Monkeypox

Question 1

How does monkeypox spread?

Answer 1

Close/direct contact with lesions,
bodily fluids or
respiratory secretions and
objects that have had contact with lesion crusts or body fluids

Infected animal or animal products

Vertical from mother to fetus

Question 2

Monkeypox symptoms

Answer 2

Begins with

• fever
• HA
• muscle aches
• backache
• lymphadenopathy (distinguishes from smallpox)
• chills
• exhaustion

1-3d after fever
- rash - lesions progress over 2-3w : macules, papules, vesicles pustules, scabs- can also be umbilicated

Question 3

What are some key characteristics for identifying monkeypox ?

Answer 3

Lesions- well circumscribed, deep seated, and often umbilicales- same size and stage on a single body site
Fever prior to rash
Lymphadenopathy
Disseminated rash is centrifugal (more lesions on face and extremities)
Lesions on palms and soles
Lesions are painful until crust appears when they become itchy

Question 4

Incubation stage of monkeypox

Time, symptoms, contagious or not?

Answer 4

7-14d, range 5-21d
Asymptomatic during this time
NOT contagious

Question 5

Stage after the incubation phase of monkeypox?

Time, symptoms, and contagious or not?

Answer 5

1-3 d
Prodrome of fever
CONTAGIOUS

Question 6

Onset of monkeypox rash lasts ?

Answer 6

2-3 w

CONTAGIOUS until all scab have fallen off AND a fresh layer of intact skin has formed underneath

Question 7

What genus does monkeypox belong in?

Answer 7

To the orthopoxvirus
Variola virus- Smallpox
Vaccinia virus- used in smallpox vaccine
Cowpox

Question 8

Monkeypox definition/criteria

Answer 8

New characteristic rash
Meets one of the following:
- contact w a person w similar rash or confirmed/probably monkeypox dx
- close or intimate in person contact w individuals in a social network experiencing monkeypox activity OR
- traveled outside the US to a country w confirmed cases of monkeypox
- had contact w a dead or live wild animal or exotic pet that is an African endemic species or used a product from such animals (meant, creams, lotions…)

Question 9

Monkeypox testing

Answer 9

PCR test of lesion material available through state health department/ CDC

Question 10

Severe cases of monkeypox can cause …

Answer 10

Hemorrhagic disease 
Confluent lesions- painful 
Sepsis 
Encephalitis 
Etc.

Question 11

Who is at high risk of severe disease of monkeypox?

Answer 11

Immunocompromised 
Peds, especially <8
Pregnant or breastfeeding 
Atopic dermatitis or other active exfoliative skin conditions 
One of more complications/comorbidities

Question 12

Post exposure ppx for monkey pox

Answer 12

Jynneos vaccine in CO- small pox vaccine

Post exposure ppx for close contacts after consultation w state health dept

Question 13

Monkeypox prevention

Answer 13

Avoid skin to skin contact if lesions
If resp symptoms present, those in contact should mask
Avoid contact w objects that may have come into contact with monkeypox: bedding/linens, towels, sex gear and toys