Monkeypox: What Millennials Need to Know
Written by Melissa Schenkman, MPH, MSJ
What do you know about mpox?
It’s a different name for the same virus that has now landed back on our news feeds along with those fairly gross (if we are being honest) pictures of blisters covering a person’s skin. In 2022, the World Health Organization (WHO) decide to change its name to mpox to reduce stigma and the name’s association with monkeys.
Two years later, WHO has once again declared it a public health emergency of international concern —“an extraordinary event which is determined to constitute a public health risk to other countries through the international spread of disease and to potentially require a coordinated international response.”
As opposed to previous strain of the virus, the viral strain behind this outbreak is clade 1 mpox, which is believe to be up to 10 times more deadly with children under age 5, pregnant woman, and immunocompromised people at greatest risk.
The good news is: your risk of getting mpox, especially without international travel is still low. However, with the WHO giving mpox an overall designation of being a moderate risk to people in other parts of the world, it’s important for us to have useful information about how this virus spreads and who is actually at risk.
That’s why I collaborated with fellow millennial and infectious disease specialist, Lindsay Morrison, MD, MSCI to learn what communities among our generation are at risk, how this virus actually differs from the COVID-19 virus, and what precautions, if any, we travel this fall.
Lindsay Morrison, MD, MSCI, cares for patients at Georgia Infectious Disease in Atlanta, Georgia.
YMyHealth: What is mpox?
Dr. Morrison: mpox is a zoonotic disease caused by an orthopoxvirus. It is related to smallpox but much milder. As you might guess from the name of the virus, it was first discovered in monkeys in the 1950s. It was not until the 1970s that the first cases of the disease occurred in humans.
YMyHealth: How are people contracting the virus?
Dr. Morrison: The virus primarily enters through breaks in the skin, mucous membranes surfaces (eyes, mouth, vagina, anus), or the lining of the respiratory tract.
Person-to-person transmission occurs after direct contact with infected sores on the skin or body fluids, such as large respiratory droplets. Increasingly, sexual fluids are becoming a concern as a potential mode of transmission.
Transmission from infected animals or fomites (material carrying infected fluids, such as clothing or bedding and sex toys) can also spread the infection.
YMyHealth: A lot of media reports have been about how mpox is something to be on alert for in the gay male and bisexual community. Is this something that millennials regardless of their sexual orientation should be aware of and on guard for? If so, why?
Dr. Morrison: Right now, the spread of mpox has primarily been between men who have sex with men. Spreading outside of the gay community is inevitable; in fact, several cases have been reported in children and women.
Regardless of your gender or sexual orientation, you can contract the infection.
YMyHealth: What are some symptoms that millennials should be aware of?
Dr. Morrison: Symptoms of mpox typically involve:
Fatigue
Fevers
Shaking chills
Swollen lymph nodes.
The most obvious lymph nodes are in the neck, armpits, and around the groin. mpox also causes a characteristic rash. The rash starts as red spots on the body which develop into fluid-filled vesicles, like blisters, or pustules, like large pimples. These lesions then develop into open sores and eventually scab over and fall off.
YMyHealth: How does this virus differ from COVID-19?
Dr. Morrison: mpox differs from SARS-CoV2, the virus that causes COVID-19 in a few ways.
The incubation period is more variable and can be up to 21 days, although it typically falls into the 7-14-day range. The mpox virus is spread primarily through close contact with skin or infected fluids. Respiratory droplet transmission is possible for both viruses but for mpox transmission requires more prolonged and more proximal (face to face) exposure. Also, because mpox requires close contact for transmission it has less potential to spread rapidly.
YMyHealth: For millennials who are planning to travel either domestically or internationally, what’s your advice when it comes to protecting themselves from mpox?
Dr. Morrison: Case numbers have been on the rise almost solely on the African continent so far with more than 18,000 cases reported by the WHO there. Cases have spread from the Democratic Republic of Congo and other countries where mpox has been endemic for years to other countries in Africa that include Kenya, Uganda, and Rwanda. Outside of Africa so far there have been two travel-related cases, with individuals from Sweden and Thailand, respectively.
With this new strain in Africa scientists are seeing more non-sexual forms of person-to-person contact spreading the virus. Yet, the risk of contracting mpox is still higher with certain activities that involve close skin contact such as massages, close-quartered gatherings that involve a lot of exposed skin or skin contact, or sexual activity. Limiting your exposure to these activities is the best way to reduce your risk. Dental dams and condoms can also reduce risk of transmission but will not eliminate the risk.
Aside from these activities your risk of mpox is still low, including for air travel.
It is rare and unlikely for a public surface to become contaminated with the virus. However, you can take steps to protect yourself by wearing clothing that covers your skin or wiping down high-touch surfaces like arm rests.
Since the overall incidence of mpox is low right now your chance of sitting next to someone on an airplane with an active infection is also low. If you are immune compromised or pregnant, you can consider wearing a mask for air travel.
At a hotels, linens and towels are typically cleaned between guests so these surfaces are unlikely to harbor the virus.
For more information on mpox, visit the CDC’s mpox page. It includes images of the rash as well as a map with reported cases by country.
If you think you may have mpox you can find a testing center here.
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