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Recently, the WHO and CDC began considering issuing an emergency declaration concerning monkeypox. This infection, unheard of by most, seemingly came out of nowhere overnight. Just as they did with COVID, news anchors are breathlessly reporting on the number of new cases. They seem to be trying to scare the hell out of everyone, even as they try to hang on to COVID as if it was still a real threat – it isn’t. To paraphrase WR Hearst, sensationalism sells newspapers. Risk of death from COVID is now about the same as it is for the common cold. Both are a risk mostly to those who are chronically ill and severely compromised.

Monkeypox (MP) is still a rare infection that circulates in some animals in forested areas of Central and West Africa. Cases in humans have been reported in multiple countries. MP is closely related to smallpox, which was declared eliminated from the world in 1980. MP is transmitted by close contact with an infected animal or human. Human-to-human spread usually requires skin-to-skin contact with a person who has MP sores, rash, or scabs. It is also spread through respiratory droplets or oral fluids during intimate sexual contact (kissing; oral, anal, and vaginal sex). It can also be spread by contact with objects and fabrics contaminated by the MP virus (clothing, bedding, and towels). Symptoms of MP include fever, headache, swollen lymph nodes (neck, armpits, or groin), back and muscle aches, and fatigue. Not all MP patients suffer from these flu-like symptoms. Typically, about one to three days after the fever, a rash develops, usually first on the face, then the rest of the body including the mouth, vagina, and anus. The rash starts as flat red spots which become fluid filled, firm, raised bumps which eventually scab over and heal.

Human MP cases are rare. This year the WHO has reported cases in at least 23 countries that do not have endemic MP. For reasons that are yet unknown, almost all cases occur in men who have sex with men. Presently, MP appears to be of minimal to no risk to the general, non-homosexual, population. Most importantly, death from MP is extremely rare. The CDC recommends that anyone who has MP symptoms AND has either 1. Travelled during the month preceding the illness to countries in Africa or elsewhere that have reported MP cases or, 2. Had contact with a person with suspected or confirmed MP or 3. Is a man who regularly has sex with other men should seek medical care. There is no specific treatment at present for MP, however severe cases or cases in those who are immunosuppressed, pregnant, breastfeeding, or younger than 8 years may be placed on antiviral treatment. A vaccine is available and is being administered to the small segment of the population that is at risk. Since MP is not airborne, preventing infection merely involves avoiding close contact with at-risk or infected individuals.

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 By Peter Galvin, MG

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