Monkeypox treatment information available online today

Animal to human transmission

A human can get the monkeypox virus from infected wild animals in the following manners:

• Scratched/bitten by the infected animal

• Close contact with the infected animals

• Consuming meat of the infected animals

Human to human transmission

Monkeypox human to human infection can happen via direct or indirect contacts. For transmission through close contact, the virus can pass from an infected person to the next person by directly coming into contact with the monkeypox rash, scabs, or bodily fluids. Such close physical contact can take place during:

• Hugging, massage, and kissing

• Oral, anal, and vaginal sex or touching the genitals

• Breathing in the respiratory droplets of the infected person (when the person coughs or sneezes)

• Touching/sharing the same objects, fabrics (clothing, towels) as the infected person

• According to the Centers for Disease Control and Prevention (CDC), a pregnant person can spread the virus to their baby.

Monkeypox symptoms begin within 3 weeks of exposure to the monkeypox virus. The symptom progression may vary from person to person. Some people get a rash first, followed by other symptoms, while others only get the rash. The typical initial symptoms of monkeypox are flu like symptoms, including:

• Fever

• Chills

• Headache

• Swollen lymph nodes

• Exhaustion

• Muscle aches and backaches

• Respiratory symptoms (e.g. nasal congestion, or cough)

These early symptoms are then followed by the characteristic rash that may be located on or near.

• Genitals (penis, testicles, labia, and vagina) or anus (butthole)

• Extremities such as hands and feet

• Chest

• Face or mouth

The rash can then develop into skin lesions, mucosal lesions, scabs, before healing.

Tecovirimat (TPOXX, ST-246)

TPOXX is an FDA approved antiviral medication that treats smallpox in adults and children. Tecovirimat is available as a pill or an injection.

Vaccinia Immune Globulin Intravenous (VIGIV)

VIGIV is used to treat complications due to vaccinia vaccination including eczema vaccinatum, progressive vaccinia, etc. According to CDC, VIGIV may be used as treatment of orthopoxviruses (including monkeypox) in an outbreak. VIGIV can also be used as PEP in immunocompromised when Jynneos/ACAM200 is contraindicated.

Cidofovir (Vistide)

Vistide is an FDA approved antiviral medication for treating cytomegalovirus (CMV) retinitis in patients with Acquired Immunodeficiency Syndrome (AIDS). However, it has shown to be effective against orthopoxviruses in studies. Vistide is administered via a one-hour IV infusion weekly, for two consecutive weeks. Vistide has been used in pediatric and adult populations. It is limited by nephrotoxicity and risk of neutropenia, as well as carcinogenic, teratogenic and hypospermia risk profile. Vistide is stockpiled and available from the federal government to dispense to states.

Brincidofovir (CMX001 or Tembexa)

CMX001 is an FDA approved antiviral medication treating human smallpox CMX001 is a two-dose oral antiviral FDA approved for smallpox treatment for all ages (neonate to adult). It is dosed weekly for two consecutive weeks. CMX001 is not yet available in the US from the Strategic National Stockpile (SNS).

Other conditions may appear with symptoms that look very similar to the rashes caused by Monkeypox. These other rash illnesses include:

Smallpox - a highly contagious disease that is caused by the variola virus

Chickenpox - a milder form of the same virus that causes shingles

Both of these diseases can be prevented with vaccines. (The smallpox vaccine is no longer given in the United States because the disease has been eradicated.)