hMPXV (the human version of the monkeypox virus) is a DNA virus related to smallpox. As news on the internet spreads pertaining to this Virus, we want the students of OSU to know what it is, what to watch for and when to seek help if symptoms arise.

Information About the Virus

hMPXV (the human version of the monkeypox virus) is a DNA virus related to smallpox. It infects animals and is endemic to forested areas of Central and West Africa. It's unclear what animals act as a reservoir for hMPXV, but rodents are the prime suspects. The virus can also infect rats, squirrels, prairie dogs, and some monkeys, among other animals, The first human case was identified in 1970 in the Democratic Republic of the Congo. There are two strains of monkeypox: MPXV-1 is typically more severe and has a case fatality rate of up to 10%. MPXV-2 causes milder illness, with an estimated case fatality rate in endemic countries of around 1%.

It’s in the same group of viruses, but this isn’t smallpox! hMPXV is much harder to catch, and it is not as severe. There are two strains of this virus, and the main one that’s circulating now causes milder disease. Most people are recovering at home without any special treatment.

It got its name because the first recognized outbreak was in monkeys in a Danish laboratory in 1958. hMPXV is the human version of the monkeypox virus. According to the World Health Organization, the term “Monkeypox” will soon be renamed after scientists criticized the current name as discriminatory and stigmatizing.

Historically, people have become infected by handling wild animals and bush meat, although hMPXV can also be transmitted person to person. This can happen through prolonged, close contact, either skin to skin, contact with fluid from hMPXV lesions, or possibly from large respiratory droplets. Most infections in the current outbreak appear to be due to skin-to-skin contact. 

An ill person who coughs or sneezes on someone else could possibly spread the infection. However, most transmission in the current outbreak appears to be from prolonged, skin-to-skin contact. 

Illness typically starts with fever, headache and muscle aches. This is followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks. 

Usually within seven to 14 days, with a range of five to 21 days. 

Ill people can potentially transmit the infection from when symptoms start until the rash has resolved. However, this is not an easy infection to catch. It typically requires prolonged, close contact. People at increased risk include sexual partners of an ill person, or family members and health care workers caring for someone ill with monkeypox. 

Spread before symptoms develop hasn’t been reported. 

Information about the current outbreak

Many of the infections in the current outbreak are from prolonged, skin-to-skin contact during sexual activity. Most but not all infections have been among gay, bisexual, and other men who have sex with men who have traveled to countries with hMPXV cases or who have had contact with someone else with hMPXV. 

The virus spreads through close, prolonged, skin-to-skin contact, not sex specifically. Though risk of infection is not high, anyone who has close, prolonged, skin-to-skin contact with someone ill with monkeypox could possibly catch it. 

MPXV-2, which tends to be the less severe of the two strains, is responsible for most illnesses in the current outbreak. 

Many people in the current outbreak have not had typical symptoms. Many had no symptoms prior to developing a rash, which has often been localized rash in the genital or perianal area. 

It is unusual that most of those with hMPXV haven’t traveled to areas where the virus typically circulates. This suggests some transmission in countries that don’t usually experience it. 

It's theoretically possible but considered to be a very low risk. In a previous U.S. outbreak of hMPXV in 2003, 47 people were infected via pet prairie dogs housed with monkeypox-infected rodents from Ghana. All 47 human cases were directly linked to the infected pet prairie dogs. Although health investigators did extensive testing of other domestic and exposed animals, they found no evidence of spread to animals. 

Response to the current outbreak

There is a vaccine specifically for hMPXV and smallpox called Jynneos. It could be used to protect people with high-risk exposure to someone ill with hMPXV. There is another vaccine, ACAM2000, that is approved to prevent smallpox. It could be used under special arrangements with CDC, but it is more likely to cause adverse effects. 

Currently there are no specific treatments approved for hMPXV virus infections. However, antivirals developed for use in patients with smallpox may be helpful in treating people with severe disease or who are at risk for severe or complicated infections. 

if you are concerned you have been exposed to hMPXV, please contact your primary care provider to find out if you would qualify for the vaccine.  People who have been exposed to monkeypox should receive a vaccine called JYNNEOS to prevent them from developing the disease. This is called post-exposure prophylaxis or PEP. PEP may also be given to people without a known exposure but who are most likely to have been exposed. People who are infected with monkeypox should not receive the vaccine. The state of Oregon currently has a limited supply of vaccine from the Strategic National Stockpile and are working to provide vaccine to people most at risk.

OHA is working with community partners to share information about hMPXV, the outbreak and infection prevention strategies with people who might be at increased risk of infection. 
OHA also is sharing information with clinicians about the outbreak, how to recognize and test for hMPXV illness, and how to prevent spread.