Monkeypox: symptoms, causes, and treatment

It seemed like the world was beginning to get back to “normal” following two years of the COVID-19 pandemic. And then, we heard about a new, different type of viral outbreak: monkeypox. If you haven’t been feeling well lately, it’s best to check in on your symptoms. Maple makes it easy, as a telehealth platform that gives you access to Canadian-licensed doctors and specialists online.

Monkeypox is an infection that can cause a painful rash among other uncomfortable symptoms, and certainly shouldn’t be overlooked. To date, there are just over 1,289 cases of monkeypox in Canada. In the United States, that number is climbing.

So, just how serious is monkeypox, and should you be getting a vaccine? Here’s what you need to know.

What is monkeypox?

Monkeypox is a highly contagious, rare disease caused by the monkeypox virus. It’s also called a zoonotic disease because it spreads from animals to humans. But let’s backtrack and give you a little monkeypox history lesson since the name might strike you as odd. Monkeys are indeed a part of the reason why this disease got its name.

It was discovered in colonies of monkeys used for research more than 60 years ago, and the first human case was recorded 12 years later. Despite first being discovered in monkeys, it’s believed that the virus originated from rodents native to Africa.

Since that first human case, monkeypox has been reported in more people in central and western African countries. And, almost all cases outside of Africa were linked to international travellers to countries that had reported cases or through imported animals.

Monkeypox is closely related to smallpox because it’s from the same virus family — orthopoxvirus. It’s milder, however, and most people recover from it in a few weeks. That doesn’t mean that this virus will be mild for everyone, though. Babies, young children, and the immunocompromised can get seriously ill and are even at risk of death.

What are the symptoms of Monkeypox?

Monkeypox symptoms typically develop between five to 21 days after exposure and can last anywhere from two to four weeks. They include:

• A rash that looks like pimples or blisters in the genital region, hands, mouth, face, arms, legs, and hands. The rash may also be painful, and become itchy as it crusts over.
• Fever
• Chills
• Swollen lymph nodes
• Fatigue
• Muscle and joint pain

Symptoms don’t always show up in the same order either. You may have flu-like symptoms before a rash presents itself, a rash and then flu-like symptoms, or no flu-like symptoms at all and just a rash.

What does a monkeypox rash look like?

A monkeypox rash doesn’t appear right away as large pimples or blisters. The lesions start off small and get bigger. Here are the four monkeypox rash stages:

• Macules — flat, discoloured areas on the skin
• Papules — raised areas on the skin that look like bumps
• Vesicles — fluid-filled blisters
• Pustules — pus-filled blisters

After the second week, pustules will scab and become crusty. They’ll fall off about a week later.

How long is monkeypox contagious and how does it spread?

Monkeypox is extremely contagious right from the onset of symptoms. It can spread through close contact with an infected person’s body fluids, skin lesions, or respiratory droplets. This also includes touching objects like fabrics or surfaces that have been used by someone with the virus.

As well, monkeypox can spread through close physical contact and sexual transmission, such as:

• Oral, anal, and vaginal sex, or any genital touching
• Hugging, kissing, or massaging
• Extended face-to-face contact
• Touching fabrics or items during sex used by someone with monkeypox that haven’t been disinfected

To prevent others from becoming infected, you’ll need to isolate as soon as you notice any symptoms until the scabs from your monkeypox rash have fully healed. You’ll also want to speak to a healthcare provider right away for medical advice and treatment methods.

Are there any long-term side effects from monkeypox?

The most common long-term side effect of monkeypox is pitted scarring from the lesions. While this might be bothersome visually, pitted scarring doesn’t have any effect on your physical health. You might want to consider speaking to a dermatologist to help improve the appearance of scars down the line if they’re really bothering you.

Is there treatment for monkeypox?

There isn’t a specific treatment to rid you of monkeypox. A healthcare provider can however treat you with pain and wound management, but preventing infection in the first place is key. And, unlike SARS-CoV-2 where we had to wait for a vaccine, one is already available.

There are similarities between monkeypox and smallpox, which is why the smallpox vaccine Imvamune is approved for use in Canada to help prevent monkeypox. You’re eligible to get the vaccine if you’re 18 years of age or older and are at a high risk of exposure.

You’re considered high risk if you’re a healthcare worker or are part of the gay, bisexual, or men who have sex with men (gbMsM) community, and:

• You’re seeing more than one sexual partner
• You work where people have skin-to-skin contact, such as a sex club
• You’ve tested positive for a sexually transmitted infection (STI) in the last six months
• You’re planning on having sex with someone who is also high risk

Is the monkeypox vaccine safe?

Research is ongoing about how much protection the vaccine provides against monkeypox, but yes, the vaccine is considered safe. There are some mild side effects you may experience after getting it, such as:

• Bruising and swelling around the area of the needle
• Fatigue
• Headache
• Fever or chills
• Body pain
• Loss of appetite
• Nausea

There have been rare reports of cardiac symptoms after receiving the vaccine, but none were considered serious. It’s important to seek medical attention right away if you do feel shortness of breath, chest pain, or chest palpitations though soon after being injected.

How can you test for monkeypox?

By now you likely know very well what a PCR test is — a polymerase chain reaction test. If a healthcare provider suspects you may have monkeypox, they’ll use this test to swab one or more lesions, which will then be sent off to a lab.

Monkeypox can mirror other infectious diseases, such as STIs or even chickenpox. So, if you’ve been in contact with someone who has a confirmed case or has developed any symptoms, you’ll want to contact a healthcare provider right away to make sure monkeypox is indeed what you need a test for.

Who can be affected by monkeypox?

Unfortunately, anyone can be affected by monkeypox if they come into contact with someone who is infected. The majority of cases reported to date have been from men who have had sexual contact with other men, but anyone who has sex with multiple partners faces an increased risk of infection.

Can you prevent monkeypox?

Absolutely. Prevention is your best line of defence against monkeypox. If you’re in a high-risk situation and are eligible for a vaccine, it’s best to get one. You can also prevent the illness and avoid passing it along by:

• Washing your hands or using sanitizer frequently
• Having an open discussion with your sexual partners
• Avoiding sex if you think you may have any symptoms

Is monkeypox dangerous?

Monkeypox typically goes away on its own within two to four weeks, and symptoms aren’t considered severe for most. However, as mentioned earlier on, monkeypox may be dangerous for babies, young children, and immunocompromised people.

The fatality ratio has ranged from 0-11% in the general population in the past, with higher numbers for young children. More recently, the fatality ratio was around 3-6%. This is one of the reasons why prevention is so important. Even though most people will be fine, the risk of contracting monkeypox just isn’t worth it.

If you’ve come into contact with someone who has monkeypox, you should get in touch with your local public health unit immediately. They’ll be able to provide you with the appropriate next steps, like isolating and discussing if the vaccine may be helpful for you. If you think you may have monkeypox symptoms, it’s best to get in touch with a healthcare provider for advice on testing and medical care.

We’re no strangers to keeping our distance from others if there’s any risk of catching a virus. And, while monkeypox is still rare, it’s important to use preventative measures. Get vaccinated if you’re eligible and avoid close contact with those who have or might have the virus — it’s the right time to put some of those pandemic practices into play to stay safe from the monkeypox outbreak.