Monkeypox in Florida: Are your skin lesions monkeypox or chickenpox?

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Monkeypox has now spread to at least 75 countries with over 5,000 cases in the United States and 442 cases in Florida as of July 31, according to the Florida Department of Health.

That’s an increase of 169 probable or confirmed monkeypox cases here in one week, mostly from Broward, Miami-Dade, Palm Beach, Orange and Pinellas counties, and a sharp rise from the first possible case here on May 22

On  July 22, the World Health Organization declared monkeypox a “public health emergency of international concern,” up there with COVID-19 and polio.

What is monkeypox? Should you be worried about it? How can you tell if you have it? We’ve got answers.

Monkeypox sightings around Florida:

What is monkeypox?

Monkeypox is a rare disease caused by infection with the monkeypox virus. It’s similar to smallpox (and from the same family of viruses) but it’s milder and rarely fatal. Monkeypox is not related to chickenpox.

Monkeypox occurs mostly in tropical rainforest areas in central and west Africa and is occasionally found in other regions from travelers.

Is monkeypox fatal? Is there a cure?

Currently, there is no proven, safe treatment for monkeypox, although there is a vaccine and antiviral drugs approved by the FDA to treat smallpox may be considered for emergency treatment for monkeypox.

According to the World Health Organization, the case fatality ratio has been around 3-6% in recent times. People most likely to develop severe forms of the disease are children younger than 8, people with eczema, the very old and those with compromised immune systems.

Monkeypox can, however, be extremely painful. The lesions can cause severe pain, both persistently, and, depending on the location, when using the bathroom or eating.

‘Bursts of sharp jabbing pain’: What it’s like to have monkeypox – and the fight against stigma

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Complications of monkeypox can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision.

What are the symptoms of monkeypox?

Fever, headache, muscle and back aches, swollen lymph nodes, chills, exhaustion, sore throat, nasal congestion, cough, and a rash of painful, itchy lesions often starting on the face and then spreading to other parts of the body such as on or near the genitals or anus, the hands, feet, and chest.

Most people with monkeypox will get a rash, some get other symptoms later or not at all.

Addressing myths about monkeypox: A look at symptoms, treatment and other common questions

What does monkeypox look like?

The rash usually begins within a few days of a fever, although in this latest outbreak the rash has been spotted first, said Dr. Marshall Glesby, an infectious disease specialist at Weill Cornell Medicine and New York-Presbyterian. 

Once it arrives, the rash moves from simple lesions to slightly raised, firm lesions, to lesions filled with clear fluid, to pustules (lesions filled with yellowish fluid), and then the lesions crust up and fall off. The number of lesions can range from a few to several thousand.

How can I tell the difference between measles, chickenpox and monkeypox?

It’s not easy. Chickenpox and monkeypox have been mistaken for each other and in some cases only medical tests will tell you which one.

The spread of the rash also may give you a clue. Monkeypox rashes often start on the face and spread elsewhere, usually one to five days after a fever. Chickenpox rashes tend to start on the chest, face and back, one to two days after a fever.

The biggest difference is that monkeypox can give you swollen lymph nodes and chickenpox does not. Testing will determine that for certain.

Measles rashes start at the hairline or forehead and spread down, and they look like flat red spots or slightly raised bumps, without fluid in them.  

How long does monkeypox last? How long is monkeypox contagious?

Symptoms usually begin within three weeks of exposure to the virus, according to the CDC. From the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed — usually about 2-4 weeks — you are contagious.

How is monkeypox transmitted and contracted?

Monkeypox is spread through close, personal contact, often skin-to-skin. That can include direct contact with the rash, scabs, bodily fluids or respiratory droplets from someone with the virus.

Monkeypox is not an STD, but it can be spread through oral, anal and vaginal sex or touching the genitals of a person with the virus. Also through hugging, kissing, massage, or prolonged face-to-face contact.

You cannot get monkeypox through casual contact (handshake, peck on the cheek) or a toilet seat.

It’s possible monkeypox may be transmitted by touching objects or fabrics (bedclothes, towels, clothing, sex toys) used by someone who is infected but there is no evidence anyone has caught it that way during this outbreak, Glesby said.

It’s also possible to get monkeypox from infected animals, from a bite, scratch or bodily fluids, primarily from rodents. In the last outbreak in 2003, people were infected after having contact with pet prairie dogs.

Arrival in the U.S.: First US case of monkeypox this year found in Massachusetts, confirmed by CDC

More: As monkeypox cases rise, health expert says travelers shouldn’t worry about casual contact

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Zoonotic diseases, like monkeypox and COVID-19, are on the rise

From monkeypox to COVID-19, zoonotic disease outbreaks are on the rise. Here’s how viruses spread from animals to humans.

Just the FAQs, USA TODAY

What do I do if I get a rash?

If you have a new or unexplained rash or other symptoms, avoid close contact with anyone until you can be checked out by a healthcare provider or local clinic. That includes sex or physical intimacy.

You may need to ask specifically for a monkeypox test, as some healthcare providers are still learning about this as well and may be unaware it’s spreading in the community.

Should I get vaccinated against monkeypox?

So far, those at highest risk for monkeypox in the 2022 outbreak are gay, bisexual or other men who have sex with men, health officials say. It’s also a danger for lab and medical personnel and any other people such as close family members of infected people who might be exposed to monkeypox. 

Monkeypox vaccines: How to get a vaccine against monkeypox in the US. Who should get one?

Where can I find the monkeypox vaccine near me? Who is eligible for the monkeypox vaccine?

There are two vaccines licensed by the FDA but one of them, ACAM2000, is not recommended for people with compromised immune systems or those who have close contact with them because it uses a live virus that can be transmissible. The safer vaccine, JYNNEOS or MVA, is not as widely available but the Biden administration has made more than 1.1 million doses of vaccine available, with 5.5 million more coming in 2023. It requires two doses, taken four weeks apart.

In Florida, vaccines are available through your county health department or healthcare providers who have received doses from the health department. Because of the scarcity of supplies, it is not available through local pharmacies such as CVS, Walgreens or Publix.

Does the smallpox vaccine protect against monkeypox?

If you are old enough that you received a smallpox vaccine before regular vaccination ended in the U.S. in the 1970s, you likely will still have some protection from monkeypox, experts say, but how much isn’t clear yet.

Should I be concerned about monkeypox?

You should remain aware of it, and pay attention to local media reporting and updates from the local and state Department of Health. 

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‘This is not a gay disease’: WHO expert weighs in on monkeypox stigma

Five Americans are likely infected with monkeypox, according to the CDC, warning that people might first mistake the infection for an STD.

USA TODAY

Is monkeypox a gay disease?

No. Although the latest outbreak came to public attention because of an apparent superspreader event among raves and bathhouses in Europe, the virus has probably been spreading and evolving in Nigeria for the past five years, according to Dr. Ali Khan, an epidemiologist and dean of the College of Public Health at the University of Nebraska Medical Center. Monkeypox can be transmitted through close or intimate contact between anyone of any sexual orientation. Two children in the U.S. in close contact with infected family members have been diagnosed with it.

Gay people should not be stigmatized just because the virus started circulating among men who have sex with men, said Dr. Mahdee Sobhanie, an infectious disease specialist at the Ohio State University Medical Center.

“Don’t think of this as a gay disease. It’s a disease that can occur through close contact,” he said.

Monkeypox is not a gay disease: But LGBTQ leaders say they need more help for gay men and everyone else

Contributor: Karen Weintraub, Mike Snyder, USA TODAY, Douglas Ray, Gainesville Sun

C. A. Bridges is a Digital Producer for the USA TODAY Network, working with multiple newsrooms across Florida. Local journalists work hard to keep you informed about the things you care about, and you can support them by subscribing to your local news organizationRead more articles by Chris here and follow him on Twitter at @cabridges

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