270T Monkeypox An Under Reported Virus in the U. S?

Joseph R, Anticaglia, MD
Medical Advisory Board

Monkeypox (MPX) is a rare, viral, infectious disease that’s related to, and distinct from smallpox, and cowpox. It is caused by the Monkeypox virus (MPXV). The disease occurs primarily in the tropical rainforest areas of central and west Africa, and is exported to other regions. Of particular concern is the surging number of cases since May of this year. The outbreaks have emerged, as of this writing, in forty-seven countries where the disease is not usually found, according to the World Health Organization (WHO).

The officials at WHO said, “Most reported cases so far have been identified through sexual health or other health services in primary or secondary health-care facilities and have involved mainly, but not exclusively, men who have sex with men.”

Transmission Risk of MPXV

The monkeypox virus enters the body through broken skin, mucous membranes (eyes, nose, or mouth) , or the respiratory tract. The virus spreads from an infected person to another through the close contact of bodily fluids, blood, lesions, respiratory droplets, and contaminated materials such as bedding. Animal to human (zoonotic) transmission can occur from direct contact with infected animals (e. g., monkeys, rodents).


The incubation period is time (interval) between the initial contact with the person infected with MPX, and the time that the first symptoms appear. The onset of symptoms with monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.

The MPX usually begins with a fever, rash, and lymphadenopathy. A few days after the appearance of the fever, a rash develops often initially on the face, thereafter to other parts of the body. The rash eventually forms a scab which later falls off. When all the scabs fall off with intact skin underneath, the person is noncontagious. Other symptoms include backache, muscle aches, and fatigue.

Photo Credit: NHS England High Consequence Infectious Diseases Network


Swollen lymph glands, ((lymphadenopathy), which is present in 90% of unvaccinated persons with monkeypox help differentiate this disease from chickenpox, and smallpox. Also, the so-called febrile prodrome , meaning the fever precedes the onset of the other monkeypox symptoms is another prominent features of this viral infection.

If monkeypox is suspected, a sample of the lesion should be collected, and delivered to an appropriate laboratory for evaluation. Polymerase chain reaction (PCR) is the preferred laboratory test given its accuracy and sensitivity.


Management is directed at treating symptoms, and complications of MPX, and preventing long term aftereffects of the disease (sequalae). Therapeutic options approved to treat monkeypox include: TPOXX. an antiviral drug, and Tembexa, is another antiviral drug.


The use of smallpox vaccines has been shown to be effective against monkeypox, Officials from the Center for Disease Control, and Prevention (CDC) said the United States has millions of doses of Jenneos, the two dose smallpox vaccine available to combat MPX. In addition, the CDC officials said the government has more than one hundred million doses of another smallpox vaccine (ACAM2000).

Ordinarily, monkeypox is a self—limiting disease, and people recover in usually in two to four weeks. MPS spreads when people come in close contact with an infected human, animal, or stuff infected with the virus , such as bedding or towels. People ought to understand the symptoms of MPS, how it spreads, and what to do if you’re exposed to it. It’s another virus that seems to be galloping our way.


  1. World Health Organization; Monkeypox. May 19,2022
  2. CDC; About Monkeypox; JUNE 17,2022
  3. CDC; Monkeypox; June 24, 2022


TPOXX — tecovirimat
Tembexa — brincidofovir


The monkeypox outbreak does not currently constitute a global public health emergency; the World Health Organization (WHO) officials said on June 25,2022, “intense response efforts” are needed to control further spread of MPX.

Monkeypox virus belongs to the Orthopoxvirus genus of viruses which include the variola virus which causes smallpox, the vaccina virus which is used in the smallpox vaccine, and cowpox.

Monkeypox Credit Nigeria Centre for Disease Control

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.