7/25/2022

by Matt Murphy, DNP RN CEN TCRN

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What You Should Know About Monkeypox

The 2022 Monkeypox outbreak we are experiencing feels especially frustrating as it falls on the heels of a 2-year international pandemic. Just as many of us felt like things were finally getting back to normal we have yet again another health-related concern.

The big difference is that we know a lot more about Monkeypox than we did about COVID when the pandemic first started. Knowledge is powerful, so the key to staying safe is to stay informed. We should remain cautious and appropriately concerned, but let’s not be alarmed. We can do that with a good foundation of Monkeypox information and knowledge of where to turn if you have questions.

Monkeypox is a historically rare illness, that wasn’t seen in humans until 1970. Monkeypox is a viral illness with true origins unknown but was however first seen in monkeys being kept for research in 1958. Monkeypox comes from the same family of viruses that causes smallpox.

In comparing the two, Monkeypox is similar but thankfully associated with less severe illness than smallpox and contrary to similar naming convention Monkeypox is not related to chickenpox.

Monkeypox Symptoms

The symptoms of Monkeypox includes those that would be associated with a flu-like illness and a rash. This means someone infected with Monkeypox would experience symptoms like:

• Fever
• Chills
• Headache
• Fatigue
• Muscle aches
• Swollen glands.
• Lesions to tongue and mouth

The rash is much more unique and most likely where many people catch on that something isn’t right. The rash associated with Monkeypox can look like blisters or pimples that appear on the face, inside the mouth, hands, feet, anus, or genitals.

The rash typically starts as flat red bumps and progresses to pimples or blisters filled with fluid or puss until they eventually scab over and fall off lasting in total anywhere from 2 to 4 weeks. Depending on what part of your body is affected the rash can be quite painful.

How it Spreads

Monkeypox is contagious from the time a person starts showing symptoms until their rash has completely healed over. Monkeypox can be spread from person to person in a couple of ways:

• Direct contact with the rash, scabs, or fluid from the blisters
• Prolonged face-to-face contact with exposure to respiratory fluids, intimate physical contact such as kissing or sex.
• Touching items such as clothing or linens that had been in contact with the rash or body fluid.

Prevalence and Prevention

When you look at the data for the United States as a whole, unfortunately about one-third of the almost 1500 cases have been identified in New York. Not tragically surprising given the concentration of people in New York as well as the access and attraction of things like the international travel New York is known for.

It is nonetheless significant to those of us living and socializing here. More concerning may be the high number of those people coming down with Monkeypox that also identify as members of the community of men who have sex with men (MSM).

Information specific to this concern is somewhat in its infancy with many medical and scientific professionals being careful not to send out a stigmatizing message that has been seen in the past.

The reality is that all types of sexual contact carry with it the same risk of giving or getting Monkeypox. It just so happens that the current data available, without solid rationale, is telling us that the MSM community is presently being hit the hardest.

So while certain efforts such as a focus on vaccination availability inside the MSM community will help, self-care and awareness will get us all headed in the right direction.

Prevention at Social Events

It may be stating the obvious but if you feel ill you should be staying home and seeking medical attention from a licensed medical professional. If you’re feeling well and headed out to a social gathering like a party, rave, club, or festival you need to give consideration about how much close personal contact you will be exposing yourself to.

Now you may be asking, what does close personal contact mean? This means skin-to-skin contact where body fluid from that person can get on you. This does not mean you need to be scared to go out and have fun. It does not mean that if you do you should be preoccupied with maintaining a certain distance from others around you or only talking to people through a glass partition. It simply means being mindful of coming into physical contact with people where their skin touches yours.

Again, let us not be alarmed but make informed decisions about risk. Here are some basic considerations:

• Events, where people are likely to be fully clothed without much skin-to-skin contact, are safer but be mindful of things like kissing.
• At events where people may not be fully clothed do your best to limit contact.
• Enclosed spaces such as a private room may come with a greater risk of contact which you may choose to avoid.

Sex Associated Risk

You and your partners should maintain an appropriate level of concern surrounding illness and talk to each other if you’re not feeling well.

Be aware of signs of illness in yourself and if you’re not feeling well don’t have sex until you are evaluated by a medical professional. You’re also not going to want to share things like clothing, towels, or toothbrushes until you’re in the clear as well.

Sex clubs, bathhouses, and private sex parties where intimate and potentially anonymous sex is occurring is obviously going to be accompanied by greater risk.

Using condoms is not enough to prevent potential exposure so using the knowledge we have and limiting the number of partners you are allowing yourself to be exposed to offers a meaningful way to limit risk.

If you do decide to have sex here are some ideas to consider to keep yourself safe:

• Remember to wash your hands, clothing, toys, towels, and linens after having sex
• Avoid touching any part of your partner’s body with anything that resembles a rash.
• Consider postponing the kissing until a future date and time
• Consider “virtual” sex by adding those smartphones and virtual platforms to your prevention plan

What about that Monkeypox vaccination you may have heard about?

Vaccines can be an effective measure of prevention if administered prior to or shortly after being exposed. According to the Centers for Disease Control and Prevention (CDC) the vaccine is shown to be most effective post-exposure if given within 4 days.

Getting vaccinated beyond the 4 days isn’t completely useless either though, doing so may not prevent you from getting Monkeypox but may lessen the severity of the symptoms.

It is important to know that if you are using the vaccine as a measure of prevention, you are not considered fully vaccinated until enough time has passed for the vaccine to become effective.

This means that depending on which vaccine you get with some only being a single shot and some requiring two, you may not be fully protected until after 2-4 weeks have passed.

It is important to inquire with those medical professionals administering the vaccine about whether or not there is a need for a second dose and when you can consider yourself protected. It is also important to keep yourself safe using the preventative methods mentioned above while your body builds its defense.

Treatment

There is no treatment specific to Monkeypox. It is a virus and there are antiviral medications out there that can be prescribed to manage the illness. Viruses are not treated with medications like antibiotics, which means if you have any laying around from a previous illness they would not be beneficial to take.

Some medical professionals may recommend against you taking antiviral medications for Monkeypox. This is often related to the stage of the illness which can influence how well the medication may work and the risk of side effects that may accompany the medicine. This would be something you should discuss with the medical provider taking care of you.

Remember knowledge is power and you should be informed of all of your options. Options that may include management of the symptoms. This means managing the pain associated with the rash using treatments or medication may be beneficial to limiting discomfort while the illness is running its course.

Know the Facts

At the present time, organizations like the World Health Organization do not consider the spread of Monkeypox to be a pandemic, but it is an outbreak to be taken seriously. Our best defense is to maintain an appreciation for knowing the facts and proven methods for prevention.

From there we need to remain diligent in limiting our risk. Reliable sources like the CDC and NY State Department of Health will provide you with reliable up to date information and always seek medical attention for concerning symptoms or illness. Stay informed and stay safe.

References:

https://www.cdc.gov/poxvirus/monkeypox/about.html

https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html

https://medicine.yale.edu/news-article/monkeypox-what-you-need-to-know-about-the-recent-outbreaks/

Matt Murphy is a Doctor of Nursing Practice (DNP)  prepared registered nurse, holding board certifications in both emergency nursing and trauma nursing with over a decade of clinical experience in a variety of clinical environments. Do you have questions for Nurse Matt that you would like answered?  Send us an e-mail to [email protected].