Monkeypox and COVID-19: Here Are Key Differences

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University Hospitals Rainbow Babies & Children'sExperts in Children's Health
Monkeypox virus illustration

Monkeypox, a rare disease usually found in West and Central Africa, is hop-scotching across continents, with cases popping up in the United States, Europe and Australia. While the outbreak is attracting headlines, there is no threat of a global pandemic – and no comparison to COVID-19.

There are important differences that make monkeypox a much less serious threat than COVID-19, says Amy Edwards, MD, University Hospitals Rainbow Babies & Children’s pediatric infectious disease specialist. These include:

  • Monkeypox does not spread easily.
  • Infected people are easier to identify.
  • Outbreaks are easier contain.
  • The smallpox vaccine is effective against monkeypox.

“Unlike COVID-19, this virus doesn’t transmit human to human very efficiently,” Dr. Edwards says. “It’s also much easier to isolate infected individuals and prevent the spread.”

Symptoms of monkeypox are skin rashes or lesions that spread on the body. The virus also can produce flu-like symptoms. Dr. Edwards shares more information about the virus and answers common questions.

How does monkeypox spread?

Dr. Edwards: Transmission happens during close contact – prolonged physical contact or direct contact with body fluids or lesion material. It may also spread face to face through respiratory droplets or contact with contaminated bedding or clothing.

It doesn’t spread through the air like COVID-19. And unlike COVID-19, monkeypox isn’t contagious until the infected person becomes symptomatic. That makes it much easier to isolate infected individuals and prevent the spread.

What is the incubation period?

Dr. Edwards: The incubation is relatively long, up to two or three weeks. We don’t know exactly because there have not been a lot of cases to study. The smallpox vaccine can prevent the disease in a person who has been exposed or who is at risk of being exposed, such as a caregiver or household contact.

The fact that we already have an effective vaccine is another thing that sets monkeypox apart from COVID-19, which was a novel virus that required development of a new vaccine. We know how to handle monkeypox because it’s so closely related to smallpox.

How severe is monkeypox infection?

Dr. Edwards: Most people will have a relatively minor infection. A strain from West Africa that is spreading has a fatality rate of less than 1 percent. But that’s the mortality rate in Africa. It may be very different in developed countries where medical care is better.

When monkeypox jumps to another continent, it’s always the West African strain. Nobody in the United States has ever died from the West African strain.

There is another strain from Central Africa that is more severe. That strain is not involved in the current outbreak in North America, Europe and Australia.

Are there treatments?

Dr. Edwards:There is no specific monkeypox treatment, but a vaccine and antiviral drugs that were developed for smallpox are effective against monkeypox.

Sounds like there’s no cause for alarm?

Dr. Edwards: There is not. But we should take the viral outbreak as a warning that we need a strong public health sector to protect us from these things. COVID-19 brought to light deficiencies in our underfunded public health system. Public health is our best defense.

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