Ron Smith, MD
Monkeypox in the News
This digitally-colorized electron microscopic (EM) image depicted monkeypox virus particles, obtained from a clinical sample associated with the 2003 prairie dog outbreak. It was a thin section image from of a human skin sample. On the left were mature, oval-shaped virus particles, and on the right were the crescents, and spherical particles of immature virions.
28 November 2022. W.H.O. Says Monkeypox Is Racist: Decrees ‘Mpox’ as Alternative
WHO goes all-woke crazy. They are not trustworthy healther sources.
31 October 2022. Monkeypox Spreads in Africa Without Vaccines, Treatments
27 October 2022. CDC Analysis: More Than 8 in 10 Monkeypox Patients in Study Also Had HIV
26 October 2022. Study: Monkeypox Potentially Fatal For Those with HIV or Weak Immune Systems
1 October 2022. CDC: Monkeypox Elimination Unlikely in US
21 September 2022. Youngest Monkeypox Case Is an Infant under 2 Months from Florida, CDC Confirms
5 September 2022. Monkeypox Can Harm the Heart
2 September 2022. New monkeypox strain identified in the UK after patient travels to West Africa
30 August 2022. First US Death Tied to Monkeypox Reported in Texas
19 August 2022. Monkeypox Patient’s Crusted, Discolored Nose Rots After Doctor Misdiagnosed Pimple as Sunburn
19 August 2022. CDC Director: 98 Percent of Monkeypox Cases Are Occurring in Men
18 August 2022. Toddler Listed as First Pediatric Monkeypox Case in Texas
23 July 2022. Monkeypox Strikes Two Children on Opposite Coasts of U.S.
July 23, 2022. WHO declares monkeypox outbreak global health emergency
July 23, 2022. WHO Boss Tedros Officially Declares Monkeypox a Global Emergency
22 July 2022. Monkeypox Virus Could Become Entrenched as New STD in the US
July 22, 2022. CDC Director Confirms First Two Pediatric Monkeypox Cases in US.
TABLE 32.2.4 Centers for Disease Control and Prevention Case Definition for Monkeypox
Ryan, Edward, T. et al. Hunter's Tropical Medicine and Emerging Infectious Diseases E-Book. Available from: Elsevier eBooks+, (10th Edition). Elsevier - OHCE, 2019.
Depth (diameter in mm)
Time to desquamation
Frequency of lesions on palms or soles of feet
Superficial to deep (4–6)
Mild or none
CRITERIA FOR CLASSIFICATION
• Rash (macular, papular, vesicular, or pustular; generalized or localized; discrete or confluent)
• Fever (subjective or measured temperature of ≥99.3°F [≥37.4°C])
• Other signs and symptoms:
• Chills and/or sweats
• Sore throat
• Shortness of breath
• Exposure * to an exotic wild mammalian pet † obtained on or after April 15, 2003, with clinical signs of illness (e.g., conjunctivitis, respiratory symptoms, and/or rash)
• Exposure * to an exotic or wild mammalian pet † with or without clinical signs of illness that has been in contact with either a mammalian pet § or a human with monkeypox
• Exposure ¶ to a suspect, probable, or confirmed human case of monkeypox
• Isolation of monkeypox virus in culture
• Demonstration of monkeypox virus DNA by polymerase chain reaction testing of a clinical specimen
• Demonstration of virus morphologically consistent with an Orthopoxvirus by electron microscopy in the absence of exposure to another Orthopoxvirus
• Demonstration of presence of Orthopoxvirus in tissue using immunohistochemical testing methods in the absence of exposure to another Orthopoxvirus
• Meets one of the epidemiologic criteria, AND
• Fever or unexplained rash, AND
• Two or more signs or symptoms with onset of first sign or symptoms less than 21 days after last exposure meeting epidemiologic criteria
• Meets one of the epidemiologic criteria, AND
• Fever, AND
• Vesicular-pustular rash with onset of first sign or symptom less than 21 days after last exposure meeting epidemiologic criteria, OR
• If rash is present but the type is not described, demonstrates elevated levels of IgM antibodies reactive with Orthopoxvirus between at least days 7–56 after rash onset
• Meets one of the laboratory criteria
• An alternative diagnosis can fully explain the illness, OR
• The case was reported on the basis of primary or secondary exposure to an exotic or wild mammalian pet or a human (see epidemiologic criteria) subsequently determined not to have monkeypox, provided other possible epidemiologic exposure criteria are not present, OR
• A case without a rash does not develop a rash within 10 days of onset of clinical symptoms consistent with monkeypox.
• The case is determined to be negative for non-variola generic Orthopoxvirus by polymerase chain reaction testing of a well-sampled rash lesion by the approved Laboratory Response Network (LRN) protocol, OR
• The case is determined to have undetectable levels of IgM antibody during the period 7–56 days after rash onset.