Mpox, formerly known as monkeypox, is a viral illness. It can cause a painful rash, enlarged lymph nodes, and flu-like symptoms. Understanding this virus remains important for public health worldwide.
Understanding Monkeypox
Mpox is caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus, which also includes the virus that causes smallpox. While related to smallpox, mpox presents with less severe symptoms and is not as easily transmissible. The virus was first identified in monkeys in 1958, leading to its original name. The first human case was recorded in 1970 in the Democratic Republic of the Congo.
The virus has two main clades: Clade I and Clade II. Clade I is historically found in Central Africa and is associated with more severe disease and higher fatality rates than Clade II. Clade II, prevalent in West Africa, was responsible for the global outbreak that began in 2022.
Current Global Picture
The global picture for mpox has changed since 2022. A worldwide outbreak of the Clade IIb strain began in May 2022, spreading rapidly to countries where the virus was not common. This led the World Health Organization (WHO) to declare it a public health emergency. This outbreak primarily spread through sexual contact among men who have sex with men, though anyone in close contact could be infected.
The WHO ended the global emergency for this outbreak in May 2023 due to control measures like vaccination and public health information. However, cases continue to be detected globally at lower levels. A new epidemic of a Clade Ib variant began in Central Africa in September 2023, primarily affecting the Democratic Republic of the Congo. By September 2024, over 29,000 suspected cases and over 800 fatalities were reported. This new Clade Ib outbreak has a higher fatality rate, around 3-4%, compared to less than 0.2% in the 2022-2023 outbreak.
How It Spreads
Mpox primarily spreads through close, personal contact with an infected individual. This includes direct skin-to-skin contact with lesions, scabs, or body fluids from a person with mpox. Contact can occur through touching, kissing, or sexual activity, including oral or penetrative sex.
The virus can also be transmitted through contact with contaminated objects, such as bedding, clothing, towels, or sex toys used by an infected person. Respiratory droplets from coughing or sneezing during prolonged face-to-face contact can also spread the virus. Pregnant individuals can pass the virus to their fetus during pregnancy or to the newborn during or after birth.
Signs and Symptoms
The incubation period for mpox ranges from 3 to 21 days. Initial symptoms resemble the flu and may include fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes. Some individuals may develop a rash first, without experiencing these flu-like symptoms, or may only develop a rash.
The characteristic rash progresses through several stages over two to four weeks. It begins as flat, red spots, which then become raised bumps. These evolve into fluid-filled blisters, then pus-filled lesions, which can be painful. Finally, the lesions crust over and form scabs that eventually fall off, revealing new skin underneath. The rash can appear anywhere on the body, including the face, hands, feet, mouth, genitals, or anus.
Protecting Yourself and Others
Preventing the spread of mpox involves several strategies. Avoid close, skin-to-skin contact with individuals who have a mpox-like rash or with animals suspected of carrying the virus. Practice hand hygiene by washing hands with soap and water or using an alcohol-based hand rub.
Vaccination is available for at-risk groups and offers protection against mpox. If you suspect you have mpox or have been exposed, you should isolate yourself immediately and contact a healthcare provider. Infected individuals should cover their lesions, wear a mask when around others, and avoid sharing personal items like bedding, clothing, or eating utensils until all scabs have fallen off and a fresh layer of skin has formed.