What Monkeypox Treatment Options Are Available?

On July 23, 2022, the World Health Organization declared monkeypox a public health emergency of international concern. As of August 1, 2022, the Centers for Disease Control and Prevention (CDC) website reported over 5,800 confirmed cases of monkeypox in the United States. What is monkeypox? And what options do doctors have for treating monkeypox infections? Please continue reading to find out more.

What is monkeypox?

Monkeypox is a rare disease caused by the monkeypox virus. This virus belongs to the same family of viruses (orthopoxviruses) that cause human smallpox disease. Monkeypox is not related to chickenpox.

While monkeypox is usually endemic to certain countries in Central Africa and West Africa, there has been a worldwide monkeypox outbreak in 2022. The CDC is monitoring emerging infections in the US as the global monkeypox outbreak continues.

How does monkeypox spread?

Monkeypox spreads through close, skin-to-skin contact. This includes direct contact with the rash or scabs in monkeypox patients. It also spreads through exposure to an infected person’s respiratory secretions and bodily fluids. Monkeypox can spread by touching objects contaminated by the virus (objects that someone with monkeypox has touched). Besides person-to-person spread, the virus can also spread from animals to humans. Rodents and primates (monkeys) are some of the animal hosts of this virus.

What are monkeypox symptoms?

A monkeypox infection causes symptoms similar to smallpox but milder. Most people with a monkeypox virus infection will develop a rash on the genitals (labia, vagina, penis, testicles, and anus). Monkeypox skin lesions can also be present in the mouth and on the face, chest, hands, and feet. The monkeypox rash can be painful and itchy. It goes through several stages before it finally scabs over and heals.

Other symptoms of a monkeypox infection include flu-like symptoms such as fever, chills, headache, muscle aches, swollen lymph nodes, tiredness, and upper respiratory symptoms like sore throat, cough, and nasal congestion.

The illness usually lasts two to four weeks. A person remains contagious until the scabs heal. Human monkeypox infection is rarely fatal.

What is the treatment for monkeypox?

Most people recover from monkeypox without any specific treatment other than supportive care, including rest, hydration, and over-the-counter medications for fever and pain.

However, it is important to seek care from a healthcare provider if you suspect you might have monkeypox, even if you don’t think you’ve been in contact with anyone who has monkeypox. Your primary care provider may refer you to an infectious disease expert if required.

What antiviral drugs are used for monkeypox?

There are no specific antiviral drugs for the treatment of monkeypox. However, as mentioned, the virus that causes monkeypox is very similar to the smallpox virus. Therefore, health care personnel can use antiviral medications developed to treat smallpox and other viral illnesses to treat people with severe cases of monkeypox.

People with severe disease or those with weakened immune systems may be given an antiviral medication such as:

Tecovirimat (TPOXX)
Cidofovir (Vistide)
Brincidofovir (CMX001 or Tembexa)

A plasma product called vaccinia immune globulin intravenous (VIGIV), which is used to treat skin conditions, is also sometimes used to treat infectious diseases like monkeypox.

It is worth noting that there is currently no data from clinical trials on the effectiveness of these antiviral drugs and treatments for human monkeypox. However, the CDC is holding an expanded access protocol and strategic national stockpile. These measures will allow the use of antiviral medications in the event of a more widespread outbreak of monkeypox in the US.

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Does monkeypox have a cure?

There is no cure for monkeypox. However, some antiviral drugs can be used to treat monkeypox. The disease is rarely fatal.

When will monkeypox vaccines be available?

Two vaccines are available for preventing monkeypox. A new vaccine called JYNNEOS (Imvanex or Imvamune) has been approved by the United States Food and Drug Administration (FDA) to prevent monkeypox virus infection. The immune response takes 14 days to develop after the second dose of the JYNNEOS monkeypox vaccine.

Another vaccine called ACAM2000, which is approved by the FDA for smallpox vaccination, is being made available for use against monkeypox. The maximum immune response develops 4 weeks after a dose of this smallpox vaccine. The ACAM2000 vaccine cannot be used in everyone, however. People with a weakened immune system, those with exfoliative skin conditions like eczema, and pregnant women should not be given ACAM2000.

Are monkeypox vaccines effective?

There is no data available as yet on whether the monkeypox vaccine is effective in infection prevention. The smallpox vaccine may be effective, but data from field settings is limited. More information will become rapidly available if the current outbreak continues.

Do I need to get the monkeypox vaccine?

Mass vaccination for monkeypox is not recommended at the current time. Infectious disease experts are recommending vaccination only for high-risk persons, such as those who live with or have been in close contact with people infected with monkeypox.

Also, people who have regular contact with animals are at greater risk, as are healthcare workers who provide medical care to monkeypox patients.

Vulnerable populations also include pediatric patients, especially newborn infants and young children who may be at higher risk of more serious monkeypox symptoms.

People born before 1980 who were vaccinated against smallpox may have some protection against monkeypox. However, even if you were vaccinated against smallpox, you should continue to take precautions to protect yourself and others from monkeypox.

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How can I protect myself and others from monkeypox?

Avoid close contact, including skin-to-skin contact and intimate contact with anyone who is suspected or has a confirmed monkeypox infection.
Wash your hands frequently or use an alcohol-based hand sanitizer.
Clean and disinfect all objects that the virus may have contaminated.
Seek medical advice if you suspect you may have symptoms of monkeypox.
Isolate from others if you suspect monkeypox (until you test negative).
If you have confirmed monkeypox, isolate yourself from others until all your skin lesions have scabbed over and healed and a new layer of skin has formed underneath.

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