Monkeypox is a self-limiting orthopoxvirus endemic to Central and West Africa. Public Health agencies around the world have recently reported cases of monkeypox. It is a viral zoonotic disease, but can also spread between people. The virus causes a flu-like illness that leads to a maculopapular rash. The West African strain of the virus has recently (May 2022) been detected in confirmed cases.
Symptoms may begin in a prodromal phase that includes:
- swollen lymph nodes
- intense fatigue
- muscle aches
- joint stiffness
The incubation period is usually 6 to 13 days but can range from 5 to 21 days. Within 1-3 days after symptom onset, a rash appears at the site of inoculation, then may appear on other parts of the body including oral mucosa, genital area, conjunctiva, palms of the hands and soles of the feet.
Atypical presentations include initial signs of a genital or perianal rash prior to prodrome symptoms which may not spread to other parts of the body, and having lesions at different stages of development. The rash turns into vesicular lesions that will eventually fall off to be replaced by new skin. The time for scabs to fall off varies by individual but typically takes 2-4 weeks.
Epidemiology on recent cases reported in the US, UK, Canada, and Western Europe shows that some cases have been clustered in men who have sex with men. In addition, many of these cases have reported atypical symptoms, including painful unusual rash/lesions in the mouth and/or genitals.