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What to know about monkeypox symptoms as the virus spreads in an unusual way across the US and Europe

A person with monkeypox holds out their hands, which are dotted with lesions.
A person with monkeypox in the Democratic Republic of the Congo holds out their hands, covered in lesions. CDC/ Brian W.J. Mahy, BSc, MA, PhD, ScD, DSc

  • Two children in the US were diagnosed with monkeypox on Monday, health officials said Friday.
  • The illness starts with a rash and a fever, and can cause pus-filled boils.
  • The virus is closely related to smallpox, and existing vaccines can be used against it.
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An unusual rash of monkeypox cases have been reported across at least a dozen European and North American countries this month, and disease experts are urgently investigating the spread.

On Friday, the first two cases of monkeypox in children in the US were confirmed by top health officials on Monday — one in a toddler in California and another in an infant who is not a US resident but tested positive while in Washington, DC, according to the Centers for Disease Control and Prevention.

The monkeypox virus can prompt pus-filled boils that hurt and are infectious for weeks. Monkeypox lesions can even infect people who come in contact with them on bedsheets and on surfaces.

The monkeypox virus family that these new cases are thought to be related to (from West Africa) has a fatality rate of about 1%.

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Symptoms of monkeypox include fever, backache, and a rash

Typically, a monkeypox infection lasts two to four weeks. It can take between five and 21 days to develop symptoms after catching the virus. 

But the first thing people notice isn't usually a rash. Some of the initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

A rash that starts on the face and spreads to the rest of the body can occur within one to three days of a person developing their fever. 

The rash may begin as flat, red bumps, that morph into round blisters that fill with pus. These boils eventually crust over and fall off. 

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There is currently no standard treatment for monkeypox, but smallpox vaccines are around 85% effective against it, and there are also some experimental treatments

Questions about why the monkeypox are spreading so rapidly

Many of the cases confirmed so far in this outbreak have been diagnosed in men who identify as gay, bisexual, or as men who have sex with men. But that doesn't mean that monkeypox is a gay disease (it is not). Instead, the spread of this disease among gay men may have a lot more to do with where these pox are located on people's bodies, rather than their sexual orientation.

Typically, monkeypox rashes tend to break out on the face, palms of the hands, and bottoms of the feet. But Swedish health authorities said on Thursday that "in European cases, the skin problems have often been reported to be localized to the genitals, groin, and the skin around the anal opening." 

Health experts know that the pus and scabs people get when they have monkeypox are super contagious. Whether they're on the hands, the feet, or the groin, if someone else touches them, it's not very hard to get infected. 

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"Those legions are chock full of a ton of virus, and that virus is extraordinarily stable — the virus is a double-stranded DNA virus, which by nature, it's really hearty," the US Centers for Disease Control and Prevention's Andrea McCollum, a poxvirus expert, told Insider. 

"Lesions are infectious in all stages, including the scab stage, until they separate and there's a fresh layer of skin." 

Fortunately, the virus can be cleaned off surfaces with bleach, and disinfected out of clothes and bedsheets too. And, while people are waiting for their scabs to fall off, covering them up with a sheet or gown or clothing (which no one else should touch without gloves on) is a great way to contain the virus.

Health Monkeypox Europe
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