The 2022 Monkeypox Outbreak: What We Know So Far
After decades of sporadic infections primarily confined to Central and Western Africa, public health officials are confronting an unusual global outbreak of monkeypox this year. As of late June 2022, over 1,600 confirmed cases had been identified across numerous countries where the virus is not typically endemic.
While the first cases were detected in May among individuals in Europe reporting no recent travel to risk areas, the origins and timeline of the initial spread remain under investigation. Most early patients were male; many reported intimate physical contact with other men. However, monkeypox can infect anyone, posing a potential threat beyond specific high-risk communities if allowed to circulate unchecked.
Orthopoxviruses like monkeypox can cause acute illness yet rarely spread sustainably between humans. So, what factors have enabled this particular strain to transmit more readily from person to person compared to prior outbreaks? Understanding basic virology and epidemiology offers clues to containing future spread.
What is Monkeypox?
Monkeypox virus belongs to the orthopoxvirus family of viruses responsible for smallpox infection. Following initial transmission via animals in Central Africa, occasional human cases were reported as humans came in contact with infected wildlife.
However, person-to-person transmission between humans has usually been limited. The virus spreads through close physical contact with lesions, body fluids, or recently contaminated materials like clothing or bedding. Unlike diseases transmitted via respiratory droplets or aerosols, airborne spread is not considered a primary concern.
This outbreak differs in two notable ways. First, sustained chains of transmission occur predominantly through intimate sexual contact rather than sporadic community exposures often linked to wildlife. Second, the virus has spread quickly across international borders, achieving a global foothold through extensive air travel before identification and containment strategies were optimized.
Symptoms of Monkeypox
Initial flu-like symptoms emerge 5-21 days after exposure, including fever, headache, chills, and swollen lymph nodes. However, a signature symptom distinguishing monkeypox from other illnesses is the characteristic rash or lesions developing 1 to 3 days later. T lesions progress through scabbing over 10-14 days before fully healing, starting on the face and spreading to other areas.
⇒ Rash or lesions:
The rash presents as raised bumps or nodules filled with clear fluid, eventually forming scabs. Lesions typically affect mucous membranes inside the mouth and anus or genital region. They can be extremely itchy and painful.
⇒ Other Less Common Symptoms:
Rare problems include secondary infections of monkeypox lesions, pneumonia, confusion, and eye issues such as conjunctivitis or corneal infection.
Transmission of Monkeypox
Monkeypox spreads through close, direct contact with infected individuals or animals. During prolonged face-to-face interactions, respiratory droplets can transmit the virus, as can contact with lesions, body fluids, or recently contaminated materials. The incubation period is typically 5-21 days. Notably, recent cases have mainly spread through intimate physical contact between people rather than animal exposure.
After exposure, it usually takes 1-2 weeks before initial symptoms of fever, headaches, and swollen lymph nodes manifest. This provides a critical window to trace contacts and encourage vigilance for any emerging signs of infection.
The Current 2022 Outbreak
The first cases in May 2022 were detected in Europe with no relevant travel histories, implying local transmission was already occurring unnoticed. Since then, over a thousand additional patients have been identified worldwide, primarily affecting urban areas. High-risk groups include sexually active men who have sex with men. Case counts continue climbing rapidly across numerous countries.
Spread in the United States
As of late June, hundreds of confirmed and probable cases had been recorded nationwide, spanning dozens of states. New York and California have witnessed intensive community expansion so far. However, broad testing access has been limited, making the actual number underestimated.
Spread in other countries
Other nations like the UK, Spain, Portugal, and Canada have documented substantial local transmission chains propagating through major cities. Aggressive contact tracing seeks to contain further spread before more generalized outbreaks occur.
Prevention
The highest priority is to avoid direct physical contact with known cases while lesions remain present. Good hand hygiene also lowers risks, as does promptly isolating contaminated materials. Depending on availability, individuals at risk due to exposure may receive post- or pre-exposure vaccination. International coordination aims to bolster limited supplies.
Vaccine availability and efficacy
Two smallpox vaccines, JYNNEOS and ACAM2000, provide robust cross-protection against monkeypox infection and severe illness. However, global manufacturing shortfalls constrain the widespread implementation of ring vaccination strategies around confirmed patients. Some high-risk communities consequently face elevated vulnerability.
What To Do If Sick
Isolating at home until all lesions scab over reduces opportunities for transmission. Due to nonspecific initial symptoms, consulting a doctor about testing is prudent. Antivirals or immunoglobulin treatments may shorten the duration of contagiousness and illness for at-risk cases. Public health follow-up tracing contacts seek to intercept further dissemination early.
Conclusion
Reinforcing the importance of prevention, vaccination, and medical guidance.