Everything You Need to Know About Monkeypox

While the current monkeypox outbreak will be the first time many have heard of the disease, the virus is thought to have been infecting people for centuries, possibly even millennia. A member of the same virus family as chickenpox and smallpox, monkeypox’s first documented cases were back in 1958, when there were two outbreaks in colonies of lab monkeys being kept for research—hence the name.

This, though, is a bit of a misnomer. The virus is usually carried by rodents such as squirrels, pouched rats, and dormice, among others. Cases tend to occur near tropical rainforests in Central and West Africa, where the virus is endemic. From the 1980s through to 2010, cases in the Democratic Republic of the Congo (DRC) rose more than 14-fold, and in 2020 alone there were nearly 4,600 suspected cases of monkeypox in the DRC. There have also been more than 550 suspected cases in Nigeria since 2017. Given these numbers and how interconnected the world is thanks to air travel, the current global outbreak isn’t actually that surprising.

But while cases have been rising, the risk of monkeypox to the general population is low. If you think you have the virus—or have come into contact with someone with it—stay calm. You probably won’t need any treatment, but you should do what you can to avoid spreading the virus further.

How Do I Know If I’ve Got Monkeypox?

Monkeypox infections occur in two distinct stages. Initially people develop flu-like symptoms such as exhaustion, fever, body aches, chills, and headache as the virus enters their cells, followed by enlarged lymph nodes as their immune system gears up to fight off the infection.

The second stage is the development of the “pox”—a nasty rash that usually begins on the face before spreading to the arms, legs, hands, feet, and trunk. Some of the patients in the latest outbreak have reported a rash around the genital area.

Doctors caution that you shouldn’t assume you have monkeypox just because you have a rash. This can also occur with diseases such as chickenpox and scabies, while genital rashes can also be a sign of sexually transmitted infections like herpes. The monkeypox rash is quite distinct—skin eruptions that begin flat and red, before starting to blister and fill with white pus. These then dry out into scabs, which eventually heal and fall off. While unpleasant, the illness is usually not too severe and resolves within two to four weeks.

How Does Someone Catch It?

Monkeypox typically affects people who have come into contact with infected animals—usually rodents that are capable of harboring the virus. People catch the virus either through a bite or scratch or, in some cases, by consuming undercooked meat.

Despite the recent rise in cases, someone catching the virus and passing it on isn’t that common. It takes prolonged close contact for someone to give it to someone else. Specifically, there are three known ways in which monkeypox can be transmitted—direct contact with pus from the sores, handling an infected person’s clothing (or perhaps sharing a towel), or inhaling respiratory droplets. In the current outbreak it appears that sexual contact has provided one route of transmission—most likely through skin-to-skin contact.

The infection rate is far lower than for Covid-19 or many common respiratory viruses, so outbreaks tend to end quite quickly. An example of this was in 2003, when monkeypox reached the US after infected animals were shipped from Ghana to Illinois. The virus was spread to prairie dogs being sold as pets in multiple Midwestern states, and 47 people became infected. But none passed it on to anyone else, and the outbreak was over shortly after it had begun.