Monkeypox Fact Sheet
What is Monkeypox?
Monkeypox is a viral infection caused by the monkeypox virus, an orthopoxvirus similar to the smallpox virus. It is a zoonotic disease with an unknown animal reservoir, although small mammals (such as rodents) are also suspected to be involved. In addition to the virus being spread from animals to humans, it is also capable of directly spreading from human to human. Monkeypox is endemic in several West and Central African countries, with occasional small outbreaks observed in these regions. Prior to the current monkeypox epidemic, only rare importations of monkeypox cases have been observed outside of these endemic regions.
Cases have now been identified in close to 90 countries globally, most of which have not had Monkeypox previously reported1.
Monkeypox has an average incubation period of 6 to 13 days (range from 5 to 21 days), and the illness and the infectious period last from 14 to 16 weeks2.
How is Monkeypox transmitted?
Animal to human transmission occur when infected animals bite or scratch humans. The virus can also transmit when in direct contact with bodily fluids of infected animals, or through preparation/consumption of infected bushmeat3.
Human to human transmission of monkeypox primarily occurs through close, prolonged contact with infected individuals during the infectious period. It spreads primarily through direct contact with body fluids – particularly secretions from fluid contained in pustules that form on the skin of infected individuals.
Transmission may also take place through respiratory secretions, and indirect contact through surfaces that have been contaminated with viral particles from infectious lesions. It can also spread vertically from mother to foetus3.
Who is at risk?
Anybody is at risk to be infected with Monkeypox, but the elderly, young children or immunocompromised individuals are at a higher risk. The current epidemic is largely among men who have sex with men – who constitute close to 98% of reported cases4, likely due to close social networks. While it is not considered a sexually transmitted disease per se, the close contact that occurs during sexual activity has driven the 2022 global pandemic.
However, the general advisory for everyone who came into contact with persons with Monkeypox or showing symptoms of Monkeypox remains the same.
What are the symptoms of Monkeypox?
Monkeypox disease begins with symptoms such as fever, malaise, weakness, headache, swollen lymph nodes and chills. This is followed by the development of a characteristic rash or pustules that can be found on the face, palms of the hands, soles of the feet, eyes, mouth, throat, genitalia and/or anal regions of the body.
The rash begins as flat lesions, then grow into pustules (i.e. vesicles filled with fluid) and finally crusts over and dries up. Infected individuals remain infectious until all lesions have crusted and scabs have fallen off5.
Most cases of Monkeypox are mild and self-limiting. However, in certain segments of the population, e.g., extremes of age groups, and immunocompromised individuals, it can lead to severe disease or death. Mortality rate for the current Monkeypox epidemic is around 3-6%2.
What is the treatment for Monkeypox?
Monkeypox symptoms usually resolve by themselves without treatment. However, symptomatic treatment can be given to patients to relieve pain (analgesics), itchiness (antihistamines) and fever (antipyretics). Patients are advised not to scratch the lesions and keep them dry when not showering and bathing to prevent secondary infection. They also should avoid physical contact with others to reduce the spread of the disease. Staying hydrated with a well-balanced diet and enough sleep will aid in recovery.
An antiviral called tecovirimat is sometimes given to high-risk or immunocompromised patients6.
How do I protect myself and others from Monkeypox?
You can reduce your risk of getting infected by avoiding or limiting physical contact with people who have suspected or confirmed Monkeypox, or animals who could be infected. Limiting contact with indirect lesion materials such as bedding, towels or clothing of infected individuals will also reduce the risk of infection.
Having awareness of the disease occurrence in your area and helping propagate accurate information about Monkeypox will also help to protect yourself and others. More information on Monkeypox situation updates and FAQ can be found at: https://www.moh.gov.sg/diseases-updates/monkeypox
Is there a vaccine for Monkeypox?
A live, attenuated modified vaccinia virus (Ankara strain) is approved against Monkeypox since 2019. Marketed under the name JYNNEOS (US), IMVANEX (EU) and IMVAMUNE (Canada), is a two-dose, subcutaneously delivered vaccine but is currently limited in availability due to low global stocks7.
An older generation smallpox vaccine, known as ACAM2000 is also approved for vaccination against Monkeypox. However, the incidence of side effects is higher, and it is not recommended for immunocompromised individuals8.
At the moment, Monkeypox vaccines are only recommended for high-risk individuals, post-exposure individuals and healthcare or public health workers8.
What do I do if I suspect I have Monkeypox?
If you suspect you have close contact with someone with Monkeypox, monitor yourself closely for symptoms over the next 21 days from the day you were exposed. Avoid physical contact with other individuals and if possible, isolate yourself.
If you suspect you have symptoms of Monkeypox, seek medical attention immediately to confirm the diagnosis, as Monkeypox is a notifiable disease. Follow the instructions of your healthcare provider. Your healthcare provider will test for Monkeypox and initiate the proper treatment and notification process.
- Centers for Disease Control and Prevention. (2022, August 12). 2022 Monkeypox Outbreak Global Map. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
- World Health Organization. (2022, May 19). Monkeypox. World Health Organization. Retrieved August 15, 2022, from https://www.who.int/news-room/fact-sheets/detail/monkeypox
- Centers for Disease Control and Prevention. (2022, July 29). How it spreads. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/transmission.html
- Thornhill, J. P., Barkati, S., Walmsley, S., Rockstroh, J., Antinori, A., Harrison, L. B., Palich, R., Nori, A., Reeves, I., Habibi, M. S., Apea, V., Boesecke, C., Vandekerckhove, L., Yakubovsky, M., Sendagorta, E., Blanco, J. L., Florence, E., Moschese, D., Maltez, F. M., … Orkin, C. M. (2022). Monkeypox virus infection in humans across 16 countries — April–June 2022. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2207323
- Centers for Disease Control and Prevention. (2022, August 5). Signs and symptoms. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/symptoms.html
- Centers for Disease Control and Prevention. (2022, August 10). Treatment. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/treatment.html
- Centers for Disease Control and Prevention. (2022, August 9). Interim clinical considerations for use of JYNNEOS and Acam2000 vaccines during the 2022 U.S. monkeypox outbreak. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html
- Centers for Disease Control and Prevention. (2022, August 5). Vaccines. Centers for Disease Control and Prevention. Retrieved August 15, 2022, from https://www.cdc.gov/poxvirus/monkeypox/vaccines.html