Auburn University virologist provides information about monkeypox

Cases of monkeypox, a viral illness, have been reported in Europe and North America, in addition to areas where it normally occurs in Central and Western Africa. Dr. Constantinos Kyriakis, an assistant professor in the Department of Pathobiology in Auburn University’s College of Veterinary Medicine, provides information about the illness.

What is monkeypox?

Monkeypox is an infectious disease caused by monkeypox virus in rodents, non-human primates and occasionally humans in Central and Western Africa. The virus was first identified in 1958 in a monkey colony in Denmark and the first human cases were found in 1970 in the Democratic Republic of Congo. The virus causing the disease is a “cousin” of smallpox virus, one of the most important pathogens in human history, which was eradicated following a massive vaccination campaign by the World Health Organization (WHO) in 1980.

Does it affect humans and animals?

Rodents are considered the reservoir of the virus, which would then spill-over to monkeys and subsequently to humans following direct contact with a monkey. Up to a few hundred cases in humans are recorded annually in Africa, most of which can be traced back to an exposure to infected animals or animal products. Until recently, very few cases were recorded outside Africa, exclusively in people who had previously traveled to endemic areas. Typically, incubation lasts between 10 and 21 days. Initial symptoms include fever, headache, fatigue, muscle pain and swollen lymphnodes, followed a few days later by the formation of blisters, which are typical of the disease. In Africa, the disease is characterized by high mortality in immunocompromised individuals, as well as young children and pregnant women. So far, no deaths have been reported in the current oubreak in Europe and North America.

How is it spread?

Until the current outbreak, human-to-human transmission was considered rare. This is the first time that community transmission of monkeypox is recorded outside Africa. The virus can spread by close contact with the infected individual or contact with materials or surfaces used by infected individuals. This does not completely exclude the possibility of transmission via respiratory droplets. The consensus of both the U.S. and European Centers for Disease Control (CDC) is that currently the risk to the general public is low.

Where is the current outbreak?

As of May 25, 2022, a total of 235 cases have been confirmed in Europe and North America. Most cases have been identified in the United Kingdom (71), Spain (51) and Portugal (49). Fifteen cases have been confirmed in Canada, with another 16 cases under investigation and two cases have been confirmed in the U.S. A small number of cases has also been confirmed in Australia (2), Austria (1), Belgium (6), the Czech Republic (1), Denmark (2), Finland (1), France (5), Germany (5), Israel (1), Italy (6), the Netherlands (12), Slovenia (1), Sweden (1), Switzerland (2) and the United Arab Emirates (1).

Is there a vaccine against it? Precautions?

Vaccination against smallpox can provide protection against infection with monkeypox. However, individuals born after 1980, when smallpox was eradicated, are not vaccinated, thus they are more susceptible to infection with monkeypox. In 2019, the Food and Drug Administration (FDA) approved a live, non-replicating vaccine against smallpox and monkeypox. The vaccine was designed for administration to those determined to be a high risk of exposure to the virus. It is also part of the Strategic National Stockpile (SNS), the largest supply of potentially life-saving pharmaceuticals and medical supplies for use in the case of a public health emergency. As of May 24, 2022, the U.S. released 1,000 doses of the monkeypox vaccine from the SNS. As we all learned during the SARS-CoV-2 pandemic, good hygiene practices can reduce virus transmission. These include hand washing and the use of hand sanitizer.

Is there a treatment?

In the U.S. and Europe, an antiviral drug, tecovirimat, is approved for the treatment of poxvirus infections, including monkeypox. Another antiviral drug, brincidofovir, approved for the treatment of smallpox, is also available. These antiviral drugs can be administered in severe cases of infection, in combination with supportive care.

About Dr. Constantinos Kyriakis:

Dr. Constantinos Kyriakis is an assistant professor in the Department of Pathobiology in Auburn University’s College of Veterinary Medicine. His research focuses on human and animal diseases, including the mechanism of interspecies transmission, novel vaccine technologies and animal models of viral disease pathogenesis and prevention. He is also an affiliated faculty member at the Center for Vaccines and Immunology at the University of Georgia. He received his Doctor of Veterinary Medicine degree from the Aristotle University of Thessaloniki in Macedonia, Greece, in 2004 and his doctorate in virology and vaccinology from the Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Belgium, in 2009.