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A message from Sault Tribe Health Director Leo Chugunov:

During last few days, new cases of Monkeypox were discussed in the mass media. Here is what is known so far.

The name “Monkeypox” comes from the first ever documented case of Monkeypox infection. This disease was discovered in the 1958 in colony of monkeys that were used for research purposes in a laboratory located in Copenhagen, Denmark. However, monkeys are not the typical reservoirs of the disease; it is often found in other mammals including rope squirrels, tree squirrels and Gambian rats that live in Central and West Africa.

 

Monkeypox virus (MPXV) is a double-stranded DNA zoonotic virus that causes monkeypox in humans and other animals. It belongs to the genus Orthopoxvirus in the family Poxviridae. It is one of the human Orthopoxviruses that includes variola (VARV), cowpox (CPX), and vaccinia (VACV) viruses. It is not a direct ancestor to, nor a direct descendant of, the variola virus, which causes smallpox. Monkeypox disease is definitely similar to smallpox, but with a milder rash and lower mortality rate, which varies between 1 and 10 percent.

The first reported outbreak outside Africa occurred in 2003 in the United States in Illinois, Indiana, Wisconsin and New Jersey. The outbreak was caused by an infection transmitted by imported animals.

Currently, there are two strains of the Monkeypox virus—one in the Congo Basin, which tends to be more severe, and another in West Africa, which is less severe. The less severe strain seems to be causing the current outbreak. Monkeypox is less contagious than COVID-19. The length of incubation periods range between 7 and 21 days. Infection from animal to human can occur via an animal bite or by direct contact with an infected animal’s bodily fluids. The virus can spread from human to human by both droplet respiration and contact with touchable surfaces from an infected person's bodily fluids. The confirmed monkeypox cases so far have been mild, with no deaths reported yet. But the virus can still cause serious health problems, particularly for immunocompromised people. Typically, the virus causes fever, swelling of lymph nodes, headache, muscle pain, chills, rash and lesions. Most people recover within 3 - 4 weeks without requiring hospitalization.

Monkeypox vaccine is already developed. The FDA-approved vaccine produced by Bavarian Nordic is called Jynneos—a live, nonreplicating vaccine for the prevention of both smallpox and monkeypox disease. It is a vaccine for adults 18 years or older who are at a high risk for smallpox or monkeypox infection. The U.S. government has begun releasing a monkeypox vaccine from the Strategic National Stockpile to protect high-risk people. Several antiviral drugs could be helpful as well.

At the time of distribution of this communication, no Monkeypox cases were detected in Michigan and the disease appears to be containable. So, it’s not of great concern for the general public, although certainly it’s of concern for health care workers. The reason for concern is that the current outbreak is the largest outbreaks we’ve seen outside of Africa. It’s also an unusually large outbreak for monkeypox, and only one of the infected patients had a travel history to an endemic area (Africa). So, the presumption is that everybody else is being infected through some sort of community transmission. It is not clear at the moment if we are observing the peak of infection or just the start of the spread.

Precautionary measures for Monkeypox disease are identical to those exercised during COVID-19 pandemic—handwashing, social distancing, masks and eye protection.

The World Health Organization is working on new guidance on vaccination strategies and is convening further meetings to support member states with more advice on how to tackle the situation. It is expected that limited vaccination of population may be necessary.

Please, be assured that the Sault Tribe Health Division is watching the Monkeypox situation very closely, communicating with IHS regarding availability of vaccine and antiviral drugs, and will act promptly upon received information when necessary.

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Photo by Ken Bosma / CC BY