Monkeypox T: Answering questions about the virus.

The virus — a milder relative of smallpox first discovered in monkeys — is rare outside of central and western Africa.

The World Health Organization on Saturday declared the outbreak a public health emergency, calling it an “extraordinary event” and calling for a response.

We spoke to experts to find out who’s most at risk, where to get tested, and what else the public needs to know.

How severe are the symptoms?

“Symptoms of monkeypox, like many other viral infections, can begin with fever, weakness, muscle aches and pains,” said Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital. “Eventually, most people develop a rash.”

Cooking is special. “It’s not just red skin,” Kuritzkes said. “These little blisters or what we call vesicles form.”

The sores fill with fluid and often look like pimples, said Nikki Alcala, public health nurse at Fenway Health. They can appear anywhere on the body – externally or internally.

A study published last week in the New England Journal of Medicine found that 95 percent of patients developed a rash, but most had fewer than 10 lesions.

Dr. Keletso Makofane, an epidemiologist at Harvard’s FXB Center for Health and Human Rights, who worked on the study, said monkeypox “depends on the severity” and level of discomfort “depending on where it is affected.”

Injuries to the rectum often cause “false health” because they interfere with bowel movements. Sore throats make it difficult to eat.

“For some people, the pain is so excruciating that it becomes difficult for them to function,” Makofane said.

For most people, the rash lasts two to four weeks and resolves on its own. The affected areas will begin to scab over and itch as they heal.

Examples of monkeypox rashes.Centers for Disease Control and Prevention

How is it transmitted?

“The primary route of transmission is close person-to-person contact, and that usually means skin-to-skin contact with open sores,” Kuritzkes said.

Monkeypox is also spread through contact with sheets, towels, and clothing used by an infected person.

It takes “a long time” for monkeypox Through respiratory or face-to-face contact, such as talking, “close contact takes much longer to transmit COVID-19 than you might think,” Kuritzkes said.

Before this outbreak, monkeypox was not known to be sexually transmitted, said Dr. Martin Hirsch, an infectious disease physician at Massachusetts General Hospital. Most of the confirmed cases now involve men who have sex with men.

In a New England Journal of Medicine study, 98 percent of those infected were gay or bisexual men, and 95 percent were sexually transmitted.

Nevertheless, experts emphasize that sexual intercourse is not the only way of infection.

“It’s sexually transmitted and it’s not just gay people who are at risk,” Alcala said.

Can you catch monkey pox while riding the T?

“It would be highly unlikely,” Kuritzkes said. “By holding the same handle, rope, or pole, you are less likely to catch monkeypox or breathe the same air.”

In a crowded car during rush hour, passengers may come into contact with other people’s skin. If they have sores, they can transmit monkeypox, Kuritzkes said.

“Wearing long sleeves would be protective,” he said.

How else can people protect themselves?

People should wash their hands and avoid close skin contact with a rash that may have monkeypox, said Dr. Erica Shenoy, deputy chief of infection control at Mass. General.

Experts also recommend that people limit the number of sexual partners.

“People in monogamous relationships have nothing to worry about, no matter what kind of sex they’re having,” Kuritzkes said.

It’s important for people to know who their partners are, who they’ve been with and whether they have symptoms of monkeypox, he said.

Condoms provide only partial protection, as infection is not limited to the exchange of secretions. “The problem is the smallpox sores — it can be genital, but it can be anywhere else, on the stomach or on the hand or arm,” Kuritzkes said.

Where can I take the test?

Testing for monkeypox — which involves swabbing sores or scabs — is available through the Massachusetts Public Health Laboratory and commercial and reference laboratories, according to a memo from state officials Tuesday.

Providers at clinics or hospitals must collect samples and send them to laboratories.

A state lab in Jamaica Plain typically processes tests and returns results to providers within 24 hours, a DPH spokeswoman said.

Commercial labs list longer turnaround times — about two to three days — if samples must be shipped out of state.

While waiting for results, people should cover any wounds, wear masks, use a separate bedroom and bathroom, and disinfect common surfaces. A person who tests positive for the virus must remain in isolation until they recover.

What is the treatment?

There are three antiviral treatments approved by the Food and Drug Administration to treat chickenpox that are also effective against monkeypox, Kuritzkes said.

“Most people don’t really need treatment, but people with severe symptoms have been treated,” he said.

Kuritzkes said the most commonly used drug in the United States is tecoxiramit, also known as TPOXX. It was distributed to states from strategic stocks held by the government.

According to Hirsch, the drug is still not enough.

A health worker prepared a vaccine against a monkey.Graham Hughes/Associated Press

Who is eligible to receive the vaccine?

People with “known contacts” or “suspected contacts” of people with monkeypox are eligible for JYNNEOS vaccine, according to the Massachusetts Department of Public Health. The vaccine is administered in two doses, at least 28 days apart.

The shot is recommended within four days of exposure to prevent monkeypox, and within 14 days to reduce the severity of the disease. People who have had multiple sexual partners in the past 14 days in an area with monkeypox are also eligible.

The shots are scheduled only at about a dozen clinics in the state, including Fenway Health, MGH Sexual Health Clinic, Boston Medical Center and Cambridge Health Alliance. The complete list is available on the government website.

Massachusetts received 2,004 doses of the vaccine from the CDC on July 5, and “more vaccine is expected to be available in the coming weeks.” government website.

How dangerous is monkey pox?

“I don’t want anyone to worry,” Shenoy said. “I want them to be aware, to be vigilant, and to know what to do if they develop symptoms that might be consistent with monkeypox” – isolation and testing.

Experts agree that monkeypox is a cause for concern, but not as severe as COVID-19.

“It’s very troubling that we’ve seen such a large increase in the number of cases,” Kuritzkes said. “It’s not going to rise exponentially like we’ve seen [COVID-19] will explode, but it could certainly lead to a major epidemic.”

Unlike COVID, there have been no deaths from monkeypox in the United States.

“So it’s not as bad as COVID,” Makofane said. Nevertheless, monkeypox is a “serious disease.”


Camille Caldera can be reached at camille.caldera@globe.com. Follow him on Twitter @camille_caldera.

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