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 (distinctive feature of monkeypox)
- 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)[1]
Diagnostic Criteria
Clinical, laboratory and epidemiologic criteria for case classification — U.S. Monkeypox Response, May 2022[2]
| 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 |
(*)The characteristic rash associated with monkeypox lesions involve the following: deep-seated and well-circumscribed lesions, often with central umbilication; and lesion progression through specific sequential stages: macules, papules, vesicles, pustules, and scabs. The rash can sometimes be confused with other diseases that are more commonly encountered in clinical practice (e.g., secondary syphilis, herpes, and varicella zoster). Historically, sporadic accounts of patients co-infected with Monkeypox virus and other infectious agents (e.g., varicella zoster, or syphilis) have been reported, therefore patients with a characteristic rash should be considered to receive testing, even if other test results are positive. † Clinical suspicion can exist if initial signs and symptoms are consistent with illnesses confused with monkeypox (e.g., secondary syphilis, herpes, and varicella zoster).
References
- ↑ "Clinical Recognition | Monkeypox | Poxvirus | CDC". Retrieved 2022-06-14.
- ↑ "Monkeypox Outbreak — Nine States, May 2022 | MMWR". Retrieved 2022-06-14.