This summer, the World Health Organization declared monkeypox a global health emergency, the first since COVID-19 . Beginning in May 2022, medical professionals began identifying cases of monkeypox in non-endemic countries, leading us to the current outbreak. To date, more than 63,000 cases have been recorded in countries that have not historically reported monkeypox .
Unlike the SARS-CoV-2 virus, monkeypox is not totally unfamiliar to medical professionals and the life sciences community. In fact, the first case of monkeypox in humans was reported in 1970, and since then outbreaks have occurred across 11 countries in Africa . The monkeypox virus belongs to the orthopox family of viruses that also includes smallpox, cowpox, and vaccinia. Presenting first with flu-like symptoms followed by a rash, monkeypox has been recognized as the orthopoxvirus of greatest concern for global public health since smallpox’s eradication . Although several countries impacted by the 2022 outbreak have previously reported sporadic cases related to travel and imported animals, this is the first-time cases and sustained chains of transmission have been reported outside endemic countries.
In the aftermath of the Biden administration declaring monkeypox a public health emergency, we sat down with Dr. Manoj Gandhi, Senior Medical Director of Genetic Testing Solutions at Thermo Fisher Scientific, to discuss some of the most common questions, concerns, and misconceptions surrounding monkeypox.
Q. Can you describe the symptoms of monkeypox?
The most obvious symptom of monkeypox is a rash, which usually begins in the face before spreading to the rest of the body. Other common symptoms of monkeypox are flu-like symptoms that include fever, chills, headache, and fatigue . However, the symptoms can also include isolated lesions on a person’s private areas that can be mistaken for a sexually transmitted infection (STI).
Q: Who can be infected with the monkeypox virus? How is it transmitted?
Although most current monkeypox cases have involved men who have sex with men (MSM), it is not a sexually transmitted disease. It is also not a disease that is specific to the LGBTQIA+ community. Like many other diseases, especially poxviruses, monkeypox can spread through extended, close physical contact with an infected person. Any person who is exposed through close contact, including sexual contact, can contract the monkeypox virus .
According to the Centers for Disease Control and Prevention (CDC), monkeypox can survive on surfaces, including clothing and linens, for up to 15 days . To avoid contracting the virus and minimize spread, experts recommend properly disinfecting surfaces encountered by an infected person as well as practicing good hand hygiene .
Q: How is the monkeypox virus unique compared to other viruses?
In most viral infections, the body’s immune system generates cytokines that can defend against the virus. However, monkeypox seems to have specific genes that prevent the activation of these cytokines and inhibits our immune system .
Q: How accurate do you think currently reported case numbers are?
It is likely that there are many more cases than has been reported . This is probably because people may be shying away from getting tested because of a perceived stigma associated with the disease. We’re just seeing the tip of the iceberg.
Q. What would you say to patients who are feeling stigmatized based on current misconceptions around the virus?
As mentioned earlier, anyone can be exposed through prolonged close physical contact or contact with contaminated surfaces: this virus does not discriminate based on gender, race, age, ethnicity. The more we know about the virus, the less we’ll point to any single group. This will help expand the reach of testing, support effective quarantine measures, accelerate treatment and protect us all equally.
Q: What public health learnings from COVID-19 would you apply to monkeypox?
Increased vigilance is needed to control spread and prevent future pandemics. As we’ve seen with COVID-19, never assume that anything will probably not spread or become a public health emergency . Still, knowledge and efficiencies gained during COVID-19 have allowed us to respond more effectively to the current monkeypox outbreak, quickly securing approval for a test that could detect monkeypox. This is, in part, thanks to partnerships formed during COVID-19, including our efforts with collaborators, such as Joshua Arant at Mako Medical Laboratories, to help scale COVID-19 testing capacity. We were able to expand our partnership with them for monkeypox, so they could implement a similar PCR workflow as for SARS-COV-2 to evaluate their monkeypox samples .
Q. When it comes to building a robust testing strategy for monkeypox, what are the next steps?
We in the field of molecular diagnostics know that by testing and getting these tests out in the field, and giving labs the ability to test, is one way to contain the spread . It’s important that we continue to apply our COVID-19 learnings. This includes expanding testing across many more labs to ensure capacity is readily available, particularly if cases continue to rise globally. Testing can also be made available at the point-of-care, at STI clinics, for example, so patients can quickly test, get diagnosed and quarantine if infected. Making at-home testing available will also expand testing capacity and improve quarantine measures.
For information on Thermo Fisher’s TaqMan Monkeypox Virus Microbe Detection Assay*, available for research-use purposes only, please visit: https://www.thermofisher.com/blog/ask-a-scientist/monkeypox-virus-surge-and-public-health-laboratories/
*For research use only. Not for use in diagnostic procedures.
- CNBC | WHO declares rapidly spreading monkeypox outbreak a global health emergency
- Centers for Disease Control and Prevention | 2022 Monkeypox Outbreak Global Map
- World Health Organization | Monkeypox
- Frontiers in Public Health | Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans
- Centers for Disease Control and Prevention | Disinfecting Home and Other Non-Healthcare Settings
- Laboratory Economics, vol 17, no 8, August 2022.