Expert: Spread of monkeypox underscores need for physicians to be ready to understand disease

Monkeypox cases are starting to sprout up throughout the globe and the U.S., and experts say physicians must bone up on new resources to identify potential diagnoses in case they miss them.

So far, there are more than 550 confirmed cases across 30 nations, and 18 here in the U.S. Experts said during a briefing Wednesday held by the Infectious Diseases Society of America that physicians need to know what to look for and ask as monkeypox isn’t a common ailment in this country. 

Massachusetts General Hospital was one of the facilities that had a monkeypox patient who presented on May 12. The patient didn’t have any connection to animals nor traveled recently but was unresponsive to conventional treatments, said Erica Shenoy, M.D., associate chief of the facility’s infection control unit, during the briefing. 

After having read published reports of monkeypox in the U.K., the hospital decided to get expedited testing on the patient and discovered they had monkeypox.

Shenoy said physicians need to be better acquainted with the signs of monkeypox, noting that only a small subset that has already treated cases in the U.S. or during a similar outbreak in 2003. 

 "People outside of that realm are probably very unlikely to have any understanding of how to diagnose a case," Shenoy said. “There can be a lot of cross overlap with other infectious syndromes that are much more common. Being able to sort through the other non-infectious causes is very important.”

She recommended physicians turn to resources provided by the Centers for Disease Control and Prevention (CDC). The agency said in guidance that monkeypox can have a similar clinical course to that of smallpox. 

“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the agency’s guidance said. 

CDC also has resources on the onset of the disease, incubation period and the rashes that can develop because of the virus. There are vaccines and therapeutics available for monkeypox, which some analysts have said could help ensure the outbreak doesn't reach a pandemic status like COVID-19.

Shenoy said more information is likely to be added for physicians as cases continue to present throughout the globe. She added there could be person-to-person transmission happening already in the U.S. but that the expected source isn’t known yet for the 18 cases in the U.S.

"Once we get more information, as these case reports are formalized and [we] get all of that information, we will know a little bit more," she said.