What is monkeypox, and what are Alaska health officials doing to prepare for its possible arrival?

At least 25 U.S. cases of monkeypox had been identified by the federal Centers for Disease Control and Prevention by the end of the week as part of a global outbreak that is prompting concern among health experts worldwide.

No cases have been reported in Alaska yet, though there’s a possibility that could change. Cases have been identified in 12 states, including Washington and Hawaii. We spoke with Alaska’s top epidemiologist, Dr. Joe McLaughlin, to learn more about the illness and what state officials are doing to prepare for its possible arrival in Alaska.

What exactly is monkeypox?

Monkeypox is a rare disease that’s caused by an infection with a pox virus that belongs to the same family of viruses that cause smallpox, as well as the recently identified Alaskapox that was discovered in the Fairbanks region.

Monkeypox was first discovered in 1958, when two outbreaks of a pox-like disease occurred in colonies of monkeys that were kept for research, which is how the illness got its name. The first human case was recorded in 1970 in the Democratic Republic of Congo. Since then, reported cases have involved people in dozens of other countries, primarily in central western Africa.

Most infections that have been identified globally have been in the Democratic Republic of the Congo. Monkeypox cases in people outside Africa have been typically linked to international travel, or imported animals. In the U.S., the CDC has tracked 25 cases as of Saturday. Detailed information about 17 of those cases was included in a May 2022 report issued Friday.

All but one of those 17 U.S. cases occurred among men who had sex with men. Fourteen had traveled to other countries in the three weeks before their symptoms began, and three patients were immunocompromised, according to the CDC.

Have any cases of monkeypox been identified in Alaska?

Not yet. The state has investigated two cases that were “clinically compatible” with the rash caused by monkeypox, but those test results have come back negative, McLaughlin said. However, “based on what we’re seeing nationally, it is quite possible that we will see monkeypox cases in Alaska in the near future,” he said.

What are the symptoms of monkeypox? Is it as serious as smallpox? And how does it spread?

The illness typically begins with a fever, headaches, muscle and backaches, swollen lymph nodes, chills and “just general exhaustion,” McLaughlin explained.

Within about one to three days, the patient will then develop a rash that often began on the face and spread to other parts of the body, but not always.

“What we’ve seen with the current outbreak is that many of the cases people have lesions that actually start in the genital areas because of sexual transmission,” he said.

The rash typically starts as a red, flat area that can turn into razor bump-like swells, and then pustules with a cloudy appearance. The illness typically lasts about two to four weeks.

Some people do develop severe infection, and without any treatment or medical interventions, the death rate is as high as 10% for monkeypox, compared with smallpox, which is closer to 30%, McLaughlin said.

A key difference is that monkeypox can cause the lymph nodes to swell whereas smallpox does not. Otherwise, monkeypox symptoms are similar to the symptoms of smallpox, but they’re typically milder.

Monkeypox spreads when a person comes into contact with the virus, either through an infected person, animal or material contaminated with the virus.

It can spread from animals to people through a bite or a scratch from an infected animal.

Between people, the virus can spread through direct contact with body fluids or sores on an infected person; it also can be spread by respiratory secretions, “but this is really during prolonged face to face contact,” McLaughlin said.

It does not spread as readily through airborne particles as COVID-19, he said.

Monkeypox can spread during intimate sexual contact between people as well.

[2 strains of monkeypox in US suggest possible undetected spread]

What are health officials doing to prepare for the possible arrival of monkeypox in the state?

“We’re making sure that we really understand the epidemiology of this outbreak, not only in United States but globally, and also staying abreast of treatment that is available to treat people who have confirmed monkeypox infection,” McLaughlin said Friday.

While monkeypox vaccine and treatments have been in short supply around the globe, McLaughlin said the state is working with federal partners who oversee the national stockpile, and “if we do have cases, we should be able to get treatment as well as vaccines very quickly,” he said.

The state health department is also communicating with health care providers and the general public about routes of transmission, what signs and symptoms to look for, and how to test and treat infected people.

“We also have been doing consultations with clinicians about patients that have suspected cases — like, they’ve got a rash and illness, and the clinician thinks maybe this is monkeypox. And so we’ll consult with those clinicians and help them determine based on the person’s history and other risk factors whether or not it’s appropriate to go ahead and test,” he said.