Monkeypox virus cells. Credit: Centers for Disease Control and Prevenction

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Minnesota this week identified its first six cases of monkeypox, a rare virus that is in the midst of a worldwide outbreak since June. 

News of a new virus spreading may conjure up anxiety among those fearing another global pandemic. But monkeypox isn’t close to as contagious as COVID, mainly because it’s spread through physical contact and not through small particles of liquid discharged into the air from someone’s nose or mouth like COVID. 

“It’s worth noting that monkeypox is less infectious than COVID, chickenpox, measles, and influenza,” Minnesota Department of Health Commissioner Jan Malcolm emphasized in a news conference this week. 

So why are health experts alarmed by monkeypox right now? Because it’s currently spreading to countries “where the disease does not typically occur,” Malcolm said.

Monkeypox was first detected in humans 52 years ago, and typically infects a few thousand people in Africa every year, according to Nature. But this year, it’s spreading to more countries outside of the continent than ever before in the virus’ history. Scientists across the globe are unsure why it’s spreading.

More than 4,000 cases of monkeypox have been detected in 47 countries since last month. There are more than 306 cases in 27 states across the United States. Health officials are telling people to take precautions, to be on the lookout for symptoms, and to quarantine if infected. 

Sahan Journal breaks down a quick guide to what monkeypox is, how to avoid contracting it, and what to do if you’re infected. 

What is monkeypox?

Monkeypox is a virus found mostly in central and west Africa. Monkeypox originated in animals and jumped to humans a half century ago. It’s a type of orthopoxvirus, which also causes smallpox.

How is it spread? 

Monkeypox spreads through “respiratory secretions” during close physical contact, including sex and kissing, according to the U.S. Centers for Disease Control and Prevention (CDC). It can also be spread by touching an infected rash, scab, or bodily fluids. Touching materials like bedding and clothes that were recently in direct contact with an infected rash, scab, or bodily fluids can also cause infection.

Malcolm also cited “prolonged face-to-face contact” as a cause of infection.

Animals infected by monkeypox can also spread it by scratching or biting people. Preparing or eating infected animals can also cause infection.

The CDC said it’s unknown whether the virus can be spread through semen or vaginal fluids. 

What happens when you’re infected? 

Most people will develop a rash that looks like pimples or blisters that most commonly appear on the hands, feet, genitals, anus, chest, face, and inside the mouth. The rash can hurt or be painless. Some will experience multiple rashes.

Visible rashes can range from just a few tiny sores or appear like fluid-filled blisters like a herpes or syphilis infection, especially in the genital area, Malcolm said. Rashes in the rectum area can get excruciatingly painful, she added. 

Monkeypox incubates with no symptoms for one to two weeks after exposure. People infected do not spread the virus during incubation period, according to the CDC. 

A rash typically occurs one to two weeks after infection. But symptoms can start a few days before that with fever, headache, swollen lymph nodes, fatigue, or sore throat. Many people may experience only rashes. 

How sick do infected people get?

The illness lasts for about three to four weeks. It is usually mild and typically requires no medical treatment. But a small number of people infected with monkeypox can get more serious symptoms like pneumonia or sepsis.

Infections can also be deadly. How deadly? It’s hard to pin down. The World Health Organization says the fatality rate for monkeypox has ranged from 0 percent to 11 percent over the last half century, with children at a higher risk of death than adults. 

Rashes that get into the eye, including on the cornea, can cause blindness, Malcolm said. 

What precautions can I take to avoid infection from the monkeypox virus?

The CDC recommends being fully clothed while attending crowded events like festivals, concerts, and raves. Crowded clubs and parties where people wear “minimal clothing” come with “some risk,” according to the CDC. 

“Avoid any rashes or sores you see on others and consider minimizing skin-to-skin contact when possible,” CDC guidelines say

The CDC also advises to abstain from or limit sexual contact if you’re infected. 

Jan Malcolm speaks about children getting vaccinated against COVID-19 at Brooklyn Center Elementary STEAM on Thursday, Nov. 4, 2021. Credit: Jaida Grey Eagle | Sahan Journal

What should I do if I come into contact with someone who has monkeypox?

Refrain from close physical contact with the person during their infection period. This includes not touching the person’s rash area and refraining from kissing, hugging, and sex. Do not share utensils, cups, clothes, bedding or towels with infected people, the CDC warns.

Wash your hands periodically after physical contact with infected people.

Should I social distance to prevent the spread of monkeypox?

You don’t need to social distance like with COVID, where people were encouraged to wear masks and stay at least six feet apart in public. However, the CDC advises people who are infected with monkeypox to avoid being in the same room with others while they have rashes. 

To lower the risk of infection during sex, the CDC recommends that partners discuss recent illnesses and keep on the lookout for new, unexplained rashes.

Can I get tested for monkeypox if I come into contact with someone who is infected?

If you believe you may have monkeypox, the Minnesota Department of Health recommends contacting a health provider to determine whether a test is necessary. The department also lists the following free or low-cost testing sites:

Is there a vaccine against monkeypox?

Yes, but supply is extremely limited. The Minnesota Department of Health has advised health care providers to reserve the vaccine for people who know they were exposed and people who are at highest risk for infection. The department lists those criteria here.

Red Door Clinic offers the vaccine based on those criteria, and provides updates on supply and changing guidelines on its website.

Also, if you are in your 50s and lived in the United States as a child, you may have received the smallpox vaccination before the government ceased smallpox vaccination efforts in the 1970s, when that disease became eradicated. The World Health Organization (WHO) says the smallpox vaccine provides strong protection against monkeypox. 

If I get infected with monkeypox, should I quarantine myself?

The CDC recommends that infected people isolate themselves at home until the virus has run its course. People with active rashes should not be in the same room as others, including pets, who can contract the virus. 

If I get infected with monkeypox, when should I seek medical treatment? 

State and federal health officials recommend anyone with symptoms of monkeypox, regardless of severeness, to contact their health provider. If an infection becomes particularly severe, medical professionals can prescribe antiviral medication like tecovirimat, which treats orthopoxviruses like monkeypox. 

When is an infection no longer contagious? 

After all rashes have scabbed over, fallen off, and new skin appears.

I heard that the LGBTQ community is susceptible to monkeypox. Is that true?

MDH officials say that gay and bisexual men are overreppresented in current confirmed cases worldwide. But they stress that people of all sexual orientations and identites are equally susceptible to monkeypox. 

Where did monkeypox originate?

The virus first jumped from animal to human in west and central Africa in the mid-20th Century. It’s currently endemic in 10 African countries in west and central Africa, most notably Cameroon, Nigeria, Republic of Congo, Democratic Republic of Congo, and Central African Republic. It’s spread primarily from infected rodents to humans. 

Of the six Minnesota residents with confirmed infections, one came into contact with the virus traveling to Europe and another became infected traveling domestically. The origins of the other four infections aren’t publicly known.

Is monkeypox causing another global pandemic? 

Scientists and health experts may be alarmed at the current global spread, but state health officials stress that the risk of contracting monkeypox is currently low.

For more information, visit the Minnesota Department of Health, CDC, and WHO websites.

Sahan Journal reporter Sheila Eldred contributed to this report.

Joey Peters

Joey Peters is a reporter for Sahan Journal. His work has appeared in Reuters, Public Radio International, Columbia Journalism Review, KFAI Radio, the Pioneer Press, City Pages, MinnPost and more. He previously...