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WTF Is Monkeypox — Here's What You Need To Know

Children are most susceptible to the disease.

​A black and white close-up of the monkeypox virus outside a host cell with darker oval-shaped mature virus particles on the left and circular, less mature on the right.

A black and white close-up of the monkeypox virus outside a host cell with darker oval-shaped mature virus particles on the left and circular, less mature on the right.

A rare viral illness called monkeypox is popping up in Quebec, Canada, and the United States.

Over a dozen cases have been reported in the belle province and are under investigation by the Ministry of Health and Social Services (MSSS). Disease symptoms are similar to those seen in smallpox patients, although milder, and include fever, fatigue, and a pus-filled rash that often starts on the face and can spread to genitalia.

WHO data shows that smallpox vaccines used to eradicate the disease in the 1980s can be up to 85% effective against monkeypox. Children are at higher risk of complications from the disease. Around 10 percent of those who catch the illness can die, but the case-fatality rate for youth unvaccinated against smallpox can range up to 14 percent.

The first confirmed case of monkeypox south of the border was recorded in someone who recently visited Canada. The virus is usually contained in areas of Central and West Africa with tropical rainforests, so recent global outbreaks are raising concerns over what's causing the spread of the infectious disease.

Until recently, cases outside of Africa have been few and far between. International outbreaks of the virus have been linked to contact with a sick individual on a flight or imported animals.

"It is likely that there is a common origin from people having travelled from Western Africa to other countries," Dr. Anne Gatignol, a professor of immunology and microbiology at McGill University, told MTL Blog.

The virus has caused several outbreaks in Africa since 2017, causing more than 3,000 human cases last year. The first outbreak of the disease outside of Africa occurred in the United States in 2003. Around forty-seven people across six Midwestern states caught the illness after contact with infected pet prairie dogs. The animals were infected with monkeypox after being housed near imported mammals from Ghana.

The spread of that outbreak was contained by a smallpox vaccination campaign, tracking potentially infected animals and monitoring possible human cases. The import of some live animals was also immediately banned.

Since then, six cases linked to monkeypox in 2018 spread to the UK (4), Israel (1), and Singapore (1). Two cases from Nigeria reached the US in 2021.

"Based on these numbers, the current situation is unusual and should be followed closely," Gatignol said.

Since early May, Europe has seen an uptick in cases with five in Portugal, eight under investigation in Spain, and nine now confirmed in England. The UK has responded with a smallpox vaccination campaign. The British government is also advising individuals to look for "unusual rashes or lesions on any part of their body" before having sexual contact with someone else.

Health Canada reports that within the first few days of catching the virus, patients have fever, headache, backache, and fatigue. Over the next two to four weeks patients develop a rash with pustules that eventually scab over. Swollen and enlarged lymph nodes are a prominent symptom of monkeypox. The illness can last up to a month.

Among cases in Africa, monkeypox has caused death in around 1 per 10 people who contract the disease.

According to the WHO, the infection is transmitted to humans from wild animals, like primates, but can also be spread between people. Aerial transmission of the virus occurs via respiratory droplets, while spread can also occur through physical contact with monkeypox lesions, blood and other bodily fluids, and even contaminated bedding.

The vaccine used to eradicate smallpox in the 1980s provides protection against the virus. An updated version of the vaccine has been approved by the WHO for the prevention of smallpox and monkeypox. Antiviral agents are also in development.

Those who are tired of COVID-19 and alarmed by the reemergence of monkeypox can be reassured.

"The two viruses are not from the same family, do not originate from the same place, and the symptoms they cause have few similarities. Maybe there's an indirect link, in the sense that close contact between people decreased for the last two years and now barriers are lifted, travel has increased and so has close contact, including multiple sexual contacts for some," said Gatignol.

She advises staying aware of how the virus spreads and reducing sexual contact with unknown partners.

"For those who have been in contact with somebody who is a suspected case, avoid having more close contacts for 21 days, which is the maximum incubation time of the virus," she said.

"And keep some of the COVID measures, like washing hands frequently, to help decrease transmission."

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