Health Topics

By Rachel Reimer, PhD, Professor and Chair of the Master of Health Care Administration and Master of Public Health Programs at Des Moines University Medicine and Health Sciences

Mpox, previously known as monkeypox, is a viral infection in the poxvirus family, which includes smallpox. While cases of mpox were previously rare outside Africa, it has spread globally since April 2022. With cases rising and a couple of isolated cases reported in Iowa recently, understanding its transmission, symptoms and prevention is critical for health and safety. Here are seven key questions and answers to help you stay informed about mpox.

1. What Is Mpox and What Are the Symptoms?

Mpox is a virus in the poxvirus family such as cowpox, smallpox and others. Mpox symptoms usually appear five days to three weeks after exposure. Initial symptoms are often flu-like, such as fever and chills, headache and fatigue followed by a rash or blisters. Blisters usually appear one to four days following initial symptoms. They can take many forms throughout the duration of illness. Blisters can appear on or near the genitals, anus and other areas such as the hands, feet, face, mouth and torso. One recent study found that among those with active mpox infections, most patients had fewer than 10 blisters or lesions and many had only a single lesion.

2. Where Does Mpox Originate and Has it Spread?

Prior to April 2022, it was rare to observe cases of mpox outside of Africa. The recent outbreak is occurring largely in countries where mpox has not been regularly reported, indicating that the virus is spreading across the globe.

Mpox has been considered endemic in African regions since the virus was first identified in the 1970s. The recent global outbreak suggests changes in the virus, changes in behavior or both. Most U.S. cases have been among gay or bisexual men; however, mpox is not a sexually transmitted disease.

3. How Many People Have Mpox?

Mpox, while present in the United States, is circulating at low levels. The virus has been known to affect children in regions with ongoing outbreaks, raising concerns about the potential risk to children in the U.S. However, mpox cases here continue to be reported at low levels, and public health measures are helping to control its spread.

Some researchers believe that the virus is more widespread than is currently known, possibly due to mpox infections being misdiagnosed as sexually transmitted infections or left undiagnosed entirely.

4. How Is Mpox Spread?

Mpox is spread in three primary ways:

• From an infected animal (non-human mammals, especially rodents, are a natural reservoir).
• Person-to-person physical contact.
• Contaminated objects.

This includes skin-to-skin contact, contact with contaminated objects and/or clothing or fabric such as bedding, as well as through respiratory droplets. The most common way is through direct skin-to-skin contact with someone who has the virus. Direct contact includes sexual contact, hugging and kissing. Other close physical contact can cause the spread, but that is rare and usually occurs within households.

5. How Can Mpox Be Prevented?

The first and most effective public health measure is good hand hygiene. Washing hands often with warm soapy water or using alcohol-based sanitizer is an important preventive measure. Other effective measures are avoiding skin-to-skin contact with people who have a rash and avoiding touching objects that a person with mpox has touched.

6. Why Was Mpox Declared a Public Health Emergency?

When the government declares a public health emergency, it establishes a 90-day window, which can be extended, that opens additional grant funding opportunities. This allows health care professionals to access treatment and other medical supplies and increases interagency data-sharing agreements that support the overall response. This assists public health and health care agencies in quickly identifying at-risk populations and treating infected individuals quickly to reduce spread. Traditionally, the case-fatality rate has been between 1 percent and 10%. There have been no reported deaths from the current U.S. outbreak.

7. Is There a Mpox Vaccine?

There are two mpox vaccines currently available, although supplies are limited. Vaccination will first prioritize high-risk individuals. The two-dose vaccine, Jynneos, is currently FDA-approved to prevent smallpox and mpox in adults 18 and older. The vaccine is 85% effective. Most cases resolve on their own without a need for advanced medical treatment or hospitalization.

Accurate resources and information during public health emergencies are vital to stopping the spread of disease and protecting lives. The Center for Disease Control and Prevention offers clinical guidance for providers on how to prevent, diagnose and treat mpox and protocols for personal protective equipment and infection control strategies in health care settings. The Iowa Department of Public Health website offers information on the vaccine, including the eligible population, administration and vaccination sites.

The expert family medicine providers at the Des Moines University Clinic can help you and your loved ones stay healthy. For more information or to make an appointment, visit the DMU Clinic website or call 515-271-1710.