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Monkeypox: The Next Great Pandemic?

“This will cause the next pandemic...”

Ever since Covid stamped the word into our collective lexicon, people have been on the lookout for the next great health crisis to hit our planet.

Scientists, for example, have been warning about the “zombie” viruses that are waking up from their dormancy on the grounds of the thawing Arctic. Global warming may not just be a temperature crunch but also a health emergency waiting to happen as “a gigantic reservoir of ancient microbes or viruses” are released from the North.

Understandably, the public is wary of anything that can send them scurrying back into a lockdown for weeks on end.

Then on the last week of July, the World Health Organization declared the monkeypox outbreak as a Public Health Emergency of International Concern (PHEIC)—which sounded eerily familiar.

As of this writing, the US is experiencing the largest monkeypox outbreak and has breached 10,000 infections. Authorities are working hard to contain the cases, which seem to hit primarily men having sexual contact with other men.

Much is yet to be learned about the nature of monkeypox, and our understanding of its behavior is evolving every day. But here are the things you need to know about the virus.

What is Monkeypox?

Monkeypox is a virus that got its name because it was first discovered in a group of research monkeys in 1958. However, it is believed that rodents are the primary carriers of the virus. Monkeypox is similar to smallpox and is in the same family as the variola virus.  

The first recorded human infection came in 1970, and since then, there have been sporadic outbreaks in many Central and Western African countries. But the virus’ behavior is highly unusual this year with the rapid rates of infection and its widespread reach.

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Monkeypox is characterized by rashes or round papules that appear on the face, hands, inside the mouth, around the eyes, and genitals. These rashes and lesions are not your usual patches of irritated skin. They are extremely painful. These pimples or blisters are excruciating. Painkillers are often prescribed to manage the pain.  

These begin as flat lesions which become raised and gradually fill up with white-then-yellowish fluid. Over time, when things are on the mend, the pustules dry up and fall off.

The rashes may last between 1-2 weeks and are considered infectious until they have dried and sloughed off.

(Although chickenpox and monkeypox both present with rashes, these two are unrelated.)

What are the Symptoms?

Monkeypox has a long incubation period, which means symptoms only start to appear 4-21 days after exposure.

In addition to the painful rashes mentioned above, flu-like symptoms include:  

  • Fever

  • Headaches

  • Muscle aches

  • Back pain

  • Weakness and lethargy

  • Swollen lymph nodes

  • Sore throat

The rashes can either come before or after the flu-like symptoms. But some patients experience only the flu-like symptoms without the rashes or the other way around.

In addition, patients have also reported rectal pains or painful defecation. Penile swelling and abscesses in the groin area have also been recorded.

That said, some people experience no symptoms at all.  

How Is Monkeypox Transmitted?

A great number of monkeypox cases have been attributed to men having sexual interactions with other men—leading many to believe that monkeypox is transmitted only sexually.

But sex is just one of the ways the infection can be passed. People in the same household can infect one another even without sexual contact. The virus is passed through close, personal and physical contact with an infected individual. Face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-face, and exchange of bodily fluids can lead to infection.  

The monkeypox virus can survive for weeks on surfaces, and infected surfaces can transmit the virus when they are unknowingly touched by others. In a study cited by the CDC, the virus can persist 15 days after the infected individual has left the room. So beddings, clothes, towels, and personal effects should be disinfected immediately.  

A person is considered infectious from the time the first symptoms appear until all the rash has healed and crusted over. (The course of the disease is about 2-4 weeks.)

According to studies the rashes have a significant viral load and prolonged contact with them can lead to infection. Monkeypox has also been detected, to a lesser degree, in respiratory droplets and airborne particles. But lower viral loads in these have led researchers to believe that this is not the primary mode of transmission.

But the evidence is clear: Everybody is at risk. Monkeypox doesn’t just infect men having sexual relations with other men. Getting the virus may be as simple as touching an infected keyboard, doorknob, or smartphone. Men, women, and children can get it. (The first human case of monkeypox was a 10-year-old from the Democratic Republic of Congo.)

Pregnant mothers can even pass the virus to their unborn child through the placenta.   

What To Do When You Get It?

Monkeypox is rarely fatal, and most who contract it get better in 2-4 weeks without any medical attention. But, as with all diseases and medical conditions, people with comprised immune systems can be hit hard by the virus.  

As of this writing, there’s no treatment specifically directed at monkeypox. But because of its similarity to the smallpox virus, drugs and vaccines for smallpox can be used for monkeypox.

The person must isolate from others to prevent further spread. The minimum health standards that we learned from Covid-19 will come in handy.  

And because no specific treatment is available, we are left with managing its symptoms—which means dealing with the flu-like conditions and alleviating the impact of the rash. Ibuprofen or acetaminophen will help deal with the first, and powerful painkillers will deal with the second. It’s also very important not to touch or scratch the rash. Topical creams or oral antihistamines can help with the itching.

Make no mistake, going through monkeypox is an incredibly difficult ordeal:

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Will it be the next pandemic? 

Will monkeypox possibly lead to lockdowns and leave us stuck in our homes again, waiting for the government’s “ayuda?”

While nobody can precisely predict the future, it is highly unlikely that monkeypox will go the way of Covid. There are 3 important differences between monkeypox and the recent pandemic:

#1 We know about the disease.

In the early days, Covid was called “NCov” or “Novel Corona.” It was something new to the medical community. It was a curve ball, and scientists rapidly worked on sequencing its genome.

Unlike Covid-19, we’ve known about monkeypox since the 1950s. We’ve had the first recorded human infection in 1970. And unlike Covid, we already have standing vaccines for monkeypox. We have the tools to fight this battle. Countries like the United States and the U.K. are on a buying spree and beefing up their portfolios of these vaccines.      

#2 Transmission requires prolonged physical contact.

Covid can be transmitted when someone coughs, sings, or breathes. Research has found that although the monkeypox virus is also found in nasal droplets and can become airborne, this is not the primary route of infection. Unlike Covid where sharing the same confined spaces like an elevator or an airplane cabin can significantly increase the chances of catching the virus, monkeypox has a higher threshold for infection.

While indirect infection is possible through touching or handling of infected surfaces, direct and prolonged physical contact has been the most common mode of transmission.       

#3 Monkeypox often resolves on its own and is rarely fatal.

The World Health Organization reports fatality rates to be around 3-6 %. Some have argued that if this is the case, then we would have seen much higher death tolls. The Canadian Medical Association Journal (CMAJ) argues that these numbers might be higher than they are, citing that the mild cases are underrepresented or unreported.

Only the most severe cases see the light of day and are given medical attention and reported. Factoring this in, CMAJ estimates fatality rates to be around 0.03%.

  

But these should not lead us to take monkeypox lightly. Despite the little chance of it becoming the next pandemic, going through the disease is not a walk in the park. Having one’s body covered in painful lesions is extremely discomforting and mentally taxing. Some are experiencing excruciating pain, so much so that they are not even able to swallow their saliva.  

Yes, it can resolve by itself, and it is rarely fatal, but make no mistake: It is still very tough to go through.

On July 29, the Philippines logged its first case of monkeypox. The race is on to contain the spread. The last thing the community can do is add stigma to the individuals suffering from the virus. With solidarity, correct information, and close observance of the common health protocols, the nation can weather this new threat to everyone’s health.

(The Philippines’ Research Institute for Tropical Medicine or RITM is the primary testing and isolating facility for monkeypox cases.)


Bloodworks Lab is your well-being partner. We are your one-stop shop for all your blood test needs. We provide quick and accurate medical tests and screenings for a wide range of conditions. Bloodworks Lab is also proud to be the first in the country to offer the Anti Acetylcholine Receptor (lgG) Antibody Test and the Anti N-Methyl-D-Aspartate Receptor (Anti NMDA Receptor) Antibody Test.

In times like this, it pays to be informed. Book your appointment today.

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