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Monkeypox. You've probably heard about it by now, but what is it and is it a threat that you need to worry about? 

"It's in the same family as smallpox but it should not be confused with it in terms of level of alarm. With smallpox, 10-30% of people can die," said Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group, in a recent podcast.

"With the particular strain of monkeypox that is circulating right now, that death rate in Africa is 1% or less. It causes symptoms that look very much if not identical to smallpox, with one exception. With monkeypox you get lymph node swelling, and you don't get that with smallpox."

Symptoms typically begin with flu-like symptoms before the patient develops a rash, possibly beginning on the face and spreading to other parts of the body. More on how the disease can evolve, according to the Mayo Clinic: 

"Monkeypox is a rare infection that begins with flu-like symptoms followed by a distinctive rash. The rash initially consists of flat patches, then progresses to raised nodules and then to vesicles, with one or two days in each phase. The final stage of pus-filled blisters can last five to seven days."

Most people recover within 2-4 weeks without treatment, though there are two different vaccines that can benefit people infected by monkeypox, and the U.S. has a large stock of them that can be deployed to limit spread.

In an announcement Monday, the Centers for Disease Control and Prevention (CDC) said it's "likely" that there will be more cases of monkeypox in the U.S., but only a handful of cases have been confirmed so far, none of which are in Minnesota. 

Most global cases are associated with people who identify as gay and bisexual men, the CDC said. But what the CDC is investigating is the oddity of the virus spreading to different countries, as many of those recently testing positive for monkeypox have not reported travel to Africa, which is abnormal.  

It's possible that contributing to this is waning immunity to viruses linked to smallpox, which was eradicated 45 years ago thanks to a global vaccination effort.

"I think, like many of you, we have a strong scientific concern that monkeypox is a little different spreading this way than we've seen before," said Jennifer McQuiston, deputy director of the CDC's highly pathogenic department. "Right now, the case count is low, so I don't think that there is a great risk to the general community for monkeypox in the United States."

Typically, monkeypox is spread by skin-to-skin contact with someone who has an active rash, or through respiratory droplets coming from an infected person who has lesions in their mouth. 

That is different from COVID-19, which can spread through much smaller airborne particles known as aerosols. The transmissibility of monkeypox is much lower than it is with COVID.

"It's not a situation where if you're passing someone in the grocery store you're going to be at risk for monkeypox," said McQuiston. 

It's for this reason U.S. health officials are talking only about localized vaccinations to people who have been exposed to those with the virus, such as healthcare workers, rather than mass vaccinations.

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