Since May, the Centers for Disease Control and Prevention has been tracking a monkeypox outbreak in the United States. More than 100 cases have been confirmed in Indiana since then, with thousands more across the United States.
We asked Graham McKeen, Indiana University’s director of public and environmental health, some common questions about monkeypox and what members of the university community need to be aware of.
Question: What is monkeypox?
Answer: Monkeypox is a disease caused by infection with the monkeypox virus. It’s part of the same family of viruses as variola virus, which causes smallpox.
Monkeypox symptoms are similar to smallpox symptoms, but less severe, and this particular clade of monkeypox is rarely fatal. We’re seeing just a fraction of a percent mortality rate globally right now, thankfully.
It is not related to chickenpox, which is a varicella zoster and part of the herpes family of viruses. Monkeypox is an orthopox virus. There are actually a number of other orthopox viruses with names like cowpox, raccoonpox, camelpox and dolphinpox.
Q: How does monkeypox spread?
A: Monkeypox generally does not spread easily between people without close contact (e.g., direct physical contact with the infectious rash, including during intimate contact such as kissing, cuddling, sex or prolonged face-to-face contact), the touching of contaminated objects or contact with respiratory secretions. It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.
The risk of contracting monkeypox is low for those who have been in casual, rather than close, contact with an infected individual (e.g., being in the same room). No deaths have been linked to this outbreak in the United States at this time.
Q: What are the symptoms of monkeypox?
A: Symptoms can include fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, and a rash that can look like pimples or blisters that may appear on the face, inside the mouth, and/or on other parts of the body, like the hands, feet, chest, genitals or anus. Some people will have the flu-like symptoms before the rash, while others will get the rash first and then other symptoms. Others will only experience a rash.
The illness typically lasts two to four weeks, and someone is considered infectious with monkeypox from the onset of symptoms, until their rash has fully healed and a fresh layer of skin has formed.
Q: Is there anything I can do to lower the risk I might contract monkeypox?
A: Yes, these are several steps you can take, including:
Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
Do not touch the rash or scabs of a person with monkeypox.
Do not kiss, hug, cuddle or have sex with someone with monkeypox.
Do not share eating utensils or cups with a person with monkeypox.
Do not handle or touch the bedding, towels or clothing of a person with monkeypox.
Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
Q: What do I do if I think I have monkeypox or have been exposed?
A: If you develop symptoms consistent with monkeypox and/or have a new and unexplained rash, isolate away from people and animals and contact your campus student health center or your primary care physician to discuss evaluation and testing. Call your provider first rather than walking in.
Avoid close contact and sharing items with others until you can be evaluated by a provider. Wear a mask and cover any open lesions for your appointment.
If you’ve been exposed to monkeypox and are a close contact, you do not have to quarantine. You can continue to go to work and school as long as you do not have any symptoms. In coordination with their local health department, close contacts will monitor their health for 21 days following exposure and should check their temperature twice a day.
If you develop any symptoms, get tested. Depending on the degree of contact, some close contacts may be advised to get post-exposure prophylaxis (most likely the Jynneos vaccine), which may prevent you from developing an infection or at least lessen symptoms if you do become infected.
Q: What treatments are available for monkeypox?
A: We are fortunate to have both a vaccine that’s effective against monkeypox as well as an antiviral medication to help treat infection. For those in a high-risk group, there are opportunities to be vaccinated in Indiana. You can pre-register through the Indiana Department of Health to be notified of vaccine clinics in your area.
Q: What is IU doing about monkeypox?
A: Indiana University is closely following the monkeypox outbreak and is coordinating with local health departments as well as the Indiana Department of Health. We’ve also spent a lot of time developing internal public health guidance, continuing surveillance and coordinating with our on-campus student health centers in regard to clinical presentation and testing.
Education is also extremely important, so we’ve been working closely with on-campus housing, housed student organizations, LGBTQ+ centers, dining, custodians and housekeepers to share information on general cleaning and disinfection procedures, isolation, and general awareness about monkeypox.
Protect IU has also launched a page that contains information and frequently asked questions. That site will be updated if the outbreak should impact the university and its multiple campuses across the state.