[Q&A] Swollen Lymph Nodes and Rash on Arms and Legs... Is It Monkeypox or Chickenpox?

For Prevention, 'Hand Washing' Is More Important Than Masks

[Image source=Yonhap News]

[Asia Economy Reporter Kim Young-won] As monkeypox spreads globally, including one confirmed case in South Korea, interest in prevention and treatment is growing. As of the 4th, a total of 6,157 confirmed monkeypox cases have been reported in 59 countries. Namjoong Kim, Chairman of the Korean Society of Infectious Diseases (Professor of Infectious Diseases at Seoul National University Hospital), stated on the 5th regarding concerns about monkeypox, "(Monkeypox) is transmitted through close contact, so there is absolutely no possibility of a pandemic like the COVID-19 outbreak." Based on responses from Chairman Kim and the Central Disease Control Headquarters, we have summarized common questions about monkeypox.

How does monkeypox infection progress?

Monkeypox goes through incubation, prodromal, rash, and recovery stages. The incubation period lasts about 5 to 21 days, with a median of around 8 days. During the prodromal stage, symptoms such as fever, headache, and back pain appear, and lymphadenopathy (swelling of lymph nodes) occurs in the neck and groin around the same time as the fever. Usually, a rash appears 1 to 3 days after the fever starts.

The rash progresses in the order of macules, papules, vesicles, pustules, and crusts. Unlike chickenpox, multiple skin lesions simultaneously progress to vesicles, pustules, and crusts. Chickenpox lesions often show mixed forms on the body. A distinctive feature of monkeypox rash is the presence of a "central umbilication." Also, chickenpox rashes mainly appear on the face and trunk, whereas monkeypox rashes often appear on the face, limbs, and palms and soles. The most helpful way to distinguish monkeypox from chickenpox is the presence or absence of lymphadenopathy.

What is the mortality rate if infected with monkeypox?

Generally, the mortality rate is known to be 3-8%, but since there have been no deaths in non-endemic areas, this does not correspond to the situation in South Korea. More than 5,000 confirmed cases have occurred in non-endemic regions such as Europe and the United States, but no deaths have been reported. Monkeypox is classified into Central African and West African clades; according to data before the 2022 outbreak, the Central African clade had a mortality rate of 10.6%, and the West African clade had a mortality rate of 4.6%. While deaths could occur if immunocompromised patients become infected under current conditions, it cannot be said that the mortality rate reaches 3%.

Is a large-scale outbreak through community transmission possible?

Transmission within the community can occur, but the possibility of a pandemic like COVID-19 is virtually nonexistent. Monkeypox can be transmitted through close contact and droplets, but the main route of infection is close contact. One imported case has already occurred domestically, and there is a sufficient possibility of new cases being imported in a similar manner. While additional cases through close contact are possible, since transmission mainly occurs through close contact, a pandemic is unlikely.

Can monkeypox be diagnosed during the incubation period?

There is no way to diagnose monkeypox during the incubation period. However, it is known that the disease is not transmitted during the incubation (asymptomatic) period. The currently recognized standard diagnostic test is genetic detection. If monkeypox virus genes are detected in vesicles, pustules, or other sites, the test is positive. Culturing the virus from vesicles or pustules is the most accurate method but has the disadvantage of taking too long.

Does monkeypox leave scars after infection?

As the disease name suggests, monkeypox is caused by a virus similar to smallpox. However, monkeypox is generally a milder disease compared to smallpox. Smallpox has a high mortality rate and often leaves scars (cicatrices) on the face even after recovery, but monkeypox rarely leaves scars. Some scarring may remain after recovery, but it is known to gradually fade over time and mostly disappear.

How can monkeypox be prevented?

Hand hygiene is the most important, just like with COVID-19. Also, close contact with suspected animals or patients with monkeypox should be avoided. If close contact within 2 meters is necessary, wearing a mask helps. In other situations, it is not necessary to wear a mask specifically for monkeypox prevention.

This content was produced with the assistance of AI translation services.