The Situation:
The US CDC is tracking multiple clusters of monkeypox reported from early- to mid-May in several countries, including in Europe (Belgium, France, Germany, Italy, Portugal, Spain, Sweden, and the UK), Australia, Canada, the United States, and most recently, Israel.
These recent cases are atypical for several reasons:
1. All but one of the recent cases have no relevant travel history to areas where monkeypox is endemic, such as West or Central Africa.
2. Many initial cases were detected through sexual health services and are among men who have sex with men and while Monkeypox is not typically spread through intercourse, prolonged exposure and sharing bedding may be contributing factors.
3. The geographically dispersed nature of the cases across Europe and beyond, this suggests that transmission may have been ongoing for some time.
Incubation: The incubation period (time from infection to symptoms) is usually 7-14 days but can range from 5-21 days and, according to experts, individuals can be infectious from 1 day before a rash appear up to four weeks after the onset of symptoms or until all skin lesions have formed scabs and no other symptoms are present.
Transmission: The virus can be spread from person to person, although it is much less infectious than smallpox. The virus is thought to be transmitted by respiratory droplets during direct and prolonged face-to-face contact. Monkeypox may also spread by direct contact with body fluids of an infected person or with virus-contaminated objects, such as bedding or clothing. Monkeypox has an estimated transmission rate from 3.3-30%; however, during a recent outbreak in the Democratic Republic of Congo, the transmission rate was estimated at 73%.
Fatality rate and vaccination: In rural central and West Africa – where people live in remote areas and are medically underserved –case-fatality ratios of 1% to 10% have been reported. While there is no Monkeypox vaccine, the Smallpox vaccine may reduce the risk of infection. Persons who have had close or intimate contact with individuals or animals confirmed to have Monkeypox may want to consider vaccination as precautionary measure. Exposed persons may be vaccinated up to 14 days after exposure.
Symptoms: Swollen lymph nodes are common. Initially, flu-like symptoms may occur including, fever, headache, muscle aches, backache, swollen lymph nodes, chills, and fatigue. Next a rash, characterized by macules and papules, develops 1 to 10 days later; the macules and papules develop into vesicles and pustules and, in the final stage, form scabs. The skin lesions usually occur on the extremities but may also occur on the head and torso.
Mitigating Factors to Apply:
• Monitor local authorities for updates
• Enroll in a Safe Traveler program to receive warnings from your preferred embassy
• Avoid exposure to those presenting the aforementioned symptoms
• Avoid contact with animals or humans that could harbor the virus (including sick or dead animals especially in areas where monkeypox occurs)
• Avoid contact with materials, such as bedding, that has been in contact with a sick animal or human
• Practice aggressive hygiene by washing hands with soap and water or using an alcohol-based hand sanitizer.
• Seek medical care immediately if you experience symptoms and have recently traveled to an infected area; notify your healthcare provider of your recent travel
• Speak to a healthcare provider before travel if you are concerned
DISCLAIMER and Hold Harmless Disclaimer: LSDS™ gathers information from multiple sources and offers insight and perspective to travelers. Sources cannot be validated for accuracy in every instance. Travelers assume all risk associated with their travel and are responsible for the decisions associated with travel and for their own safety. Users of this reference document agree, to hold harmless LSDS™ (LLC) its employees and clients associated with any risk or injury incurred during travel.
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