New monkeypox symptoms differ from previous outbreaks: Here’s what to look for

With more than 22,000 confirmed cases worldwide, the World Health Organization has declared the current outbreak of monkeypox a global health emergency. As of July 28, there were nearly 5,000 cases reported in the United States alone, according to the US Centers for Disease Control and Prevention.

Monkeypox has been endemic to West and Central Africa for years. But its spread in 2022 to dozens of normally underreported countries – most notably the US, UK and Spain – worries public health officials. This is especially true where monkeypox appears somewhat differently than in previous outbreaks, including painful rashes, blisters, and open sores.

Currently, most cases in the United States are among men who sleep with men, although health officials are clear that anyone can get monkeypox through close skin contact.

Here are the symptoms to look for, including early signs of monkeypox and how the current outbreak looks different from its predecessors. For more information, read about monkeypox testing, transmission, and treatment.

What is monkeypox?

Monkeypox is a virus in the same family as the smallpox virus, which causes smallpox, although it is milder and is rarely fatal.

It was first identified in laboratory monkeys in 1958, and the first documented cases in humans were in 1970, among six children in central Africa. Today, monkeypox is an endemic disease in parts of central and western Africa, particularly the Democratic Republic of the Congo.

Monkeypox virus particle under a microscope.

Smith Group / Gado / Getty Images

Initially, transmission mostly came from animal contact, but by 1996, the majority of cases in the Congo outbreak were from human contact. The first reported cases of monkeypox in the United States were in 2003, all again linked to infected prairie dogs.

Mortality rates are very low, between 1% and 10%, and deaths usually occur in young children and those with weakened immune systems due to HIV.

What are the early signs of monkeypox?

While many people won’t realize they have monkeypox until the rash appears, some early signs can include flu-like symptoms:

  • Fever
  • Headache
  • exhaustion
  • Sore throat
  • muscle soreness
  • Swollen lymph nodes.

Symptoms of monkeypox are similar to those of smallpox, but are usually milder, which was declared eradicated by the World Health Organization in 1980.

What are the symptoms of monkeypox disease?

Monkeypox can appear as a rash or individual sores that look like pimples or blisters and can appear almost anywhere on the body, including the hands, face, chest, groin, inside the mouth or anus.

Lesions can be flat or raised, filled with a clear or yellowish fluid, and eventually dry and fall off.

How do current monkeypox symptoms differ from previous outbreaks?

Historically, after reporting flu-like symptoms, “a characteristic rash often appears on multiple sides of the body, often on the face, arms and hands,” Rochelle Wallinsky, director of the Centers for Disease Control and Prevention, said in a June briefing.

But in more recent cases in the West, some patients have developed a localized rash – often around the genitals or anus – which is very painful. Others develop pimple-like blisters or pimples rather than a diffuse rash. Flu symptoms may never appear.

Blisters on the hands of a monkeypox patient
The appearance of blisters on the hands of a patient with monkeypox.

Courtesy of CDC/Getty Images

Some patients in the United States have reported proctitis, a painful inflammation of the lining of the rectum that can cause diarrhea, bleeding, and discharge, according to the Mayo Clinic, as well as a constant feeling of needing to use the bathroom.

The Centers for Disease Control and Prevention (CDC) has warned that a different presentation can cause monkeypox to be misdiagnosed or miss entirely.

Read more: How do I get the monkeypox vaccine?

How long do monkeypox symptoms last?

The illness typically lasts two to four weeks, although the incubation period ranges from five to 21 days, according to the CDC. This means that people will most likely develop symptoms within three weeks of exposure.

Unlike COVID-19, it is generally understood that monkeypox is not contagious during the incubation period. In general, monkeypox can spread until the sores have healed and a new layer of skin has formed.

Transmission can occur by direct skin-to-skin contact with lesions, rashes, scabs, or fluids. It can also be transmitted by touching surfaces, clothing, or other objects that an infected person uses.

Contact with respiratory secretions can also spread the virus, although it is not yet known whether transmission can occur via semen or vaginal fluid.

The information in this article is for educational and informational purposes only and is not intended to provide health or medical advice. Always consult a physician or other qualified healthcare provider with any questions you may have about a medical condition or health goals.

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