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Monkeypox | What you need to know

Updated: Sep 29, 2022

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Photo: Wix




 

Topics
  • What is Monkeypox?

  • How is Monkeypox spread?

  • What symptoms are associated with Monkeypox?

  • How long does Monkeypox last?

  • How is Monkeypox diagnosed?

  • How can I manage laundry if exposed to Monkeypox or manage laundry during an exposure? How is Monkeypox treated?


 


What is Monkeypox?



Monkeypox was just labeled a public health emergency. Many of my patients have expressed concern and eagerness to learn about and understand this disease.

Monkeypox is caused by a virus from the Orthopoxvirus family endemic to western Africa. The first time it was recognized in humans was 1970. Prior to this, it was considered a zoonotic disease found primarily in animals.







How is Monkeypox spread?



Although contact with infected animals is a known source, the current outbreak is related more to person-to-person spread. So, how can you get it? The three main methods of transmission are:


  • Contact with an infected person’s rash or scabs, or through intimate contact.

  • Contact with fomites touched by an infected person- such as unwashed clothing, towels, and linens.

  • Less common spread is through prolonged face-to-face contact via respiratory droplets.


It can take as long as 2 weeks after exposure to develop the symptoms.

I have been asked routinely if Monkeypox can be spread through doorknobs and handrails. Although it is theoretically possible, it is actually much less likely.


What symptoms are associated with Monkeypox?



Some people have URI symptoms then the rash, some people may get a rash then URI symptoms and others may just see a rash


The first symptoms you may experience are:
  • Fever

  • Headache

  • Weakness or Fatigue

  • Muscle aches

  • Enlarged lymph nodes

  • URI symptoms such as cough, sore throat, and nasal congestion


After experiencing these symptoms for about 1 to 5 days, a rash may develop.

The rash can appear anywhere such as the head, hands, feet, genitalia, and inside the mouth, and potentially spread.

The spots associated with the rash go through stages. It starts off as a red macule then progresses into a papule then a vesicle then a bulla or pus-filled blister. This then scabs over. These can leave behind scars in the form of discoloration or even pitted scars. Once the scabs fall off a person is no longer considered contagious.





How long does Monkeypox last?



It can take about 3 to 4 weeks to completely resolve. The challenge is that there may be secondary complications that arise. Pneumonia, respiratory distress, and encephalitis are possible complications. Secondary infection and/or discomfort associated with the lesions, especially sores in the mouth or throat may also occur.






How is Monkeypox diagnosed?



A clinical diagnosis can be made by a Dermatologist or other skilled physician based on presentation. Confirmation of the diagnosis can be made by swabbing the base of a lesion and second for lab testing.


How can I manage laundry if exposed to Monkeypox or manage laundry during an exposure?

Very few studies are available to evaluate the effectiveness of the laundering process on bacteria, yeast, fungus, and viruses. To understand this let’s review each component of the laundering process on antimicrobial activity. The concept of Sinner’s circle is based on recognizing the 4 factors that contribute to cleaning are time, temperature, mechanical factors, and chemistry. In the laundering process, this would mean the time involved in laundry, the temperature of the water, the mechanical properties of the washing machine, and the detergent used.
To understand the laundering process of Monkeypox, the first thing to recognize is that Monkeypox is an enveloped virus. This means that the DNA that comprises the virus is surrounded by an envelope, almost like a container. This is important simply because studies have shown that the laundering process with surfactants in detergents tends to be more effective against enveloped viruses compared to nonenveloped viruses. Although enveloped viruses can sustain higher temperatures in the laundry, they cannot easily survive laundry detergents with surfactants even at colder temperatures.






What does all this mean? As colleges resume classes soon I recommend a few steps to attempt to keep your clothes, linens, and towels clean.
  • Collect your laundry in a washable cloth bag.

  • From the perspective of viruses, it is ok to wash on the cold cycle with laundry detergent. Be sure to avoid overloading the machine and use the right amount of detergent.

  • Throw the cloth laundry bag in the wash as well.

  • Avoid folding laundry in common areas.







How is Monkeypox treated?



There are no specific treatments for Monkeypox. Supportive care is the primary management. For symptomatic cases, Tecovirimat is an antiviral medication that has been used. It is thought that those that received the smallpox vaccine likely have some immunity to monkeypox leading to less severe cases. The last smallpox vaccinations were administered in 1972.



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