US Pharm. 2024;49(10):15-16.

A Public Health Emergency

Mpox is currently a public health emergency. It is a rare viral infection that is caused by the monkeypox virus and is mostly found in Central, West, and East Africa. Cases have been on the rise globally, however, including in the United States. Mpox can be spread through direct contact with an individual or animal with the infection. Symptoms can start within 3 weeks after exposure. The first symptoms of mpox are typically fever, muscle aches, and sore throat. Eventually, a rash develops that becomes fluid-filled and can be itchy or painful. Usually, these symptoms dissipate over 2 to 4 weeks, but complications and death are higher in individuals with weakened immune systems.

Mpox Is Spreading

Over 120 countries reported having mpox cases from January 2022 to August 2024. Mpox is transmitted by close contact. This includes contacting the rash or lesions, scabs, blood, other bodily fluids, saliva, or upper respiratory secretions or having prolonged face-to-face contact, such as breathing near or talking with a person with mpox. It can also be transmitted from mother to baby during pregnancy, by being scratched or bitten by or eating the meat or using products of an infected animal, or touching objects or surfaces recently contaminated by the virus. It can take a few days to weeks to notice symptoms, and it can be spread up to a few days before they appear.

The first symptoms are usually headache, fever, chills, sore throat, nasal congestion, cough, swollen lymph nodes, muscle aches, fatigue, and rash. Some people may experience vomiting, diarrhea, and difficulty swallowing. The rash starts off as flat, discolored bumps but may look like blisters and become pus-filled. These can affect the face, palms of the hands, bottoms of the feet, groin, genitals, anal regions, mouth, throat, or rectum. Eventually, the sores crust over and fall off. Not everyone experiences the same symptoms; some may not have any. Some people may develop serious complications such as an infection of the skin, lungs, brain, heart, eyes, genitals, rectum, or urinary passages. If stiff neck, confusion, difficulty thinking clearly, trouble speaking or moving, loss of consciousness, or seizures occur, seek immediate medical care.

Diagnosis and Management

Mpox can affect anyone. It is important to notify your doctor to evaluate if the symptoms are due to mpox or a different virus. The diagnosis is made based on patient history and physical examination. A swab of the rash, throat, or anus can be taken for a DNA test using polymerase chain reaction to identify if it is mpox. Newborns, children, pregnant women, or others with weakened immune systems, such as those with advanced HIV, may be at higher risk for complications. Wearing a mask, covering ulcers or sores around others, and avoiding other people and pets until the lesions scab over and a new layer of skin develops can prevent the virus from spreading.

The main treatments are symptom management and hydration to prevent dehydration. Pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs, such as ibuprofen, can help with pain and fever. Oatmeal baths may soothe the dryness and itchiness of the skin rash. Antibiotics are only helpful if a bacterial infection develops. There are currently no medications to treat mpox. However, there are a couple of clinical trials investigating if medications such as tecovirimat, a drug used for smallpox, can treat mpox. Remember to always talk to your doctor to determine what treatments are most appropriate for you.

Vaccines and Other Preventive Measures 

Getting vaccinated and avoiding contact with animals or people with mpox can limit the spread of the infection. Other preventive measures include thoroughly cooking all meats and meat products, thorough and frequent hand washing, practicing safe sex, wearing a mask that covers the mouth and nose, cleaning and disinfecting contaminated surfaces, and using personal protective equipment when caring for those with the virus.

Currently, the Jynneos and ACAM2000 vaccines for mpox are available in the United States. ACAM2000 has more side effects, and not everyone qualifies for receiving it. Jynneos requires two doses that are administered 4 weeks apart. It is recommended that those exposed to mpox receive the vaccine within 4 days and up to 14 days after exposure. It is also recommended for people who are in close contact with someone with mpox or those who belong to a high-risk group.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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