By Ann Lima, MD MPH

Monkeypox is in the family of orthopox viruses, and was first isolated in monkeys in 1958 and the first human case was reported in 1970. The monkeypox virus is endemic to countries in Africa, but has only recently been observed to have extensive human to human transmission outside of Africa.
The current outbreak in the United States started in May 2022, when the first case was reported, and now more than 23,000 cases have been confirmed, 12 of those in the state of Idaho, with no deaths reported.
The disease usually presents 1-2 weeks (4-17 days is the range) after exposure to someone with active infection. It usually starts with nonspecific viral symptoms of fever, headache, fatigue, muscle aches and enlarged lymph nodes and then is followed shortly thereafter by a rash. The rash consists of skin lesions that start as red spots which turn to bumps then blisters and pimple-looking lesions that will open up and then crust over before healing over several weeks. The course of the disease usually lasts 2 to 4 weeks.
Although not a sexually transmitted infection in the typical sense, it is transmitted by close contact usually during sexual activity or intimate contact, with the skin lesions being the most infectious source of virus. Avoiding direct skin to skin contact with skin lesions, or direct contact with clothing, bedding or towels used by a patient with active disease, can prevent infection.
There are 2 vaccines that can be used to prevent disease in specific populations based on risk factors. The vaccines are licensed to prevent smallpox, but research suggests there could be 85% cross-protection against monkeypox, although it is unclear how long the protection lasts. The vaccine can be given prior to exposure or within 4 days of an exposure to prevent more severe disease.
There are also antiviral treatments available, again targeted at smallpox but with likely effect on monkeypox, that are available for patients who have severe disease, are immunocompromised, young children or pregnant patients.
If you have more questions about monkeypox or if you believe you may have been exposed or have the disease, please make an appointment to discuss with your healthcare provider. There is also more information on the extent of the outbreak, pictures of the typical rash, and prevention strategies on the CDC website (cdc.gov/poxvirus/monkeypox/).