You’ve heard about monkeypox? 
A Boehringer Ingelheim expert shares what you need to know. 

Two and a half years after the first cases of COVID-19, normality is returning to many countries around the world. With monkeypox, the next disease is already spreading, though. What exactly is it, how is the virus transmitted, what are the most noticeable symptoms? Christoph Keller, Senior Medical Advisor at Boehringer Ingelheim, explains.  

Mr. Keller, where was the current monkeypox outbreak first observed? 

In recent weeks, more than 100 infections with the monkeypox virus have been observed in several countries outside the African continent.  Only some of them are connected to journeys to African endemic areas, i.e. regions in which the disease is detected more frequently. The routes of infection are being further investigated. Already in February 2022, an article pointed out that infections with monkeypox in Africa have increased more than tenfold in the past decades and are becoming more and more of a globally relevant disease. We at Boehringer Ingelheim are monitoring the development of infectious diseases worldwide very closely, although we do not have a vaccine or therapy against this disease – after all, we are always looking for ways to improve the health of humans and animals. 

How is monkeypox transmitted? 

Risk factors include contact with infected animals and humans or with contaminated items such as clothing, towels or eating utensils. The monkeypox virus is able to remain contagious on surfaces or substances for days to months. Droplet infections are possible as well. Transmissions from person to person are rare but possible through close contact, for example with body fluids and scabs or with sexual contact. However, according to the WHO, the longest chains of infection from person to person in recent years have been six to nine consecutive infections only. Overall, monkeypox does not spread very effectively among humans. 

What are typical symptoms?  

The incubation period for monkeypox takes usually between 7 and 21 days. In humans, flu-like symptoms such as sudden fever, headache, muscle and back pain, as well as swollen lymph nodes initially occur. The typical pox often develop a few days after the fever first on the face and then spread over the whole body. 

Can this disease take a severe course?  Are there risk groups? 

Serious illnesses are rare but can also be fatal. In recent years, the WHO assumes a fatal outcome in three to six percent of cases in Africa, whereby the actual case mortality rate is likely to be lower due to an under-recording of mild infection courses.  

There is little information about infections in immunocompromised patients. However, in patients with a parallel HIV infection, more severe disease courses with more damage to the skin were observed. In severe disease courses, disfiguring scars usually remain and corneal damage occurs, which can lead to blindness. 

Can we protect ourselves from monkeypox with a certain behavior? 

Currently, the general health risk from monkeypox is estimated to be low. Nevertheless, anyone who has had contact with an infected person during the incubation period or observes the first symptoms should contact the local health authorities. Staff in doctors' offices, health authorities or hospitals should be informed of the suspicion of monkeypox when they arrive or even when an appointment is made already.  

Infected people should avoid any kind of close contact or exchange of potentially contaminated items with other people until the rash has completely healed and the last scab has fallen off – this can take up to four weeks. 

Is there a vaccine for prevention? And how can a monkeypox infection be treated? 

There is no special vaccine against the monkeypox virus. However, the vaccines to protect against classical human smallpox offer a good protection of about 85 percent due to the similarity of the viruses. Vaccination can lead to a milder course of infection even after infection contact. In the countries concerned, there are initial considerations to vaccinate certain risk groups. 

Since most patients recover within a few weeks, the therapy is primarily symptomatic and supportive. 

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Monkeypox is a viral disease caused by the monkeypox virus (MPV). The virus is related to the classic human smallpox virus (eradicated worldwide for about 40 years) and cowpox. Like COVID-19, monkeypox is a zoonotic disease, a disease which can be transmitted from animals to humans and vice versa.  

The monkeypox virus was first discovered in monkeys in a laboratory animal in 1958. As early as 1970, monkeypox was detected for the first time in humans in the Democratic Republic of Congo - these days now also increasingly in countries where the disease does not occur frequently and which are therefore not endemic. 

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Boehringer Ingelheim's VPH Center works to combat contagious diseases that can be dangerous not only for the animals themselves, but also for humans and agriculture.