2022

What do we know – and need to know - about monkeypox?


Dr. Anne Rimoin, UCLA FSPH professor of epidemiology, has been studying monkeypox for two decades.

Dr. Anne Rimoin

Q. In simplest terms, what is monkeypox?

A. Monkeypox is a viral zoonosis, a virus that is transmitted from animals to humans. It’s endemic in parts of Central and West Africa. Monkeypox is from the same family as smallpox but causes less severe disease. Monkeypox was discovered in the late 1940s when outbreaks of a pox-like illness occurred in monkey colonies that were being used for research in Denmark - hence the name monkeypox. But the name is a misnomer. Monkeys can be infected by the virus, but it’s thought to be more commonly spread by small rodents and squirrels that are native to the forests of Africa.

There are two genetically distinct types, or clades, of the monkeypox virus. The Central African, or Congo Basin, clade and West African clade. The Central African clade is thought to spread more easily and causes more severe disease. It is also associated with a higher mortality rate (6 – 10%) than the West African clade (1-3.5%).

Q. How do you get monkeypox?

A. Transmission can occur when a person comes into contact with the virus from an animal, human, or materials that are contaminated with the virus, known as fomites. The virus enters the body through broken skin, the respiratory tract or mucous membranes – meaning the eyes, nose or mouth. Animal-to-human transmission generally occurs from a bite or a scratch, preparing or eating wildlife, direct contact with body fluids or lesion material, or indirect contact through contaminated materials like bedding.

Q. What are the symptoms?

A. The initial symptoms of monkeypox are typically flu-like. The first few days of symptoms include fever, headache, aches and pains, fatigue, and swollen lymph nodes. Within a few days, a distinctive rash develops; the illness is usually self-limiting and lasts 2-4 weeks.

Monkeypox is a serious infection and can be fatal; mortality estimates range from 1 – 3.5% for the West African clade and up to 10% for the Central African clade. It’s important to note that these figures are from lower resource African settings with more limited access to health care. Of the cases that have been reported in high resource settings – including the 2003 outbreak in the U.S. Midwest and importations to Europe, Israel, Singapore, U.K. and U.S. - there have been no fatalities. This suggests that supportive care and treatment can be very effective.

Q. Are there vaccines and therapeutics that can be used to prevent or treat monkeypox?

A. Because monkeypox virus is closely related to smallpox virus, the smallpox vaccine can protect people from getting monkeypox. Past data from Africa suggests that smallpox vaccine is at least 85% effective in preventing monkeypox. Smallpox and monkeypox vaccines are effective at protecting people against monkeypox, when given before exposure to monkeypox. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe.

Vaccination after exposure to monkeypox virus is still possible. However, the sooner an exposed person gets the vaccine, the better.

The U.S. Centers for Disease Control and Prevention recommends the vaccine be given within four days from the date of exposure in order to prevent onset of the disease. If given between four and 14 days after the date of exposure, vaccination may reduce the symptoms of disease, but may not prevent the disease.

In addition, there are treatments licensed for smallpox that can be used to treat cases of monkeypox including cidofovir, ST-246, and vaccinia immune globulin.

Q. How concerned should we be?

A. The risk of monkeypox to the general public is very low. Monkeypox is still a very rare infection and only a few cases have been identified so far in the U.S. That said, whenever we see a virus behaving differently or spreading in a new population, it’s concerning. We are seeing the virus move through populations in ways we haven’t seen before, so it is a situation that requires rapid attention, and a lot of study and action.

We are still in the early stages of trying to understand how and when the virus was introduced from Africa, and if it is the result of a single introduction or multiple introductions. There is also a possibility that it has been spreading silently without detection for a while and because we weren’t looking, we didn’t find it. With excellent disease surveillance, case investigation, contact tracing, and sequencing of samples, this will become clearer over time. The story is still unfolding, but we don’t even know where we are in the plot. It’s like tuning into a new series, but not knowing exactly which episode you landed on. It could be episode 2 or episode 5. We have missed some of the origin story and need to catch up.

The bottom line is, monkeypox is a rare disease. It’s unlikely that most people in the U.S. will ever come in contact with it. While a substantial illness, it hasn’t caused any fatalities in high income settings. There are vaccines and treatments. And the world is more aware of what it takes to contain outbreaks.

Dr. Anne Rimoin currently serves as the Gordon-Levin Endowed Chair in Infectious Diseases and Public Health at the UCLA Fielding School of Public Health, as a professor of epidemiology at the Fielding School, and as a professor in the Infectious Disease Division of the David Geffen School of Medicine at UCLA. She also serves as director of the UCLA Center for Global and Immigrant Health and research program director of the affiliated UCLA-DRC Health Research and Training Program, in the Democratic Republic of the Congo (DRC).

Faculty Referenced by this Article

Dr. Anne Rimoin
Anne Rimoin
Epidemiology
Read Faculty Profile
Aziz, Najib headshot_2023
Najib Aziz
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Kelika Konda
Epidemiology
Read Faculty Profile
Dr. Zuo-Feng Zhang
Zuo-Feng Zhang
Epidemiology
Read Faculty Profile
Karin Michels
Karin B. Michels
Epidemiology
Read Faculty Profile
Woman dressed in blue and wearing pearls and eye glasses
Lisa V. Smith
Epidemiology
Read Faculty Profile
Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
Read Faculty Profile
Matthew Mimiaga
Matthew J. Mimiaga
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Peter Katona
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Paul Dluzniewski
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Catherine Carpenter
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Amy Wohl
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Noel Weiss
Epidemiology
Read Faculty Profile
Julia Heck
Julia Heck
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Nicole Hoff
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Roberta Malmgren
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Vonthanak Saphonn
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Peter R. Kerndt
Epidemiology
Read Faculty Profile
Nathan Wong
Nathan D. Wong
Epidemiology
Read Faculty Profile
Sung-Jae Lee
Sung-Jae Lee
Epidemiology
Read Faculty Profile
Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
Read Faculty Profile
Elizabeth Rose Mayeda photo
Elizabeth Rose Mayeda
Epidemiology
Read Faculty Profile
Tony Kuo
Tony Kuo
Epidemiology
Read Faculty Profile
Akihiro Nishi Headshot
Akihiro Nishi
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Jian Yu Rao
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Leeka I. Kheifets
Epidemiology
Read Faculty Profile
Anne Coleman
Anne Coleman
Epidemiology
Read Faculty Profile
Otoniel Martinez-Maza
Otoniel Martinez-Maza
Epidemiology
Read Faculty Profile
Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
Read Faculty Profile
Su Yong Jung
Su Yon Jung
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Emily Beeler
Epidemiology
Read Faculty Profile
Jonathan Jacobs
Jonathan Jacobs
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Frank J. Sorvillo
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Lawrence Ash
Epidemiology
Read Faculty Profile
Alexandra Binder Headshot
Alexandra Binder
Epidemiology
Read Faculty Profile
Dr. Beate Ritz
Beate Ritz
Environmental Health Sciences Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Teresa Ellen Seeman
Epidemiology
Read Faculty Profile
Haroutune Armenian
Haroutune Armenian
Epidemiology
Read Faculty Profile
Paul Simon Headshot
Paul Simon
Epidemiology
Read Faculty Profile
Dr. Dvora Joseph Davey
Dvora Joseph Davey

Dr. Joseph Davey is an infectious disease epidemiologist with over 20 years' experience leading research on HIV/STI services for women and children.

Epidemiology
Read Faculty Profile
sheena sullivan photo
Sheena G. Sullivan
Epidemiology
Read Faculty Profile
Roch Nianogo
Roch A. Nianogo
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Niklas Krause
Environmental Health Sciences Epidemiology
Read Faculty Profile
Dr. Timothy Brewer
Timothy Brewer
Epidemiology
Read Faculty Profile
Jian Li
Jian Li
Environmental Health Sciences Epidemiology
Read Faculty Profile
Naomi Greene
Naomi Greene
Epidemiology
Read Faculty Profile
Pamina Gorbach
Pamina Gorbach
Epidemiology
Read Faculty Profile
DerSarkissian, Maral
Maral DerSarkissian
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Nina Harawa
Epidemiology
Read Faculty Profile
Sander Greenland
Sander Greenland
Epidemiology
Read Faculty Profile
Headshot
Christie Jeon
Epidemiology
Read Faculty Profile
Dr. Liwei Chen
Liwei Chen

Professor in Epidemiology

Epidemiology
Read Faculty Profile
Dr. Brian Bradbury
Brian Bradbury
Epidemiology
Read Faculty Profile
Susan Cochran
Susan Cochran
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Annette Regan
Epidemiology
Read Faculty Profile
Dr. Roger Detels
Roger Detels
Epidemiology
Read Faculty Profile
Hashibe, Mia
Mia Hashibe
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Dallas Swendeman
Epidemiology
Read Faculty Profile
Ximena Vergara
Ximena Vergara
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
Read Faculty Profile
Dr. Paul Hsu
Paul Hsu
Epidemiology
Read Faculty Profile
Bailley, Julia
Julia Bailey
Epidemiology
Read Faculty Profile
Dr. Marjan Javanbakht
Marjan Javanbakht
Epidemiology
Read Faculty Profile
Onyebuchi Arah headshot
Onyebuchi A. Arah
Epidemiology
Read Faculty Profile
Faculty/staff profile placeholder image
Jørn Olsen
Epidemiology
Read Faculty Profile
Marissa J. Seamans
Marissa Seamans
Epidemiology
Read Faculty Profile
Kamyar Kalantar-Zadeh
Kamyar Kalantar-Zadeh
Epidemiology
Read Faculty Profile
Ralph R. Frerichs, 12/25/21
Ralph R. Frerichs
Epidemiology
Read Faculty Profile

Related Content

World Health Organization (WHO) logo
June 23, 2022
UCLA Fielding School of Public Health professors named to WHO monkeypox panel

UCLA FSPH professors of epidemiology, Dr. Anne Rimoin and Dr. Zunyou Wu, to serve on an emergency World Health Organization (WHO) panel as part of the WHO’s response to the current monkeypox outbreak.

Source: World Health Organization Read Full Article
Scientist using a pipette
May 26, 2022
"Who is protected against monkeypox?"

The New York Times interviewed Dr. Anne Rimoin, UCLA Fielding School of Public Health professor of epidemiology and the Gordon-Levin Endowed Chair in Infectious Diseases and Public Health, about whether the current monkeypox outbreak is likely to swell into a large epidemic.

Source: New York Times Read Full Article