What You Need to Know About Monkeypox Published Aug. 8, 2022 By Janet A. Aker, MHS Commuicatons FALLS CHURCH, Va. -- The infectious viral disease monkeypox is slowly spreading around the world, including the United States. On August 4, the United States formally declared it a public health emergency. Monkeypox can spread by anyone to anyone. While international, national, state, and local health officials closely monitor the outbreak, Military Health System officials are carefully tracking the spread as well. As of August 4, U.S. counts are approximately 7,000 probable or confirmed cases, according to the Centers for Disease Control and Prevention. The CDC maintains a public daily case count dashboard. The number may seem small, but it increases daily. While there are few cases reported among military personnel and their families, the declaration of a national health emergency means that it constitutes a "public health risk to other states through the international spread of disease,” according to the World Health Organization. Defense health officials emphasize that if you think you may have monkeypox, “the first thing to do…is ensure you are not further exposing other people, which means not having close, intimate contact with others until you are asymptomatic,” said Army Lt. Col. (Dr.) Scott Robinson, the Public Health Emergency officer for the Defense Health Agency. What Does Monkeypox Look and Feel Like? The disease most commonly starts with fever, then painful lymph nodes and a rash that typically develops one to three days after the fever begins, according to the CDC. The rash is the most significant feature of monkeypox, spreading into small, fluid-filled blisters. They become round and hard, like pimples, and then scab. You may also have headache, muscle aches, chills, and exhaustion that begin between seven to 14 days after exposure but can develop between five to 21 days post-exposure. You are no longer infectious once your scabs have healed, dropped off, and healthy new skin has grown where the lesions were located. That usually takes two to four weeks, according to Robinson. Children under 8 years old, people who are pregnant or immunocompromised, and individuals with a history of atopic dermatitis or eczema may be at increased risk for severe outcomes from monkeypox. Transmission The CDC states that monkeypox is far less contagious than COVID-19 or the flu because you get it from an infected person when you come in direct contact with the rash on their skin, their lesions, or bodily fluids, or if you touch bedding or clothing that has come in contact with those. You can also get monkeypox through droplets that disperse during prolonged face-to-face contact, such as kissing or cuddling, and through direct, intimate physical contact such as sex, according to the CDC. Animals, such as dogs or cats, in an infected person’s household can become infected and transmit it to others. In Africa, infected wild animals are a common way people become infected. Pain as a Symptom Sometimes, the only sign of monkeypox is severe pain, Robinson said. That can be because there may be ulcers inside patients’ mouths, urethra, or rectum where the patient can’t see them but feels severe pain that may require hospitalization. “For sexually active people, I’d be concerned if they developed pain, even if it’s somewhere I can’t see. I’d want to get that checked out by a health care professional,” Robinson said. The infection can also cause lymph nodes in the groin area or on the soft tissue of your neck to swell, which should concern the patient and lead to a check-up, he explained. What To Do for Suspected Monkeypox If you think you’ve been exposed, notify your medical provider, and monitor yourself for symptoms for 21 days after your last close contact with an infected individual. You may have to isolate yourself from other members of your household to limit the spread of the disease, including from pets. This means not having close contact, including touching or other physical contact, no prolonged face-to-face encounters, and not engaging in sex. If you have a fever or a growing rash, see your medical health care professional in person. Your medical provider will help you determine your risk of becoming ill with monkeypox and may offer preventive treatment if you are at high risk. If you get a diagnosis of monkeypox, your medical provider must place you in isolation and treat you according to CDC guidelines for infection control. Most patients with monkeypox have mild disease and don’t require medical intervention, CDC said. However, treatments are available and appear effective in reducing pain and duration of symptoms. Treatment The most common treatment for monkeypox includes supportive care, such as hydration and treatment of secondary bacterial infections. There’s also an approved vaccine called Jynneos for monkeypox and antivirals that doctors may use in certain situations immediately after patient exposure, but these are not widely available in the United States. They are available from the government’s national stockpile of medicines. “The treatments have been shown to be pretty good at preventing severe illness,” Robinson said. “The earlier you get them, the better,” he noted, adding that “early treatment can prevent you from having symptoms or at least making sure that your symptoms are relatively mild.” Seeking Care [See also: How to Get Urgent Care Under Your TRICARE Health Plan] If you experience monkeypox-like symptoms, Military Health System beneficiaries have resources available at military hospitals and clinics or within the TRICARE network of providers: Notify your medical provider Call the MHS Nurse Advice Line, open 24/7, at 1-800-TRICARE (874-2273) Select Option 1, to talk to a registered nurse who can: Answer your urgent care questions Give you health care advice Help you find a doctor Schedule next-day appointments at military hospitals and clinics Go to a TRICARE-authorized urgent care center, convenience clinic, or network provider: Active-duty service members must first contact their primary care manager/provider or contact the Nurse Advice Line for a referral before visiting an urgent care center. TRICARE Prime enrollees, other than active duty, only need a referral to see an out-of-network provider. Without a referral, they may incur higher point-of-service costs. Resources The CDC has published an extensive monkeypox resource library, to include fact sheets on transmission and treatment. Health.mil, the official Military Health System web site, maintains a monkeypox information page. Army, Air Force, and Navy and Marine Corps medical services also maintain fact sheets and reference materials. MHS clinicians seeking vaccines for monkeypox post-exposure prophylaxis are encouraged to contact the DHA Immunization Healthcare Division’s 24/7 immunization clinical support center for assistance.