Monkeypox Treatments – Medical News Bulletin

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An abstract representation of the monkeypox virus.

Monkeypox is a virus within the Poxviridae family. Monkeypox has clinical presentations similar to smallpox, though usually with a much smaller fatality rate (~10%).1 In 1958, the monkeypox virus was first identified in monkeys transported from Africa to Denmark. 

The virus has been documented in other mammals, misleading the name monkeypox.2 The first human case was in 1970 in the Democratic Republic of the Congo. 

Monkeypox outbreaks

Before the eradication of smallpox in the 1970s, the smallpox vaccine provided some protection from the monkeypox virus. Once the smallpox vaccine was no longer given, monkeypox cases became prevalent.1

Cases were found in 11 different African countries before the 2000s and with the reach since being reported in previously untouched regions.3 As of October 7, 2022, there were over 71,000 confirmed monkeypox cases worldwide.4

What are the symptoms of monkeypox?

Monkeypox can initially start with nonspecific symptoms such as fever, chills, headache, fatigue, sore throat, muscle pain, and swollen lymph nodes.2 Within the first week of infection, a rash appears but usually resolves over 2-4 weeks.2

The approximate stages of a monkeypox rash are as follows: 2

  • Within 1-2 days of infection, a flat, distinct, and discoloured area of skin appears.
  • During days 2-4 of infection, the discoloured areas develop into small raised bumps appearing red, purple, brown, or pink colour.
  • 1-2 days following transformation to bumps is the development of blisters. 
  • The blisters continue to grow for 5-7 days into almost ‘pea-size’ lesions.
  • Finally, around 7-14 days, the lesions crust, scab, and eventually fall off.

Depending on the individual, other serious complications can also arise. These complications may be secondary infections, sepsis and septic shock, respiratory distress, and pneumonia.1

What are the treatments for monkeypox?

Currently, there are no treatment guidelines for monkeypox. Most individuals will recover without the need for extensive medical treatment.3 Antivirals are available for emergency use for individuals with compromised immune systems, although the drugs were initially approved for managing smallpox.5 Additional antivirals specific to monkeypox treatments require the patient to be enrolled in a clinical study.6

Conclusions

The monkeypox virus causes a disease similar to smallpox but is far less severe. The symptoms of monkeypox can range from nonspecific to the development of a rash. While some antiviral treatments are available for managing the effects of monkeypox, no official monkeypox treatment guidelines exist, as most will recover with minimal medical treatment.

References

1. Kaler J, Hussain A, Flores G, Kheiri S, and Desrosiers D. Monkeypox: A comprehensive review of transmission, pathogenesis, and manifestation. Cureus. 2022; 14(7): e26531. doi:10.7759/cureus.26531

2. Bryer J, Freeman EE, and Rosenbach M. Monkeypox emerges on a global scale: A historical review and dermatologic primer. Journal of the American Academy of Dermatology. 2022; doi.org/10.1016/j.jaad.2022.07.007

3. Monkeypox. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/monkeypox. Published May 19, 2022. Accessed October 10, 2022. 

4. 2022 Monkeypox Outbreak Global Map. Centers for Disease Control and Prevention. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Published August 4, 2022. Accessed October 10, 2022. 

5. Rizk JG, Lippi G, Henry BM, Fothal DN, Rizk Y. Prevention and treatment of monkeypox. Drugs. 2022; 82:957-963; doi.org/10.1007/s40265-022-01742-y

6. Looi MK. Monkeypox: what we know about the 2022 outbreak so far. The BMJ. 2022; 378:o2058. https://www.bmj.com/content/378/bmj.o2058





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