Monkeypox Treatment: Understanding the Options for Care

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Vaccines and Medications Help Break the Chain of Transmission
As monkeypox cases continue to spread globally, healthcare providers and public health officials are working hard to treat those affected and limit further transmission. While monkeypox is rarely life-threatening, the rash and lesions caused by the virus can be extremely painful. Treatment aims to alleviate symptoms and shorten the illness period to help break the chain of transmission in communities.

Vaccination Following Exposure

For those exposed to monkeypox through close physical contact with an infected individual, vaccination may help prevent the onset of disease if given soon after exposure, typically within 4 days but possibly up to 14 days. The smallpox vaccine, Imvanex or Jynneos, is currently being used against monkeypox as it provides cross-protection. A single dose is believed to be 85% effective in preventing the disease. Vaccination sides effects are typically mild.

Antivirals for Symptomatic Patients

For individuals who develop Monkeypox symptoms such as fever, swollen lymph nodes and the characteristic rashes, antiviral treatment can help reduce severity and contagiousness. The antiviral tecovirimat, branded as Tpoxx, inhibits viral replication and is approved for treatment of smallpox. It is available through expanded access protocols or compassionate use for monkeypox until clinical trials confirm efficacy. Tecovirimat is administered orally twice daily for 2 weeks.

Other antivirals sometimes used off-label for monkeypox include brincidofovir and cidofovir. Both work to inhibit the viral DNA polymerase enzyme. However, substantial toxicities must be monitored with these medications. Treatment typically lasts until all scabs from lesions have fallen off. Antivirals work best when given early in the illness, ideally within the first 4 days of rash onset.


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