Tech Doc: In understanding monkeypox, common sense, preventative measures should prevail

Smallpox, for good reason, brings fear into the minds of the public. Smallpox killed hundreds of thousands of people in 18th century Europe and in 1967 there were 15 million cases per year. Smallpox also is the best example of the miracle of vaccination. In fact, it is a disease that the World Health Organization has certified as globally eradicated as of October 1977.

Smallpox with its devastating fevers, blisters and scabs is gone, hopefully forever, but it has a cousin – monkeypox, another virus of the family Orthopoxvirus, that has emerged to again cause fear around the world.

The good news is monkeypox is much less severe in that it rarely causes death to its victims. Nevertheless, it is a dangerous disease and causes fever, sore throat, headache and a rash, a rash not unlike smallpox. The rash can be so severe that patients come to the emergency room for pain medicine stating they feel like glass is caught in their skin. Monkeypox is a disease you want to avoid.

There have been more than 6,000 cases of monkeypox in Texas and a few cases in Lubbock. To avoid the disease, one must understand how it is transmitted. Monkeypox is not like COVID-19. It is rarely transmitted through droplets in the air, so it is not about wearing a mask. This disease is transmitted by direct contact, usually intimate contact, with a patient that has the disease. It is not a sexually transmitted disease but you are likely to get it if you have sex with an infected person.

Common sense dictates disease prevention. Do not have close contact with someone who may have the monkeypox rash. Do not touch such a patient or even touch bed sheets, glasses, dishes, or surfaces that a monkeypox patient might have touched. The virus is in the pustules – small, inflamed, pus-filled, blister-like sores of the skin and is very contagious and easily transmitted.

Although many of the early cases of monkeypox occurred in men who have sex with men, the Centers for Disease Control and Prevention stressed “anyone, regardless of sexual orientation or gender identity, who has been in close, personal contact with someone who has monkeypox is at risk.” In the early days of the HIV pandemic many thought that AIDS could only occur in the gay population. That was proven to be untrue. Monkeypox is not a sexually transmitted disease but occurs by contact with skin lesions, close contact with an infected person.

Monkeypox has a characteristic rash but it may not be easy to separate out from other more common skin problems. Characteristically, the rash will start out as a flat discoloration of the skin, then bumps or pustules and eventually fluid filled blisters which scab over. A physician should be able to reassure you if you are simply worried about a skin lesion. A virtual visit or even a picture of the rash will be enough to distinguish monkeypox from other skin problems. In addition, there will usually be symptoms of fever, sore throat and flu like symptoms before the rash appears.

For those who have had a known exposure to a monkeypox patient and a rash or other symptoms, they should be seen by a physician or by the health department. There will be a protocol including a definitive test using the fluid from a skin lesion.

There is an antiviral medication (TPOXX) that is thought to be useful and a smallpox-like vaccine which will be given to infected patients. There will be particular concern and need for treatment for children with the disease, pregnant mothers or those with some immunosuppressive condition. A physician will describe the isolation methods necessary for a patient with monkeypox.

The current monkeypox outbreak will not be another smallpox, COVID-19 or HIV pandemic. However, this disease does need to be contained. Common sense and preventive measures should prevail.

Steven L. Berk, M.D., is an infectious disease physician and Texas Tech University Health Sciences Center executive vice president and School of Medicine dean.

This article originally appeared on Lubbock Avalanche-Journal: Tech Doc: Understanding monkeypox: Common sense, preventative measures should prevail