What we know about monkeypox: symptoms and transmission

Monkeypox is a rare viral infection caused by a virus belonging to the family Poxviridae. These viruses are transmitted directly or indirectly from animals to humans and, since they are highly resistant in dry environments or at high temperatures, they persist on infected surfaces for a longer period of time.

However, despite the resistance of the virus, monkeypox is not a highly contagious disease, since prolonged direct contact is needed for the virus to spread from human to human.

What are the symptoms?

Monkeypox is characterised by mild symptoms and most infected patients recover within a few weeks, with no treatment required.

Research has shown that monkeypox generally has an incubation period of 6 to 13 days and the symptoms developed may include: vesicular rash, which can cause pruritus (itching) or lesions on any part of the body (including around the genitals and anus), fever, sore throat, swollen lymph nodes, backache, muscle pain as well as mouth and eye lesions.

The West African variant of the virus has been reported in the European Region and, so far, it has been fatal in roughly 1 in 100 infected people.

The disease can be more severe for young children, pregnant women, or chronic patients whose bodies fail to mount a proper immune response.

What to do if you get sick?

If someone suspects that they have been infected with the virus and has specific symptoms, they should contact their doctor and provide recent travel information and their vaccination history. It is advisable for people travelling to endemic countries to avoid contact with sick animals and consuming wild game.

How is monkeypox transmitted?

Monkeypox is transmitted through prolonged direct contact with someone who has been infected with the virus or through prolonged contact with contaminated objects.

The virus can enter the body through skin lesions, the respiratory tract, eyes, nose or mouth as well as through close contact with body fluids. Monkeypox can also be transmitted from one person to another through droplets from coughing or sneezing, but only with prolonged close contact. Moreover, research has shown that transmission can also occur via the placenta from mother to foetus.

Monkeypox has not yet been declared a sexually transmitted infection, although the prolonged direct exposure which is specific to intimate contact and exposure to infected body fluids facilitate the transmission of the disease from one person to another.

Currently, the most-at-risk groups are healthcare professionals treating infected people as well as the family members or sexual partners of the infected person.

How can you protect yourself?

You need to perform proper hand hygiene, using water and soap or alcohol-based hand rub. It is advisable for those infected to be isolated and people who come into contact with them should use appropriate protective measures, such as masks and gloves.

A vaccine for preventing monkeypox has already been approved, but studies have shown that the traditional human smallpox vaccine can also provide protection against monkeypox.

People who show symptoms and are suspected of monkeypox infection should contact their doctor. It is also important to identify people who have come into contact with the infected patient so as to prevent the spread of the virus and to efficiently manage any diagnosed cases.

Emergence of monkeypox

Monkeypox was first detected in humans in 1970 in the Democratic Republic of the Congo, where most human cases of monkeypox have been reported so far. It later spread to other countries in West and Central Africa, but Europe has not become an endemic area.

In the past few weeks, a number of monkeypox cases have been reported in several Member States of the European Union, including in Romania.

Sources:

• Monkeypox – Fact Sheet, World Health Organization
• Monkeypox outbreak - Update and advice for health workers, World Health Organization 
• Methodology for the surveillance of suspected/confirmed cases of monkeypox, Romania’s National Public Health Institute