Monkeypox history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Bassel Almarie, M.D.
Overview
History
The significant information in the patient's history include:
- Recent travel to endemic area
- Recent contact with person with similar complains or infected person with monkeypox
Symptoms
After infection, the incubation period lasts 7-14 days. Initial symptoms develop at the beginning of the prodromal period such as:
- Fever
- Chills
- Lymphadenopathy
- Headache
- Myalgia
Following the prodromal period, a rash develops with the following characteristics:
- Lesions develop and evolve at the same time
- Lesions progresses from macular (1−2 days), papular (1−2 days), vesicular (1−2 days), to pustular (5-7 days), then scab (7-14 days)
Diagnostic Criteria
Clinical, laboratory and epidemiologic criteria for case classification — U.S. Monkeypox Response, May 2022
Clinical and laboratory classification | Criteria |
Suspected | New characteristic rash* OR |
Meets one of the epidemiologic criteria and has high clinical suspicion† for monkeypox | |
Probable | No suspicion of other recent orthopoxvirus exposure (e.g., Vaccinia virus in ACAM2000 vaccination) AND demonstration of the presence of |
• Orthopoxvirus DNA by polymerase chain reaction testing of a clinical specimen OR | |
• Orthopoxvirus using immunohistochemical or electron microscopy testing methods
OR | |
• Detectable levels of antiorthopoxvirus IgM antibody during the period of 4–56 days after rash onset | |
Confirmed | Demonstration of the presence of Monkeypox virus DNA by polymerase chain reaction testing or next-generation sequencing of a clinical specimen
OR |
Isolation of Monkeypox virus in culture from a clinical specimen |