[Monkeypox Emergency] Blisters on Hands and Soles, Fever and Headache... Infection Through Blood and Body Fluids

WHO Declares 'Public Health Emergency of International Concern (PHEIC)'
Fatality Rate 3-6% ... Approximately 3 Weeks of Quarantine Until Scabs Fall Off

On June 27, a nurse who will treat monkeypox patients received a monkeypox vaccine at the main building of the National Medical Center in Jung-gu, Seoul. Photo by Mun Ho-nam munonam@

[Asia Economy Reporter Jo In-kyung] The second confirmed case of monkeypox in Korea was identified on the 3rd. This is an additional confirmed case about two and a half months after the first patient was reported. Based on guidance from the Korea Disease Control and Prevention Agency, we have summarized frequently asked questions about monkeypox in a Q&A format.

What is Monkeypox?

Monkeypox is a rare disease caused by infection with the monkeypox virus. It belongs to the Orthopoxvirus genus within the Poxviridae family, which is a group of animal DNA viruses.

The name "monkeypox" was given after a disease similar to chickenpox was first discovered in monkeys bred for research in 1958. Cases of monkeypox infection were first reported in 1970 in the Democratic Republic of the Congo, and since then it has become endemic in Central and West African countries such as Gabon, Nigeria, the Central African Republic, C?te d'Ivoire, and Cameroon.

What is the current domestic and international situation?

Since May of this year, monkeypox has started to occur unusually in countries where it is not endemic, beginning mainly in Europe and spreading worldwide. According to the World Health Organization (WHO), the number of infections, which was about 3,000 as of June, exceeded 50,000 as of the 1st of this month. Although WHO declared monkeypox a Public Health Emergency of International Concern (PHEIC) on July 23, the spread has somewhat slowed down recently due to vaccination and other preventive measures.

How is it transmitted?

Monkeypox is a zoonotic infectious disease transmitted from animals to humans, humans to humans, and from contaminated environments to humans. Infection occurs through contact with infected individuals, animals, or materials contaminated with the virus. Sources of infection include the patient's blood or bodily fluids, skin lesion exudates, and clothing, bedding, or needles contaminated with the patient's blood or fluids.

Vertical transmission from an infected mother to fetus through the placenta can also occur. Airborne transmission via virus-containing fine aerosols is possible but uncommon.

What are the main symptoms?

Symptoms start with fever, headache, muscle pain, muscle weakness, chills, fatigue, and lymphadenopathy, followed by rash appearing 1 to 3 days later. Symptoms manifest within 5 to 21 days after infection (average 6 to 13 days) and last for 2 to 4 weeks.

The rash begins as round red spots resembling papules and progresses through stages of vesicles (blisters), pustules (pus-filled lesions), and crusts (dry, hardened scabs). The rash tends to concentrate on the face, palms, and soles, but also appears on the mouth, genitals, and eyes, spreading to other areas.

Severity and fatality rate

Symptoms range from mild to severe and can be fatal. The fatality rate is generally known to be between 1% and 10%. According to WHO, the recent fatality rate is reported to be 3% to 6%. During the outbreak centered in Europe, three deaths were reported: two in Spain and one in Belgium.

Diagnosis and treatment

Genetic testing is performed using blood, tissue or fluid from skin lesions, or crusts from suspected patients. The Korea Disease Control and Prevention Agency established a monkeypox testing system in 2016.

Infected individuals are isolated and hospitalized to receive symptomatic treatment. Antiviral drugs and immunoglobulins for monkeypox treatment are secured domestically. Approximately 500 doses of the antiviral drug Tecovirimat, used for monkeypox treatment, have been imported and distributed to 17 nationally designated treatment centers across the country for immediate use if necessary.

Prevention methods

About 5,000 doses of the monkeypox vaccine "Jynneos" have been imported into Korea, and vaccination for essential medical personnel has been completed. To prevent infection, avoid direct or indirect contact with infected individuals, those at risk, and animals. Refrain from visiting outbreak areas, and if visiting, follow guidelines such as wearing gloves and masks and washing hands. Avoid contact with wild animals and be cautious when handling or consuming wild game meat.

How are confirmed cases and contacts managed?

Confirmed patients must remain isolated and hospitalized until the infectious period is considered over, which is when scabs have fallen off.

Contacts are classified into three risk levels: high, medium, and low. Monitoring is conducted for 21 days only for high- and medium-risk groups. A 3-week quarantine is recommended for the high-risk group, while no quarantine is required for the medium-risk group; however, work restrictions are recommended if they work with high-risk groups. The high-risk group includes those exposed to the patient's broken skin, bodily fluids, or droplets without protective equipment, as well as family contacts. The low-risk group includes those who had physical or droplet contact while wearing protective equipment or those with no physical contact and minimal likelihood of droplet exposure.