In the midst of a COVID-19 pandemic, it can be discouraging to hear that there is another virus* spreading. However, it is important to take precautions to help prevent the situation from escalating.
Monkeypox has actually been around for a long time – it was identified in 1958 [1,2]. The virus typically circulates around central and western Africa, but, nowadays, there have been unexpected reports in several occidental countries, including Canada and the United States [3, 4].
The virus is capable of zoonotic infections: This means that, under natural conditions, the virus can be transmitted between some vertebrate animals (e.g., monkeys) and humans [2,5]. Some symptoms include rash, swollen lymph nodes, fever, muscle aches, fatigue, and more [2,6].
According to the CDC [7,8], monkeypox is typically spread through close contact. This can be done through skin contact, contact through materials (such as clothes), and/or sexual partner. Because of the risk of spreading, it is important to self-isolate if you have monkeypox.
If a person is at high risk of exposure or has already been exposed, vaccination is recommended [5,6]. The JYNNEOS and ACAM2000 vaccines actually protect against smallpox but are also effective against monkeypox due to the similarities between the viruses [9-11]. JYNNEOS has a lower risk of side effects than ACAM2000 [12]. Based on previous trials, approximately 1 in 175 people vaccinated with ACAM2000 may experience inflammation of the heart (myocarditis and/or pericarditis) as a side effect, and ACAM2000 is not be recommended in some cases (e.g., when a person has a weakened immune system) [12]. Indeed, people who are immunocompromised should preferably receive the JYNNEOS vaccine instead of the ACAM2000. Therefore, remember to always consult with your doctor if you are taking any medication.
At the moment, countries have been using a “ring vaccination” approach to contain the situation. In this approach, people that have been exposed are the ones being vaccinated [9]. Getting vaccinated after being exposed to monkeypox is part of a response called “post-exposure prophylaxis” [12]. Indeed, receiving the vaccine within 4 days of exposure could be helpful to prevent monkeypox. If the vaccine was received between 4 days and 2 weeks after the exposure, the vaccine could still help decrease the severity of the symptoms. However, considering the recent outbreaks, we need more studies to clearly assess the rates of vaccine effectiveness after exposure, especially since JYNNEOS requires two doses [9].
Part of the reason for the re-emergence of monkeypox may be due to the decreasing levels of smallpox vaccination [4]. Indeed, when smallpox was eradicated, the vaccination rate decreased or even stopped completely. As new unvaccinated generations were born, there was a greater population of people who were not vaccinated against smallpox and, thus, were more vulnerable to monkeypox.
Monkeypox has recently been declared a public health emergency by the World Health Organization (WHO) [13]. Even though this virus doesn’t spread as fast as COVID-19, the recent outbreaks in locations where it has not typically been reported before [14], and the risk of further international spread, have caused concern and led to public health responses.
*Virus - It can be considered a very small infected agent that is simpler than a cell. They can be found in the environment or inside living organisms. It has to infect a cell and use its machinery to multiply, since it cannot multiply by itself. Viruses consist of nucleic acids (DNA or RNA), a protein capsid that contains the nucleic acids and, sometimes, an external envelope of lipids. The flu, measles, AIDS and Covid-19, for instance, are caused by viruses.
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Written by: Nicole
Edited by: María and Natasha
BioDecoded is a volunteer group committed to sharing accurate scientific information about vaccines. We cannot offer any specific health advice. If you have any doubts about getting vaccinated due to previous health conditions, please speak with your healthcare professional or family physician. Your doctor can revise your medical history and advise you on the best path to follow. If you have any questions about this topic, please comment or send them to our email.
References:
Cho, C. T., & Wenner, H. A. (1973). Monkeypox virus. Bacteriological reviews, 37(1), 1–18. Available at: https://journals.asm.org/doi/10.1128/br.37.1.1-18.1973
Moore, M., & Zahra, F. (2022). Monkeypox. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK574519/
CDC (2022). 2022 U.S. Monkeypox Outbreak. Available at: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html (Accessed 27 July 2022).
Lee, H. (2022). Monkeypox: 890 cases reported in Canada, majority in Ontario. Available at: https://globalnews.ca/news/9035914/monkeypox-canada-aug-3/ (Accessed 5 August 2022).
WHO (2020). Zoonoses. Available at: https://www.who.int/news-room/fact-sheets/detail/zoonoses (Accessed 5 August 2022).
Jezek, Z., et al. (1988). Human monkeypox: secondary attack rates. Bulletin of the World Health Organization, 66(4), 465–470. Available at: https://apps.who.int/iris/handle/10665/264589 (Accessed 27 July 2022).
CDC (2022). Monkeypox and Smallpox Vaccine Guidance. Available at: https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html (Accessed 27 July 2022).
CDC (2022). How it spreads? Available at: https://www.cdc.gov/poxvirus/monkeypox/transmission.html (Accessed 5 August 2022).
CDC (2022). Considerations for Monkeypox Vaccination. Available at: https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html (Accessed 27 July 2022).
Nguyen, P. Y., et al. (2021). Reemergence of Human Monkeypox and Declining Population Immunity in the Context of Urbanization, Nigeria, 2017-2020. Emerging infectious diseases, 27(4), 1007–1014. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007331/
WHO (2022) Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. Available at: https://www.who.int/europe/news/item/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern (Accessed 29 July 2022).
WHO (2022). Episode #73 – Monkeypox. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/science-in-5/monkeypox (Accessed 29 July 2022).
WHO (2020). Zoonoses. Available at: https://www.who.int/news-room/fact-sheets/detail/zoonoses (Accessed 5 August 2022).
CDC (2022). How it spreads? Available at: https://www.cdc.gov/poxvirus/monkeypox/transmission.html (Accessed 5 August 2022).
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