MONKEYPOX What you need to know
Monkeypox is a virus that causes similar symptoms to chickenpox, usually causing fever, headache and rash on the face, hands, feet and genitals.
Recently, outbreaks of monkeypox infections have been reported in countries around the world, including Canada, Australia and in Europe, mostly among men who have sex with men. Remember: Anyone can be infected with this virus, regardless of age, gender, sex or sexual orientation.
What we know so far:
Cases in Canada and elsewhere in the world have been linked to exposures in saunas/bath houses.
Many of these recent cases are different from known monkeypox infections in the past.
Instead of, or in addition to, the symptoms described above, many men came to the clinic with rash on the penis, scrotum, perineum, and around the anus. This rash can look similar to other sexually transmitted infections like syphilis or herpes.
The virus can be transmitted through skin-to-skin contact during sex.
The virus can also be transmitted to close non-sexual contacts through touching sores, clothing, bedding, bandages, saliva and other bodily fluids while the person is infectious.
Generally, monkeypox is not dangerous for a healthy person, with mild symptoms that go away by themselves without any treatment.
Severe cases requiring hospitalization can occur.
Immunocompromised individuals and young children are at higher risk of severe symptoms and death.
Those who are pregnant are at risk of complications including miscarriage, stillbirth or infant death.
The infection can also be passed to the baby at birth with potentially severe consequences for the infant.
Monkeypox is generally not easily spread from person to person. It usually requires prolonged face to face contact or direct contact with skin sores/ulcers.
Above: Images of monkeypox patients from a 2003 outbreak in the United States
What are the symptoms?
The symptoms usually start with fever, headache, swollen glands (lymph nodes), and weakness. After several days, a rash appears.
The rash is often seen on the face, hands, and feet, but can be anywhere on the body. Sores in the mouth and on the tongue can occur.
Although this virus is not known to be sexually transmitted, close contact during sex may cause lesions at the site of contact. Recent cases have presented with sores around their genitals and anus.
Monkeypox rash typically runs its course within 2-3 weeks.
How does the rash progress?
The rash starts with red spots that become raised and filled with pus.
The first stage of the rash features red flat spots that measure no more than one centimeter across.
The spots (also called “lesions”) become raised bumps that turn into blisters filled with clear, watery pus.
The blisters get bigger and harder as they fill with pus, pressing deeply into the skin and changing from clear and watery to cloudy and yellow. Some spots develop a doughnut hole (“umbilication”) in the centre.
The pus-filled blisters will remain for five to seven days and then burst, develop a crusty scab, and begin to heal. It is important to keep the sores clean and dry as they begin to break open and scab over, to avoid complications and secondary infection.
Scabs should begin to dry up and fall off by the end of the third week of having the rash.
Once all scabs have fallen off, a person is no longer contagious.
As long as there are sores on the skin, a person can spread monkeypox via their sores and bodily fluids and contact with contaminated materials like their bedding and clothes.
You can also spread monkeypox for up to five days before the rash begins.
Healthcare workers and household contacts are particularly at risk of exposure if they're caring for infected patients.
The virus spreads during close contact, such as:
sleeping in the same bed
sharing a small space with others for a prolonged period
The virus can also spread through droplets containing virus coming out of your mouth and nose.
This is especially true if you have sores inside your mouth, because the sores contain a lot of virus particles.
You can get infected from touching infected skin, rash or sores, or from the clothing, bedding, and bandages of a person with infected skin, rash or sores.
You can breathe in the virus when you are in close contact with someone who is infected or if the virus is disturbed from clothes or bedding.
The virus can be transmitted directly through the skin, or transfer from your fingers to other skin or mucous membranes (such as the inside of the mouth, vagina or rectum).
How does monkeypox spread?
If you have monkeypox symptoms,
Go to a clinic or doctor to be assessed. Call ahead and tell them you have monkeypox so they can take precautions. When you go, wear a well-fitting mask and cover any sores you have.
While you have sores, isolate at home.
Wear a mask and cover your sores when you share space with others.
Do not share a bed with anyone while you are infectious.
Public health will follow-up with your close contacts and ask them to monitor for symptoms for 21 days after their last exposure.
For anyone who is in contact with you, during this monitoring period, practice "the fundamentals":
masking around others
wearing gloves when caring for people with monkeypox including when touching infected skin, clothes, bedding or bandages
What should I do if I have symptoms?
Monkeypox usually resolves (goes away) on its own in 2-4 weeks.
Severe cases are rare. If someone does have a severe case requiring hospitalization, there are antiviral drugs that can help a patient recover.
Are there treatments for monkeypox?
Chickenpox virus is not closely related to the monkeypox virus, but they have similar symptoms.
One way to tell the difference is that monkeypox causes sores on the palms of the hands and the soles of the feet and chickenpox does not.
Chickenpox is usually itchy from the time the sores appear. Monkeypox rash is more likely to be painful at all stages, and only starts being itchy when the sores scab over and start to go away.
How is monkeypox different from chickenpox?
Smallpox and monkeypox are related, but monkeypox is much less severe than smallpox.
Smallpox was eradicated in 1980 thanks to vaccines. People who were born before 1972, before they stopped giving routine smallpox vaccinations, have been shown to have some protection from monkeypox even decades later.
The smallpox vaccine can help reduce the severity of the monkeypox illness but only if it's caught really early.