Monkeypox: Be Cautious but Don’t Panic

I’m Julian Castaneda, MD, Medical Director at The Judge Group. Judge’s healthcare expertise meets the needs of healthcare professionals by identifying and providing the necessary talent across the entire healthcare landscape and developing and delivering training to healthcare companies. As a veteran in the medical field with a wealth of experience, Judge brought me on board to serve as a resource and advisor to Judge, as well as to our contractors and clients. In this blog, I want to quickly address monkeypox.

Be cautious, but don’t panic

Over the past two and a half years, our world has been obligated to learn so much and adhere to the safety guidelines associated with COVID-19 infection. Likewise, in order to keep ourselves and our families safe, it is essential that we also become familiarized with the characteristics, pattern of spread and safety measures necessary to evade Monkeypox infection. As of August 17, Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), reported 13,500 cases in the U.S., a third of the 39,000 total global cases.

I have not seen any cases in my hospital yet. While it is spreading, with only 13,500 cases so far, it is not spreading at a pandemic level. The World Health Organization (WHO) states that smallpox vaccines seem to present mild protection against monkeypox – though only one smallpox vaccine is shown to prevent monkeypox.

Vaccines are ready for administration

Unlike with Covid-19, a vaccine already exists for monkeypox – and has since 2019. The vaccine is administered below or between the layers of skin and requires two doses for efficacy.

The U.S. announced on August 18 that we would be boosting our supply of vaccines and making another 1.8 million doses available. The vaccine, Bavarian Nordic’s Jynneos shot, can be administered between the layers of skin and is clinically approved for recipients 18 and older. WHO states, “Monkeypox is usually a self-limited disease with symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.” However, I should put this rate into context.

COVID has about 1% mortality. There are two strains of the monkeypox virus. The type identified during this outbreak is the West African type, which is rarely fatal. Over 99% of people who get this form of disease are likely to survive. However, people with weakened immune systems, children under eight years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill. The other strain is known as the Congo Basin type of monkeypox virus, and it has a much higher fatality rate of about 10%. So, I believe that the fatality ratio quoted in the 3-6% possibly combines the risk of both strains.

Therefore, while you certainly do not want to be hugging an infected person, the disease is not a critical concern at this moment. The mortality rate is low and the ability to protect against the disease is far easier than it was with Covid.

Monkeypox appears similar to smallpox – but far less deadly

Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa – it can be transported to other regions of the globe by infected people. It presents like smallpox, a related virus, but is far less deadly and communicable. Because they are similar diseases, many of the treatments developed for smallpox also have effectiveness with monkeypox.

Smallpox itself is an infection that was declared eradicated worldwide in 1980. In fact, smallpox is one of the vaccines children are given in an effort to ensure it remains eradicated. Smallpox is a far more dangerous disease with much higher mortality rates than monkeypox.

Remain cautious and alert

In closing, I caution you to avoid contact with someone who has contracted monkeypox. An infected person will display a skin rash and have a fever and swollen lymph nodes. It can be spread through close contact with lesions, body fluids, respiratory droplets, and contaminated materials such as bedding. If you do encounter someone infected, be sure to wash immediately with soap and water and remove any potentially contaminated clothing or other items.

While you do not want to catch monkeypox, remember it is not a life-threatening pandemic that is transmitting rampantly. If we are all cautious and avoid spreading the disease, it is anticipated that we will move past the threat soon.