As of June 22, 2022, there are more than 3,200 confirmed monkeypox cases globally. According to the Center for Infectious Disease Research and Policy (CIDRAP), monkeypox cases have been reported in 42 countries in five global regions. In the U.S., to date, 142 infections have been reported as the virus has been identified in 20 states and the nation’s capital. In the U.K., the country currently with the leading number of reported infections, 793 cases have been detected. The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) are concerned about the rapid spread of the monkeypox virus to countries where it typically has not been seen. The WHO is expected to hold a meeting on June 23, 2022, to determine whether monkeypox is an “emergency of international concern.” The disease is already causing disruptions as a British Airways flight crew is reportedly being kept in isolation for 21 days after a member of the crew tested positive for monkeypox. Is this the start of another pandemic? Here is what you need to know about monkeypox.

What is monkeypox?

Monkeypox is a disease characterized by rash and flu-like symptoms caused by the monkeypox virus. The virus was first identified in 1958 in monkeys being used for research in Denmark, but it more typically has been known to be spread by rodents. It is a member of the smallpox family. Monkeypox was generally limited to outbreaks in Central Africa and West Africa for decades but, in 2003, a shipment of infected rodents from Ghana to Texas spread the virus to pet prairie dogs which resulted in 47 people infected in the Midwest. More recently, as described by the Cleveland Clinic:

“As international travel becomes more common, viruses that were once fairly confined to certain locations can more easily spread around the world. In the summer of 2021, a case of monkeypox was found in a U.S. resident who had traveled from Nigeria to the United States. Then, 2022 brought outbreaks to regions outside of Africa, including Europe, the Americas and Australia.”

The current global outbreak of monkeypox is distinguished from previous outbreaks as it’s being found in people in other countries with no history of travel to Africa—in other words, community spread.

How is monkeypox transmitted?

As described by the New York Times in “As Monkeypox Spreads, a Campaign to Warn the Public Gains Urgency,” monkeypox “mostly spreads through direct contact with lesions (but) it can also be spread via shared objects such as towels, as well as by droplets emitted when speaking, coughing or sneezing.” Further, “scientists believe it may also be transmitted through tiny aerosol particles.” To this last point on the spread via aerosols, as with the early days of COVID-19, there is disagreement in the health community. In “CDC Dismisses Airborne Transmission of Monkeypox. Some Experts Disagree,” the Times tackles the divided opinions. Per the Times reporting, the CDC “pushed back against the idea that the monkeypox virus can spread through the air, saying the virus is usually transmitted through direct physical contact with sores or contaminated materials from a patient.” By contrast, the WHO “and several experts have said that while ‘short-range’ airborne transmission of monkeypox appears to be uncommon, it is possible and warrants precautions. Britain also includes monkeypox on its list of ‘high-consequence infectious diseases’ that can spread through the air.”

Finally, per the Times, Linsey Marr, an expert on airborne viruses at Virginia Tech says, “airborne transmission may not be the dominant route of transmission nor very efficient, but it could still occur…I think the WHO has it right, and the CDC’s message is misleading.”

In short, while the monkeypox virus is not thought to be as transmissible as other airborne viruses like SARS-CoV-2, the virus that causes COVID-19, it is possible to spread through short-range aerosols.

Monkeypox and germicidal UV

Like other pathogens, the monkeypox virus can be killed with germicidal ultraviolet (UV) light. For more information see the 2008 study, “Inactivation of Poxviruses by Upper-Room UVC Light in a Simulated Hospital Room Environment.” UV helps stop the spread of pathogens on a cellular level. By penetrating a pathogen’s cell wall, UV disrupts its DNA, breaking the carbon bond, and causing the death of the pathogen and/or rendering it harmless. The monkeypox virus is an enveloped double-stranded DNA virus. Aerapy maintains a database of estimated UV dosage needed to kill pathogens in the air and on surfaces, including enveloped double-stranded DNA viruses.

Aerapy UV disinfection technology

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