Monkeypox: A Q&A with infectious disease expert Dr. Christopher Ohl

As monkeypox continues to be a concern around the world, Christopher Ohl, M.D., professor of infectious diseases at Wake Forest University School of Medicine, shares answers to some common questions.

What is monkeypox?

Monkeypox is a rare disease that is caused by an orthopox virus, which is in the same family as the virus that causes smallpox.

There are a wide range of symptoms with monkeypox. Initially people experience fever, body aches, headache, sore throat or nasal congestion. After two days, a noticeable and painful rash consisting of sores or blisters occurs. 

Monkeypox is primarily spread through direct contact with an infected person’s rashes, lesions or bodily fluids; during prolonged intimate contact with someone who is infected; or by touching clothing or other items that have been used by someone who is infected.

Generally, only people who are symptomatic, including fever and/or rash, are contagious to others. The time between infection and onset of symptoms ranges from one to two weeks. To learn more about monkeypox, see the CDC website.

How concerned should people be about monkeypox?

Monkeypox is not as contagious as COVID-19 or smallpox and at this time, I believe the risk of infection is very low for the general population; however, anyone who is intimate with or in close proximity to someone with monkeypox symptoms for an extended amount of time can become infected.

What is the risk of monkeypox to the Wake Forest community?

While infectious disease experts and public health officials continue to monitor developments, at this time, I believe monkeypox poses a very low risk to our Wake Forest community.

As with any communicable disease, we must all remain aware and vigilant to protect ourselves and each other.

Wake Forest is monitoring developments, getting regular updates from local and state public health officials and elevating awareness in the community about how to mitigate risks from the disease.

How widespread is monkeypox in the U.S.? In North Carolina?

At this time, there are just over 5800 confirmed cases in the U.S. and 60 in North Carolina,  but we expect cases to continue to increase.

New York, California and Illinois have the highest number of cases, followed by Florida, Georgia and Texas. At this time, there are no confirmed cases in Forsyth County.

Updated monkeypox case counts can be found on the CDC website.

Are the recommended precautions to prevent the spread of other illnesses enough to prevent the spread of monkeypox?

Some of the measures to reduce exposure to other illnesses can be effective in preventing monkeypox, such as isolating from others when you are ill and washing your hands well with soap and water.

However, the best way to prevent being infected with monkeypox is to avoid close, intimate contact with people who are symptomatic and to not touch clothing or other items of someone with monkeypox.

For those who contract monkeypox, how dangerous is it?

The variant of monkeypox that is currently circulating in the U.S. is rarely fatal, and hospitalizations are infrequent, although the lesions caused by the virus can be incredibly painful.

Those with weakened immune symptoms, or young children, are more susceptible to serious illness or death.

What vaccines are available?

There is a vaccine that can be given to people exposed to the virus. It is not a live vaccine, so it can be given to people who may have weakened immune systems. However, the vaccine is not widely available at this time.

People who have symptoms of monkeypox or believe they have been exposed to monkeypox should contact their health care provider or county health department to be tested.

Vaccination within four days of exposure is highly effective in preventing symptoms.

Persons at high risk of exposure, including men who have sex with men, particularly those who have multiple sexual partners, can be vaccinated prior to a potential exposure.

Is monkeypox treatable?

There is a medication, tecovirimat, that has not yet been FDA-approved for monkeypox, but appears to be an effective treatment to reduce the duration of symptoms and the likelihood of infecting others.

Access to this medication is obtained through public health authorities, and the process can be initiated by any health care provider. 

Do patients with monkeypox need to quarantine or isolate themselves?

Yes, patients who have been diagnosed with monkeypox need to isolate themselves while they are contagious. Isolation lasts until all of the scabs from all sores have fallen off, generally the isolation time is about 3 weeks. 

Please note this information is current as of August 1, 2022. Please visit the CDC and N.C. Department of Health and Human Services websites for continually updated information.