Monkeypox Symptoms Usually Show Up in This Order

  • Initial symptoms of monkeypox include fever, body aches, fatigue, and sometimes enlarged lymph nodes.
  • The disease can result in a rash that leads to red bumps on the skin that can appear on hands, feet, face, mouth, or even genitals.
  • These rashes can transform into raised bumps or painful puss-filled red papules.
  • Monkeypox is similar to the smallpox virus but much less deadly.
  • For most people, the symptoms of monkeypox, though painful, will resolve on their own without additional treatment.

​A rare condition called monkeypox has been confirmed in the United States and Europe, with more suspected cases worldwide.

There are over 4,900 cases in the U.S. currently, and more are expected.

Monkeypox is a virus that originated in animals in West and Central Africa. While usually confined to animals, as previous outbreaks have shown, it can also jump to humans.

“This is a virus that belongs to the same group as the smallpox virus; however, it’s a much milder and less deadly form of it,” says Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Tennessee.

The first confirmed case was on May 7th from a person who had traveled to the United Kingdom from Nigeria. Additional cases were noted in London but were unrelated to the first case suggesting unlinked chains of infection. So far to date, there have been no reports of death.

In a recently published study in The BMJ, scientists discovered differences between this monkeypox outbreak and previous outbreaks after investigating 197 people who contracted the virus.

In previous outbreaks, patients would see the rash, or pox, throughout the body in a widespread fashion. However, this outbreak is unique as some of the most common symptoms include rectal pain or penile edema. There have also been cases where there has been a single pox lesion – which can make diagnosis difficult as it can be confused with other illnesses that also only have single lesion findings.

While most cases have systemic symptoms including fever, swollen lymph nodes, and body aches and pains, this is not always the case with this monkeypox outbreak.

It was originally believed that the systemic symptoms came before the rash, but 38% of infected individuals in the study reported the rash before the systemic symptoms and some who had the rash didn’t have any systemic symptoms at all.

Lymphadenopathy, or enlarged lymph nodes, can also appear.

The rash can often be found on the hands, feet, face, mouth, or even genitals. These rashes transform into raised bumps or painful puss-filled red papules.

Dr. Jeremey Walker, assistant professor at the University of Alabama at Birmingham Division of Infectious Diseases, explained in an earlier interview that the “illness often lasts 2-4 weeks” and it usually necessitates avoiding close contact with others to limit and prevent spread.

If you are experiencing symptoms, Walker shares the Centers for Disease Control and Prevention (CDC) recommendations to contact your physician, especially if you “have recently traveled to Central or West Africa or areas within Europe where multiple cases have been reported.”

Additionally, if you have “had contact with a person who has had suspected or known monkeypox or are a man who regularly has intimate contact with men.”

Monkeypox is transmitted person-to-person through close contact including but not limited to sexual contact.

“With this virus, we see chains of transmission which are linked to another individual. However, unlike COVID-19, which had the ability to transmit to others by both respiratory and airborne routes, we do not expect to see a large cases of transmission with monkeypox,” Schaffner said in an earlier interview.

While officials have said certain groups including men who have sex with men may be at increased risk, the disease can affect anyone who is exposed.

There are two forms of this virus, the West African and the Central African form.

“According to the WHO, all cases whose samples have been confirmed by PCR have been from the West African clade,” says Dr. Jeremey Walker, Assistant Professor at the University of Alabama at Birmingham Division of Infectious Diseases.

“Infections with the West African clade tend to be less severe than Congo Basin, (Central African) clade, and there is a lower case fatality rate,” Walker told Healthline.

These outbreaks are not new. The virus was first discovered in monkeys in 1958, with the first human case in 1970. Since that time, there have been multiple outbreaks that have transformed from animals to humans.

While most cases are usually within Africa, previous outbreaks have shown up in Israel, the United States, and Singapore. The most recent United States outbreak was in 2003, with 47 cases.

For people exposed to monkeypox getting a vaccine soon after exposure can decrease the risk of developing the disease. There is also a treatment for smallpox called Tecovirimat or TPOXX, which has been used to treat some people with monkeypox but it is not widely available.

While the symptoms of monkeypox are vague and seem to be like many of the more common upper respiratory infections, there are reasons to contact a physician.

Walker explains, “if you have a new unexplained rash, you should contact your physician for evaluation and treatment. Your physician could assess for any concerns for monkeypox, and additionally, coordinate appropriate workup and treatment for the many other causes of a rash as well.”

Dr. Rajiv Bahl, is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find him at RajivBahlMD.com.

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