MONKEYPOX OUTBREAK: SIGNS & SYMPTOMS

 what exactly is monkey pox and i'm going to describe for you all the skin findings that happen with this particular viral infection if you are new here welcome my name is andrea i am a board certified dermatologist this channel is all things skin care if that is of interest to you definitely things may have changed by the time this video goes live but as of the filming of this blogg there have been several outbreaks around the world of monkey pox and we'll get into what exactly that is so far cases have popped up in the u.s in canada spain italy the netherlands uk belgium canary islands israel germany sweden and australia now it's not exactly clear how the people who have come down with this got infected but what is monkey pox it is a viral infection it is largely transmitted by contact with infected animals specifically rodents it was initially described and identified in a laboratory monkey in 1958 hence its name monkey pox but it's actually rodents that are the major reservoir or source of the spiral infection how do people get it it's largely through contact with infected animals whether it be handling them a bite from them or consuming or cooking or preparing meat from these animals it can be inoculated into human skin through a contact with infectious materials through anywhere on the skin where there's an impaired barrier such as a bite a scratch or any kind of skin trauma it's transmitted from animals to humans but human to human transmission can also occur through contact with the bodily fluids it also can be transmitted from human to human through large respiratory droplets such as what you would come in contact with if you're like very very close proximity to someone's face it can be transmitted through contact with surfaces that are contaminated like sheets linens a risk factor for human to human transmission is going to be crowded living conditions areas where they're poor hygiene people living very in very very close proximity to one another and it primarily happens in the rainforests of central and western africa people there do become infected with this as a result of handling infected rodents here in the u.s specifically in 2003 there was an outbreak in the midwest that particular outbreak was traced back to pet prairie dogs who had previously been housed in very close proximity to rodents that were imported to the us from ghana then last summer actually in 2021 there was a case in dallas and a case in maryland and both of those individuals had previously traveled to nigeria so they had perhaps come in contact there and came back got the illness but it was not transferred to anyone else now fast forward now to 2022 we're seeing a lot of new cases popping up around the world in europe canada the us australia so after you are infected with this virus it takes anywhere from 4 to 20 days to start developing symptoms on average about 12 days then you develop a flu-like illness and it starts with a fever you get chills profuse night sweats muscle pain body aches headache backache there's also sore throat you can feel short of breath and have a cough one of the hallmark features though of this then about two to three days of developing fever you have really really prominent and large lymph nodes specifically in your neck like under your chin your jaw area the lymph nodes get to be a couple of centimeters in size and this is an important finding it distinguishes this particular viral infection from infections like chickenpox for example because again you're going to develop a rash which brings me to the next point what exactly does the rash of monkey pox look like so the rash develops within 1 to 10 days of getting a fever it starts on the face and then spreads to involve the rest of the body the spots follow a very predictable course they start out as small red spots then they turn into bumps then those bumps turn into little blisters then those blisters fill up with pus then those pus bumps umbilicate basically just kind of sink in in the center umbilicate think of it like your belly button umbilicus a little dividend then that umbilicated bump cross over and then it flakes off this whole process every single spot kind of follows along that time course and eventually in about two to three weeks the rash completely crossed over flakes off and goes away so it's going to involve the face your torso your back your arms your legs it can involve the palms and soles and it also involves the scalp in some cases the rash can be itchy to the untrained eye it may kind of appear like chickenpox which i know a lot of you guys who are quite young you probably never had to deal with chickenpox comment below and if you had chickenpox i did it may kind of look like chickenpox but again the distinguishing feature is going to be those really enlarged lymph nodes uh under the chin in the neck and also in the groin if i didn't already mention that so this rash it can be itchy but it's typically not painful but these spots can go on to scar and leave little pock mark type scars you can also get a bacterial infection on top of the rash if you scratch it especially because the area there it's an impaired skin barrier it's more prone to infection it shouldn't be painful if it's painful that is a signal that perhaps there's an overlying bacterial infection on top of the rash so when you have this rash if someone comes in contact with the skin lesions the blister fluid they can get sick as well so it is infectious at that point but once all of the bumps of the rash have crusted over it's no longer contagious it's a pretty involved rash in the sense that it involves pretty much all surfaces scalp face body arms and legs palms and soles in some cases and it's uncomfortable a little itchy and it lasts a good long while anywhere from two to four weeks so that's a good long while to be dealing with a rash fortunately for the most part this infection is what's called self-limited meaning it follows along this very predictable course and then resolves and the rash can be complicated by an overlying bacterial infection which would further increase the risk of scarring in cases in africa the death rate from this particular viral infection is anywhere from one to ten percent most people who do end up dying from this infection have underlying poor health and it's oftentimes due to complications arising from an overlying bacterial infection well in the 2003 outbreak throughout the midwest there were no cases of death from monkey pox how is it diagnosed well history of any recent travel is really an important piece you've come in contact with people or animals who were a source a swab may be taken to culture for the virus and then a skin biopsy if you get a little piece of your skin a skin biopsy would need to be performed you look at it under the microscope and there are specific changes that are telltale of this type of viral infection they also can look at it with something called immunohis chemistry to look for specific viral pieces they also can look at the skin biopsy under a special type of microscope called an electron microscope and it can show specific viral pieces that really help make the diagnosis even further so i am in no way shape or form and infectious disease expert but i do know about the rash of monkey pox there were a couple of questions on my board exam for example about this i have never seen a case of it but i do know what the findings are i can identify them so i wanted to make this video for you all because whenever there are crazy headlines like this i know you know worries people and i thought it would be a good opportunity to talk about the skin findings it's really not clear how the people in these individual clusters and different countries who have come down with this how they were exposed yeah it'll be interesting to see how this unfolds hopefully they'll be able to identify like the uh you know trace back the original exposure contact clarify what what that was i wanted to make this video basically to share with you guys what the skin findings are because i think it's really interesting and i think that you know it's helpful for me to share that for people out there who may be wondering what the skin rash looks like and i think it's also helpful to you guys who may be reading these headlines and nervous to just kind of understand a little bit more about this particular viral infection this video is not meant to alarm anybody or evoke fear i know when we hear about viral viral infection outbreaks especially with everything that's been going on it can be very very scary but uh yeah i think at this point you know hopefully the cdc will be able to figure this out and it will be yet another outbreak like the ones we had in 2003 and you know hopefully no harm will come of it so to wrap it up to be clear this virus it's not the same as chickenpox and it's it's a totally different virus it's largely transmitted from contact with infected rodents uh but it can be uh transmitted from person to person once somebody has come down with it mostly through closed contacts with infected bodily fluids skin on skin contact or infected surfaces and it's a viral infection that can make you pretty sick for a couple of weeks and you do have a rash that is pretty involved and lasts a couple anywhere from two to four weeks and that rash can scar there are some antiviral medicines that may be offered uh for people who are you know very ill or people who have underlying medical issues where it would be a concern i don't want you guys to be unnecessarily worried but if you haven't traveled recently you know hopefully this information may be helpful to you hopefully by the time this video goes live maybe we'll have some updates some more knowledge more information .