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Monkeypox can look different than what doctors thought. Here's what they're learning

Mary Wilson

New member
June 3, 20224:00 PM ET

MICHAELEEN DOUCLEFF

For the first time in history, the world is facing an international outbreak of monkeypox. Doctors have detected nearly 800 cases across the globe, from Argentina to the United Arab Emirates. The U.K. and Portugal have detected the most cases, with about 200 and 100 cases in each country, respectively. The U.S. has recorded 21 cases and Canada has 58.

Such a broad geographic spread suggests "widespread human-to-human transmission is currently underway," said Dr. Maria van Kerkhove, with the World Health Organization, on Thursday. This transmission has "likely been ongoing for several weeks, if not months," she noted.

... But what does that rash often look like? Turns out, it's not what medical textbooks show, says infectious disease doctor Donald Vinh at McGill University. Those images depict people with their trunk or hands covered with pus-filled blisters. What's happening in this outbreak can be much more subtle, Vinh and other doctors involved with the outbreak say.

In fact, some patients have only one or two small lesions that can easily be confused with lesions caused by several sexually transmitted diseases, such as herpes and syphilis.

"I think that's actually supercritical," Vinh says, "Because you can see how these patients can be missed. But they are still contagious and may propagate the disease."

... "The patient's skin lesion that he sampled to confirm the diagnosis is extremely subtle. It's not what you're seeing on the Google pictures of monkeypox," he says.

In textbooks (and on many agency websites), monkeypox is described as a disease that begins with flu-like symptoms, including a fever, tiredness and a single swollen lymph node. Then about a week later, a rash appears, first on the face and then on the extremities. This rash contains painful blisters that eventually fill with pus and crust over. Eventually it can cover the trunk or whole body.

"So in the classic monkeypox, described in textbooks, you're supposed to have two phases," Vinh says.

But in this current outbreak, many people's symptoms don't fit this profile at all, say Vinh and several doctors involved with these cases. ...

For starters, the rash often isn't on the face or extremities at all. Instead, it typically begins on the genitals or the anus. And sometimes it doesn't spread to other parts of the body.

"You don't have head-to-toe skin pox lesions," Vinh says. "Instead it's localized to just one region of the body, like the genital regions. And some people have just one or two pox. So it's not numerous."

"Sometimes it's not even a pox," he says, "but rather an ulcer or a crater."


https://www.npr.org/sections/goatsan...theyre-learnin
 
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