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Your monkeypox questions answered

What is monkeypox and what are its symptoms?

Monkeypox is a virus that spreads primarily through skin-to-skin contact. According to the Centers for Disease Control and Prevention (CDC), people with monkeypox get a rash that may appear on the hands, feet, chest, face, mouth, or genitals. The rash may be very painful or itchy.

People with monkeypox typically experience flu-like symptoms 1 to 4 days before the rash appears. These symptoms may include:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Fatigue
  • Headaches
  • Muscle aches
  • Sore throat
  • Cough
  • Nasal congestion

The virus shows up differently for some, who may experience flu-like symptoms after the rash appears or only have a rash with no other symptoms.

The illness typically lasts two to four weeks. The rash will go through multiple stages, starting out flat and then becoming raised and fluid-filled. Lesions will scab before healing.

How serious is it?

The World Health Organization has called the monkeypox outbreak a global health emergency. As of August 18, 2022, the CDC counted 14,115 cases in the United States and 188 cases in North Carolina, so it’s important to understand how to protect ourselves and others.

In the U.S., the mortality rate for people with monkeypox is low. But people with weakened immune systems, pregnant people, children under eight, people who are breastfeeding, and people with a history of eczema may be more likely to get seriously ill.

While deaths are rare, monkeypox can cause severe pain. Some monkeypox patients have been hospitalized, mostly for pain management.

How does monkeypox spread?

Per the CDC, monkeypox can spread in several ways. The most common is close, personal, often skin-to-skin intimate contact.

A pregnant person can also spread monkeypox to their fetus through the placenta.

Monkeypox can spread through contaminated objects (e.g. touching clothing, bedding, towels or surfaces that an infected person can touch).

Researchers are still learning whether the virus is airborne, spreads through bodily fluids, and can be spread by an infected person who has no symptoms.

Who does monkeypox affect?

Monkeypox can infect and spread to anyone. According to the North Carolina Department of Health and Human Services, most of the people who have had monkeypox and are currently at increased risk are men or transgender individuals who have had multiple or anonymous male intimate partners in the last 14 days in an area where the virus is spreading. Cases have also been seen in women and children.

People living with someone who has monkeypox are also at risk.

How is it diagnosed?

If you suspect you have monkeypox, your doctor will evaluate your rash. They may order a blood test or swab the rash to look at a sample under a microscope. Your provider may contact the state’s public health lab to confirm a poxvirus. Then a sample will be sent to the CDC to confirm the diagnosis of monkeypox.

How can I protect myself and others?

The CDC recommends the following three steps to prevent monkeypox:

  1. Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
  2. Avoid contact with objects and materials that a person with monkeypox has used.
  3. Wash your hands often.

If you think you may have monkeypox, contact your health care provider right away. The CDC offers guidance on what to do if you are sick, as well as how to prevent spreading the virus to others. The CDC advises infected people to isolate at home and avoid close contact with others until all symptoms have resolved and new skin has formed over any rash.

Vaccines are available at no cost to protect against monkeypox. However, supply is still limited. If you live in North Carolina, the NCDHHS has information available to find out if you’re eligible for a vaccine and locate a health department near you that offers vaccines. If you live outside of North Carolina, contact a health care provider or your local health department for help.

Larry Wu, MD
Larry Wu, MD

Regional Medical Director

Larry is a regional medical director for Blue Cross NC providing consultative services for employee health solutions, prevention, chronic disease, care management, medical expense and utilization management. He's a family physician with over 20 years in clinical practice, has served as clinic director in the Indian Health Service, Kaiser Permanente and Duke Family Medicine and currently maintains a part-time clinical practice.

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