How Did Monkeypox Actually Start? Doctors Explain Its History

As monkeypox cases continue to climb, we’re all curious to learn more about the virus, how someone catches it, risk factors and what we can do to protect ourselves.

There are currently a lot of confusing messages out there, with some people saying you can only get monkeypox from sexual contact while others say you can get it simply from physical touch if the other person is infected.

To learn more, we spoke to several doctors to separate fact from fiction. Here's what you need to know.

The History of Monkeypox

Monkeypox was first reported in the 1950s in monkeys but occurs more frequently in African rodents. Until the current outbreak, nearly all human cases were reported in central and western Africa. Human cases outside Africa were rare and found only in people who had traveled to those regions, Dr. Robert Amler, the Dean of School of Health Sciences and Practice at New York Medical College and a former Chief Medical Officer at the CDC Agency for Toxic Substances and Disease Registry, explains.

By August 2022, more than 50,000 cases were reported worldwide—with 20,000 cases throughout the 50 States, District of Columbia and Puerto Rico, and no U.S. deaths had been reported.

Related: What Is Monkeypox, and How Worried Should We Be? Here's What Doctors Say

Is Monkeypox Primarily a Sexually Transmitted Disease?

Perhaps a “sexually transmissible” disease would be more accurate. It requires close physical contact, not necessarily sex, although there are now published reports that monkeypox has been found in semen, Dr. Dennis E. Hruby, Ph.D., Executive Vice President and Chief Scientific Officer of SIGA Technologies, explains.

“Monkeypox is transmitted primarily by close skin-on-skin contact. This can occur without sex, but often occurs during sex,” says Dr. Amler. “For this reason, sex with an infected person may result in transmission.”

Although men who have sex with men comprise the majority of monkeypox cases at the present time, anyone who has close bodily or facial contact with an infected person can become infected. Shared contact with bedding, towels, clothing and other surfaces touched by an infected person is another mode of transmission, Dr. Amler adds.

When Someone is Infectious and Likely to Spread the Virus

“Infected persons are considered contagious from the onset of symptoms until all rash lesions and sores are fully healed, dried up, and filled in from below with formation of fresh skin, often 4-6 weeks later,” says Dr. Amler.

Related: Doctors Explain These Are the First Symptoms of Monkeypox to Look Out For

Monkeypox has an incubation period of approximately two weeks before pocks become evident, Dr. Hruby explains. Once the pocks become evident, the individual could transmit the disease to close contacts via touch, contaminated bedding or close proximity.

Precautions You Can Take to Avoid Catching Monkeypox

The CDC provides guidelines to follow during sex to stay safe. These include limiting your number of sex partners, wearing condoms (although it won’t prevent all exposure since it can occur on other parts of your body) and exchanging contact information with new partners in order to follow up.

“In general, avoid close skin-on-skin contact with anyone who has symptoms or a rash that might be monkeypox,” Dr. Amler states. “Avoid contact with fabrics and objects used by a person with monkeypox and wash your hands often.”

Vaccination is an essential tool in preventing the spread of monkeypox but supplies of vaccines have been limited. Temporary changes in behaviors can reduce the risk of exposure to monkeypox until vaccine supplies are restored, Dr. Amler explains. Even after a second vaccine dose, CDC recommends taking a two-week break from activities that risk exposure to monkeypox.

Another important call out is around treatment.

TPOXX is an antiviral drug that effectively treats orthopoxvirus (smallpox, vaccinia, cowpox and monkeypox). It has been approved in the U.S. and Canada for smallpox only. However, TPOXX is approved in Europe and the U.K for orthopoxvirus infections, including monkeypox. Since the start of the recent epidemic, the drug has been used successfully in Europe, and in the U.S. as well under an expanded use of an investigational new drug (IND) held by the CDC, Dr. Hruby states.

Next up: Do You Need the Monkeypox Vaccine?

Sources

• Dr. Robert Amler, the Dean of School of Health Sciences and Practice at New York Medical College and a former Chief Medical Officer at the CDC Agency for Toxic Substances and Disease Registry

• Centers for Disease Control and Prevention: “Safer Sex, Social Gatherings, and Monkeypox”

• Dennis E. Hruby, Ph.D., Executive Vice President and Chief Scientific Officer of SIGA Technologies