked to that region of the world.

The virus has since spread around the globe and across the United States.

The U.S. declared monkeypox a national health emergency Aug. 4. The World Health Organization declared it a global emergency last month.

At the moment, the majority of patients have been men who have sex with men. But anyone can contract the virus through close contact. A few cases have been reported in children.

monkeypox
Photo is courtesy of the Centers for Disease Control and Prevention.

What are monkeypox symptoms?

  • Distinctive rash.
  • Fever.
  • Headache, muscle and back aches.
  • Swollen lymph nodes.
  • Exhaustion.
  • Chills.
  • Respiratory symptoms (sore throat, nasal congestion, or cough).

Symptoms usually begin within five to 21 days of exposure to the virus. The tell-tale symptom of monkeypox is a rash made up of bumps that look like pimples, called pustules. These pustules are filled with fluid and are deep-seated, firm and well-defined. They will generally become lesions, scab over and fall off.

Some people show flu-like symptoms before the rash, others get the rash first and then the other symptoms follow. And still others only have the rash.

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The rash can start in the place where a person was exposed to the virus. In recent cases that was the groin, sexual organs and the anus. It can then spread across the body, particularly to the face and extremities.

A person is contagious from the time symptoms start until the rash has healed, with a new lawyer of skin on top.

That usually takes two to four weeks.

How it spreads

Priest stressed monkeypox is not as contagious as COVID-19, and doesn’t spread on common surfaces, like doorknobs.

Monkeypox is transmitted through close contact with an infected person. Prolonged skin-to-skin contact is the most common method of transmission.

But the virus can also spread through touching infected body fluids or lesions, exposure to infected respiratory droplets, and by coming into contact with contaminated clothing or linens.

How is monkeypox treated?

Most people infected with the monkeypox virus will recover on their own.

Others, including people who are immunocompromised or have severe illness, children, and pregnant women, may qualify for a treatment that is not currently approved by the FDA but is available to certain people under a CDC protocol.

Priest said the treatment, TPOXX, is difficult to obtain, even with the CDC protocol. And the supply is very limited, which is why it’s reserved for certain populations – or patients with lesions on sensitive parts of their bodies, like their eyes, mouths, or genitals.

Who's eligible for vaccines?

There is a monkeypox vaccine, but, as with the treatment, the supply is limited.

In September, North Carolina expanded the eligibility criteria for who can receive the monkeypox vaccine. You may be eligible if you meet any of the following criteria:

  • Had close contact within the past two weeks with someone who has been diagnosed with monkeypox; or
  • Gay, bisexual, or other men who have sex with men, or transgender individuals, who are sexually active; or
  • People who have had sexual contact with gay, bisexual, or other men who have sex with men, or transgender individuals in the past 90 days; or
  • People who live with HIV, or are taking medication to prevent HIV (PrEP), or who were diagnosed with syphilis in the past 90 days.

The monkeypox vaccine is a 2-shot series, so you will need a second dose about 4 weeks after the first dose.

Those who do not have a primary care provider (PCP) in the Novant Health system should contact their local health department. People who have had a known exposure to monkeypox should also contact their health department. For more information: Monkeypox | NCDHHS.

Preventing the spread

Testing for monkeypox currently requires a swab of a pustule. But it’s possible for someone to be contagious before developing the hallmark rash.

The best way to prevent the spread of monkeypox, according to the CDC, is to avoid close, skin-to-skin contact with anyone showing symptoms. Don’t share utensils or cups with someone who has monkeypox and avoid touching their clothing and linens.