MONKEYPOX LAB TESTING

In most cases, the symptoms of monkeypox go away on their own within a few weeks. However, in some people, an infection can lead to medical complications and even death. Newborn babies, children and people with underlying immune deficiencies may be at risk of more serious symptoms and death from monkeypox.
Complications from monkeypox include secondary skin infections, pneumonia, confusion, and eye problems. In the past, between 1% to 10% of people with monkeypox have died. It is important to note that death rates in different settings may differ due to a number of factors, such as access to health care. These figures may be an overestimate because surveillance for monkeypox has generally been limited in the past. In the newly affected countries where the current outbreak is taking place, there have been no deaths to date.

Monkeypox spreads from person to person through close contact with someone who has a monkeypox rash, including through face-to-face, skin-to-skin, mouth-to-mouth or mouth-to-skin contact, including sexual contact. We are still learning about how long people with monkeypox are infectious for, but generally they are considered infectious until all of their lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath.

Environments can become contaminated with the monkeypox virus, for example when an infectious person touches clothing, bedding, towels, objects, electronics and surfaces. Someone else who touches these items can then become infected. It is also possible to become infected from breathing in skin flakes or virus from clothing, bedding or towels. This is known as fomite transmission.

Ulcers, lesions or sores in the mouth can be infectious, meaning the virus can spread through direct contact with the mouth, respiratory droplets and possibly through short-range aerosols. Possible mechanisms of transmission through the air for monkeypox are not yet well understood and studies are underway to learn more.

The virus can also spread from someone who is pregnant to the fetus, after birth through skin-to-skin contact, or from a parent with monkeypox to an infant or child during close contact.

Although asymptomatic infection has been reported, it is not clear whether people without any symptoms can spread the disease or whether it can spread through other bodily fluids. Pieces of DNA from the monkeypox virus have been found in semen, but it is not yet known whether infection can spread through semen, vaginal fluids, amniotic fluids, breastmilk or blood. Research is underway to find out more about whether people can spread monkeypox through the exchange of these fluids during and after symptomatic infection.

Monkeypox can spread to people when they come into physical contact with an infected animal. Animal hosts include rodents and primates. The risk of catching monkeypox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood). In endemic countries where animals carry monkeypox, any foods containing animal meat or parts should be cooked thoroughly before eating.

While instances of people with monkeypox infecting animals have not been documented, it is a potential risk. People who have confirmed or suspected monkeypox should avoid close contact with animals, including pets (such as cats, dogs, hamsters, gerbils etc.), livestock and wildlife. People with monkeypox should be particularly vigilant around animals that are known to be susceptible to the monkeypox virus, including rodents and non-human primates.

People who live with or have close contact (including sexual contact) with someone who has monkeypox, or who has regular contact with animals who could be infected, are most at risk. Health workers should follow infection prevention and control measures to protect themselves while caring for monkeypox patients.

Newborn infants, young children and people with underlying immune deficiencies may be at risk of more serious symptoms, and in rare cases, death from monkeypox.

People who were vaccinated against smallpox may have some protection against monkeypox. However, younger people are unlikely to have been vaccinated against smallpox because smallpox vaccination stopped in most settings worldwide after it was eradicated in 1980. People who have been vaccinated against smallpox should continue to take precautions to protect themselves and others.

Reduce your risk of catching monkeypox by limiting close contact with people who have suspected or confirmed monkeypox, or with animals who could be infected. Clean and disinfect environments that could have been contaminated with the virus from someone who is infectious regularly. Keep yourself informed about monkeypox in your area and have open conversations with those you come into close contact (especially sexual contact) with about any symptoms you or they may have.

If you think you might have monkeypox, you can act to protect others by seeking medical advice and isolating from others until have been evaluated and tested. If you have probable or confirmed monkeypox, you should isolate from others until all of your lesions have crusted over, the scabs have fallen off and a new layer of skin has formed underneath. This will stop you from passing on the virus to others. Get advice from your health worker on whether you should isolate at home or in a health facility. Until more is understood about transmission through sexual fluids, use condoms as a precaution whilst having sexual contact for 12 weeks after you have recovered.

The Director-General of WHO Dr Tedros Adhanom Ghebreyesus declared on 23 July 2022 that the multi-country outbreak of monkeypox is a public health emergency of international concern (PHEIC). Declaring a PHEIC constitutes the highest level of global public health alert under the International Health Regulations, and can enhance coordination, cooperation and global solidarity.

A coordinated response can stop transmission and protect vulnerable groups. The Director-General also issued Temporary Recommendations to help countries fight the outbreak and bring it under control. The Director-General’s full statement can be found here and recommendations are outlined here.

Since the outbreak began to expand in early May 2022, WHO has taken this extraordinary situation very seriously, rapidly issuing public health and clinical guidance, engaging with communities actively and convening hundreds of scientists and researchers to speed up research and development on monkeypox and the potential for new diagnostics, vaccines and treatments to be developed.

Our understanding of how long immunity lasts following monkeypox infection is currently limited. We do not yet have a clear understanding whether a previous monkeypox infection gives you immunity against future infections and for how long, if so. Even if you have had monkeypox in the past, you should be doing everything you can to avoid getting re-infected.

If you have had monkeypox in the past and someone in your household has it now, you can protect others by being the designated caregiver, as you are more likely to have some immunity than others are. However, you should still take all precautions to avoid becoming infected.

You should never give blood when feeling unwell. If you have an appointment to give blood, self-assess your health and monitor any symptoms of monkeypox and reschedule your appointment if you don’t feel well.

There are strict protocols in place for when people can give blood. The prospective donor is asked questions about how they feel, and any symptoms they are currently experiencing. This is done to reduce the risk of anyone with an infectious disease giving blood.

There have not been any reports of monkeypox spreading through blood transfusions.

Children can catch monkeypox if they have close contact with someone who has symptoms. Data from previously affected countries show that children are typically more prone to severe disease than adolescents and adults. There have been a small number of children with monkeypox in the current outbreak.