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Monkeypox Has Arrived in King County

Here's why we don't need to panic—yet.

By Angela Cabotaje May 24, 2022

Here are two words you never wanted to hear again: new outbreak. On May 23, Public Health—Seattle and King County reported a presumptive case of monkeypox, the first in the state (that has since been confirmed). But before you head to Costco to stock up on N95s and beans, here's what you need to know.

What is monkeypox?

Monkeypox is a rare disease caused by the monkeypox virus, which belongs to the same Orthopoxvirus genus as viruses like smallpox and cowpox. There are two distinct clades: central African (Congo Basin) and west African, with the Congo Basin version being more transmissible and responsible for more severe disease. The incubation period is usually between seven and 14 days but can be as high as 21 days.

What are the symptoms of monkeypox?

Just like Covid and the flu, monkeypox can begin with symptoms like fever, headache, muscle aches, chills, exhaustion, and swollen lymph nodes. Then things start to get markedly different.

Within about one to three days of the fever, sometimes more, a rash appears—usually starting on the face before spreading to the rest of the body but sometimes concentrated in the groin area. The rash progresses through sores, bumps, and fluid-filled bumps before scabbing over. 

A typical bout of monkeypox can last from two to four weeks and, according to the World Health Organization, is fatal anywhere from 3 to 6 percent of the time.

How is monkeypox transmitted?

Monkeypox is typically transmitted through respiratory droplets (sound familiar?) but can sometimes be passed on through direct physical contact with lesions, bodily fluids, or contaminated surfaces.

So what's the status of the new monkeypox outbreak?

When King County reported the first presumptive case, it was just the fifth confirmed or presumptive case in the United States. Five other cases have since surfaced in the country. So far there have been around 200 confirmed or suspected cases in 20 different countries, most in the United Kingdom and Europe. 

Early data shows a majority of cases are being reported by men who have sex with men, with two raves in Spain and Belgium suspected as the initial locations of the outbreak. It's still unclear if monkeypox was spread through sexual transmission or simply through sustained proximity to infected individuals.

Do we need to start stockpiling toilet paper again?

No need to bust out the bidets just yet. King County public health officer Dr. Jeffrey Duchin tweeted a day before the suspected case was reported, "Would not be surprised if we find cases locally, but would not expect widespread transmission."

That's because monkeypox does not spread through the air like Covid does. Prolonged proximity or direct physical contact are necessary for transmission. A majority of cases are mild and do not require hospitalization, plus we already have a smallpox vaccine and related antiviral drugs that can help prevent or mitigate the effects of monkeypox. Fingers crossed things stay that way.

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