Human​ Monkeypox

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Overview

The Maryland Department of Health (MDH) is working with partners to monitor the global Human Monkeypox outbreak and provide information to residents. Check this page for updates and follow us at http://www.twitter.com/MDHealthDept and https://www.facebook.com/MDHealthDept.​


Background

Human monkeypox is a rare but serious illness c​aused by infection with the monkeypox virus, which can infect humans and other animals, such as monkeys and rodents. The human monkeypox virus belongs to the genus Orthopoxvirus. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

Historically, most human cases of monkeypox have been identified in Central and West Africa. Rarely, human monkeypox cases have been identified outside of Central or West Africa, though many cases reported links to those regions, either through travel or exposure to humans or animals that had been infected in those areas.

In May 2022, several clusters of human monkeypox cases were reported in countries that don't normally report human monkeypox, including the United States. It's not clear how the people were exposed to monkeypox, but early data suggest that gay, bisexual, and other men who have sex with men make up a high number of cases. However, anyone who has been in close contact with someone who has monkeypox is at risk, regardless of gender or sexual orientation.

On June 16, 2022, MDH reported a presumed human monkeypox virus infection in a Maryland resident.​ Please refer to the CDC website​ for current Maryland and national case counts.
 

Signs and Symptoms

Human monkeypox typically begins with fever, headache, muscle aches, and exhaustion that appear 5-21 days after the individual was infected.  Within 1-3 days (sometimes longer) of the onset of fever, infected individuals develop a rash that often starts on the face before spreading to other parts of the body, including the hands, feet, and genitals.

The illness commonly resolves in 2-4 weeks, but it can be deadly for some individuals.
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Transmission

Transmission of human monkeypox virus occurs when a person comes into contact with an infected animal or human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth). 

Animal-to-human transmission can occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding. 

Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required. Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.

A person is considered infectious from the onset of symptoms and is presumed to remain infectious until lesions have crusted, those crusts have separated, and a fresh layer of healthy skin has formed underneath.


Prevention

There are a number of measures that can be taken to prevent infection with human monkeypox virus:

​The smallpox vaccine can offer protection against human monkeypox; however, the vaccine is not available to the general public.


Testing and Treatment

At this time, the risk to the general public appears to be low.  Individuals who believe they were exposed to human monkeypox or have an illness that could be human monkeypox should contact their healthcare provider for a risk assessment.  People without a provider or insurance should visit health.maryland.gov/CSTIP/loca​l to find contact information for their local health department.

Healthcare providers who suspect human monkeypox in a patient should ensure that the patient is properly isolated and contact their local health department for further guidance.

Human Monkeypox testing and treatments are not available through routine providers, though the health department can assist with coordinating these resources.


Monkeypox Resources

Information for Clinicians

MDH Clinician Letter (May 19, 2022) 
CDC Health Alert Network Advisory: Monkeypox Virus Infections in Non-endemic Countries (May 20, 2022)

Other Resources​