This week we will discuss Monkeypox with Dr. Tiffany Najberg.

Dr. Tiffany Alexis Najberg Pronouns: She/her Physician licensed in the state of Louisiana Dr. Tiffany is a Board Certified Emergency Physician who has served in busy emergency departments and provided prehospital care as well as remote care since 2007. A transwoman currently transitioning herself, she is the first open trans woman Emergency Physician in Louisiana. She is a business owner who co owns her clinic, UrgentEMS, in Shreveport Louisiana. She practices urgent care, some primary care, and gender affirming care there and via telehealth throughout the state. Her experience in remote medical direction led her to begin practicing transgender medicine via telemedicine, as making it accessible to all, even in isolated locations, is something she cares deeply about. She received her medical degree at the University of North Texas in Fort Worth, completed her emergency medicine residency at LSU New Orleans (Charity Hospital), and her EMS fellowship with New Orleans EMS. She has been a teaching staff at Ochsner in New Orleans and St. Francis in Monroe, and has a passion for medical education. She still actively instructs medical students at her clinic. Her non medical interests include amateur storm chasing, writing, all things social, and she is a fierce advocate for public health, trans rights, women’s rights, and lgbtq+ issues through her sizable online platforms.

Dr. Tiffany goes more in depth about this new form of pox quickly spreading around the world.

Symptoms of monkeypox can include

Fever
Headache
Muscle aches and backache
Swollen lymph nodes
Chills
Exhaustion
Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
A rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) but could also be on other areas like the hands, feet, chest, face, or mouth.
- The rash will go through several stages, including scabs, before healing.
- The rash can look like pimples or blisters and may be painful or itchy.

You may experience all or only a few symptoms

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.
Most people with monkeypox will get a rash.
Some people have developed a rash before (or without) other symptoms.

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

If You Have a New or Unexplained Rash or Other Symptoms...

Avoid close contact, including sex or being intimate with anyone, until you have been checked out by a healthcare provider.
If you don’t have a provider or health insurance, visit a public health clinic near you.
When you see a healthcare provider, wear a mask, and remind them that this virus is circulating in the area.

Monkeypox spreads in a few ways.

Monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:
- Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.
- Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
- Contact with respiratory secretions.

This direct contact can happen during intimate contact, including:
- Oral, anal, and vaginal sex or touching the genitals (penis, testicles, labia, and vagina) or anus (butthole) of a person with monkeypox.
- Hugging, massage, and kissing.
- Prolonged face-to-face contact.
- Touching fabrics and objects during sex that were used by a person with monkeypox and that have not been disinfected, such as bedding, towels, fetish gear, and sex toys.

A pregnant person can spread the virus to their fetus through the placenta.

It’s also possible for people to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.

Scientists are still researching:

If the virus can be spread when someone has no symptoms
How often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions.
Whether monkeypox can be spread through semen, vaginal fluids, urine, or feces.

Protect Yourself and Others

Following the recommended prevention steps and getting vaccinated if you were exposed to monkeypox or are at higher risk of being exposed to monkeypox can help protect you and your community.

Take the following steps to prevent getting monkeypox:

Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
- Do not touch the rash or scabs of a person with monkeypox.
- Do not kiss, hug, cuddle or have sex with someone with monkeypox.
Avoid contact with objects and materials that a person with monkeypox has used.
- Do not share eating utensils or cups with a person with monkeypox.
- Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially before eating or touching your face and after you use the bathroom.

In Central and West Africa, avoid contact with animals that can spread monkeypox virus, usually rodents and primates. Also, avoid sick or dead animals, as well as bedding or other materials they have touched.

CDC recommends vaccination for people who have been exposed to monkeypox and people who may be more likely to get monkeypox.

People more likely to get monkeypox include:

People who have been identified by public health officials as a contact of someone with monkeypox
People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox

People whose jobs may expose them to orthopoxviruses, such as:
- Laboratory workers who perform testing for orthopoxviruses
- Laboratory workers who handle cultures or animals with orthopoxviruses
- Some designated healthcare or public health workers

Treatment

There are no treatments specifically for monkeypox virus infections. However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.

Antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill, like patients with weakened immune systems.

If you have symptoms of monkeypox, you should talk to your healthcare provider, even if you don’t think you had contact with someone who has monkeypox.

(Credits: CDC)

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