Issue link: https://www.ascpskindeepdigital.com/i/1481047
New member benefit! Get the ASCP SkinPro app at ascpskincare.com/skinpro 75 or "clade" of the virus that is highly virulent), and to West Africa (a different, less virulent clade). In Central Africa especially it can be a serious health threat, with infections severe enough to cause death in 3–10 percent of diagnosed cases. Ironically, some effective vaccines against this virus have been developed, but they are not made available to African populations who need them most. Statistics As of mid-July, over 10,000 cases of monkeypox had been reported globally this year. In addition to parts of Africa, these occurred in Europe, Asia, South America, North America, and Australia— all places where monkeypox is not typically seen. By early September, worldwide, the confirmed case count for monkeypox climbed to 52,026; and most of those cases were outside Africa. The US confirmed 21,274 cases. Deaths have occurred in Brazil, Ecuador, Cuba, India, and Spain, as well as in African countries, and we have seen two deaths in the US at the time of this publication. However, this is not a typical outcome; only 18 deaths related to monkeypox have been reported this year around the world. Also, in many, the deaths occurred in people who were severely immunocompromised. It's also worth noting that in many countries, new monkeypox infections appear to have peaked and are now subsiding. The US numbers have been falling since early August, but this is a trend that should be watched carefully, because it could change. SIGNS AND SYMPTOMS In its most typical form, monkeypox infections usually incubate for 1–2 weeks after exposure. Then patients may develop fever, malaise, and inflamed lymph nodes; this is the prodrome stage. This is followed by a painful rash with blisters that then fill with pus, and eventually become itchy as they scab over and heal over a course of 2–4 weeks. The rash may be all over the body or local to the site where the infection was contracted. However, some people don't experience the prodrome stage with fever and inflamed lymph nodes; their first symptoms are the characteristic blisters, which can range from being mild to excruciatingly painful. The less virulent form of monkeypox is a self-limiting infection: If the patient is healthy to begin with, it runs its course and then resolves without life- threatening complications. However, it can cause substantial and long-lasting pain in some patients. And in people who are immunocompromised, it may cause central nervous system infections that can be dangerous or deadly. TRANSMISSION Historically, monkeypox was spread from infected animals to humans through close contact, bites and scratches, or preparation of an animal for consumption. Human-to-human spread is a new phenomenon. It occurs through direct, often intimate or sexual, contact with a symptomatic person, or through prolonged contact with their bedding, clothing, or other intimate items—these are fomites. Researchers believe it may also be spread through respiratory droplets, as well as by way of contact with infected skin lesions. It is communicable from the onset of symptoms until after the skin lesions are fully healed, which can take several weeks. The public health community is working to discover how easily monkeypox virus can be spread through asymptomatic shedding from an infected person. Some evidence suggests this is possible, but not common—at this point most cases are related to prolonged skin- to-skin contact or skin-to-fomite contact. TREATMENT As a viral infection, monkeypox can't be treated with antibiotics. No antiviral medications have been officially approved for it, but some have been provisionally used in the absence of other options. Testing is underway for other medications. But getting through monkeypox is usually a matter of time— from exposure to prodrome fever and swollen lymph nodes through the rash and healing of the lesions. So far, this infection is usually mild and self-limiting. Infected people are counseled to isolate, and others in their circle may qualify for vaccination to help limit community spreading. Two vaccines against monkeypox are available in the US. They are distributed through local health authorities who may place priority on holding vaccines for people who are most at risk. IMPLICATIONS FOR THE ESTHETICS INDUSTRY What does all this mean for your practice? We know a few things about monkeypox that can help you feel confident about your decisions, at least until information changes. The main issue to remember is that while your work involves touch and close contact, this infection does not appear to be easily communicable in asymptomatic people. Reasons to reschedule an appointment: • If your clients have fever, malaise, and swollen lymph nodes. This was true before monkeypox was an issue. • If your clients have undiagnosed blisters, pustules, or scabs that started as blisters. This is a good reason to add a new question to your intake form: Do you have any blisters or pimples in a new pattern? If the answer is yes, the client should pursue more information with their health-care provider. Because it is possible that respiratory droplets may carry some virus, it is important to continue to observe excellent hygienic practice. In short, if you follow basic precautions about not working with people who have