What is Monkeypox?

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Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. Monkeypox is not related to chickenpox.

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox”, the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.

The first human case of monkeypox was recorded in 1970. Since then, monkeypox has been reported in people in several other central and western African countries. Prior to the 2022 outbreak, nearly all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs, or through imported animals.

Sign & Symptoms: 

Monkeypox is a rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as smallpox. Monkeypox symptoms are similar to smallpox symptoms, but milder; and monkeypox is rarely fatal. Monkeypox is not related to chickenpox.

Symptoms of monkeypox can include:

  • Fever
  • Headache
  • Muscle aches and backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion
  • A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
    • The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks.

Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

Prevention:

There are number of measures that can be taken to prevent infection with monkeypox virus:

  • Avoid contact with animals that could harbor the virus (including animals that are sick or that have been found dead in areas where monkeypox occurs).
  • Avoid contact with any materials, such as bedding, that has been in contact with a sick animal.
  • Isolate infected patients from others who could be at risk for infection.
  • Practice good hand hygiene after contact with infected animals or humans. For example, washing your hands with soap and water or using an alcohol-based hand sanitizer.
  • Use personal protective equipment (PPE) when caring for patients.

Practice good hand hygiene after contact with infected animals or humans.

JYNNEOSTM  (also known as Imvamune or Imvanex) is an attenuated live virus vaccine which has been approved by the U.S. Food and Drug Administration for the prevention of monkeypox. On November 3, 2021, the Advisory Committee on Immunization Practices (ACIP) voted to recommend JYNNEOS pre-exposure prophylaxis as an alternative to ACAM2000 for certain persons at risk for exposure to orthopoxviruses.

Diarrhea and Swimming

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You can get sick with diarrhea if you swallow contaminated recreational water—water in pools, hot tubs, water playgrounds, or oceans, lakes, and rivers. In fact, diarrhea is the most common illness reported for outbreaks linked to recreational water.

Which germs in recreational water cause diarrhea?

You can get diarrhea from germs such as

These germs can survive in properly chlorinated water for minutes to days, depending on the germ.

How do germs that cause diarrhea spread in recreational water?

If someone is sick and has diarrhea in the water, millions of germs can contaminate the water. These germs can make other people sick if they swallow even a small amount of contaminated water. Swallowing 10 or fewer germs can make people sick. Germs can also get in the water if swimmers have poop, even tiny amounts, on their bottoms.

Pool chemicals and filters help kill germs

Filters and disinfectants (chemicals that disinfect the water, such as chlorine or bromine) work together to help kill germs in pools, hot tubs, and water playgrounds. Filters remove debris (such as leaves), which use up the disinfectant in the water. Pool staff make sure chlorine or bromine is at the level needed to kill most germs in the water within minutes. You can still be exposed to germs during the time it takes for the water to go through filters and for the disinfectant to kill germs. You can also get diarrhea from germs that are hard to kill, such as Crypto. Crypto stays alive for more than 7 days, even if water is properly filtered and disinfected.

Many places with pools use one filtration system for more than one pool, which causes water from multiple pools to mix. This means germs from one person’s body could contaminate the water in more than one pool.

How do I protect myself and those I care about?

We all share the water we swim, play, or relax in. Each of us can help protect ourselves, our families, and our friends from germs that can cause diarrhea.

Take the following steps when swimming in any type of water:

  • Stay out of the water if you are sick with diarrhea.
    • If you have Crypto, don’t go in the water until 2 weeks after diarrhea has completely stopped.
  • Don’t poop in the water.
  • Don’t swallow the water.
  • Take kids on bathroom breaks and check diapers every hour.
    • Change diapers away from the water’s edge to keep germs from getting in the water. Wash your hands after.

Before going in pools, water playgrounds, and hot tubs, also take these steps:

  • Use test strips to make sure the water has proper free chlorine (amount of chlorine available to kill germs) or bromine level and pH.
    • Free chlorine level: at least 1 part per million (ppm) in pools and water playgrounds and at least 3 ppm in hot tubs
    • Bromine level: at least 3 ppm in pools and water playgrounds and at least 4 ppm in hot tubs
    • pH (affects how well chlorine and bromine can kill germs): 7.2–7.8
    • Most superstores, hardware stores, and pool supply stores sell test strips. Follow the directions on the test strip package.
  • Shower before you get in the water.
    • A 1-minute shower removes most of the dirt, sweat, and oils on your body that use up chlorine or bromine needed to kill germs.

Follow these and other healthy swimming steps to help protect you and those you care about from getting sick.

Loneliness and Social Isolation Linked to Serious Health Conditions

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Social isolation was associated with about a 50% increased risk of dementia and other serious medical conditions.

Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.

A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated.1 Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone, the loss of family or friends, chronic illness, and hearing loss.

Loneliness is the feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated.

Health Risks of Loneliness

Although it’s hard to measure social isolation and loneliness precisely, there is strong evidence that many adults aged 50 and older are socially isolated or lonely in ways that put their health at risk. Recent studies found that:

  • Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.1
  • Social isolation was associated with about a 50% percent increased risk of dementia.1
  • Poor social relationships (characterized by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.1
  • Loneliness was associated with higher rates of depression, anxiety, and suicide.
  • Loneliness among heart failure patients was associated with a nearly 4 times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.

Immigrant, LGBT People Are at Higher Risk

The report highlights loneliness among vulnerable older adults, including immigrants; lesbian, gay, bisexual, and transgender (LGBT) populations; minorities; and victims of elder abuse. It also points out that the literature base for these populations is sparse and more research is needed to determine risks, impacts, and appropriate actions needed.

Current research suggests that immigrant, and lesbian, gay, bisexual populations experience loneliness more often than other groups. Latino immigrants, for example, “have fewer social ties and lower levels of social integration than US-born Latinos.” First-generation immigrants experience stressors that can increase their social isolation, such as language barriers, differences in community, family dynamics, and new relationships that lack depth or history, the report states. Similarly, gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.

What Can You Do If You Are Experiencing Loneliness?

Your doctor can assess your risk for loneliness and social isolation and get you connected to community resources for help, if needed. The following national organizations also offer helpful resources:

AARP—Provides helpful information to seniors to help improve quality of life and provides access to Community Connection Tools.

Area Agencies on Aging (AAA)—A network of over 620 organizations across America that provides information and assistance with programs including nutrition and meal programs (counseling and home-delivered or group meals), caregiver support, and more. The website can help you find your local AAA, which may provide classes in Tai Chi and diabetes self-management.

Eldercare Locator—A free national service that helps find local resources for seniors such as financial support, caregiving services, and transportation. It includes a brochure that shows how volunteering can help keep you socially connected.

National Council on Aging—Works with nonprofit organizations, governments, and businesses to provide community programs and services. This is the place to find what senior programs are available to assist with healthy aging and financial security, including the Aging Mastery Program® that is shown to increase social connectedness and healthy eating habits.

National Institute on Aging (NIA)– Provides materials on social isolation and loneliness for older adults, caregivers, and health care providers. Materials include health information, a print publication available to view or order no-cost paper copies, a health care provider flyer, and social media graphics and posts.

Health Care System Interventions Are Key

People generally are social by nature, and high-quality social relationships can help them live longer, healthier lives. Health care systems are an important, yet underused, partner in identifying loneliness and preventing medical conditions associated with loneliness.

Nearly all adults aged 50 or older interact with the health care system in some way. For those without social connections, a doctor’s appointment or visit from a home health nurse may be one of the few face-to-face encounters they have. This represents a unique opportunity for clinicians to identify people at risk for loneliness or social isolation.

NASEM recommends that clinicians periodically assess patients who may be at risk and connect them to community resources for help. In clinical settings, NASEM recommends using the Berkman-Syme Social Network Index (for measuring social isolation) and the three-item UCLA Loneliness Scale (for measuring loneliness).

But patients must make their own decisions. Some people may like being alone. It is also important to note that social isolation and loneliness are two distinct aspects of social relationships, and they are not significantly linked. Both can put health at risk, however.

Old lonely woman sitting near the window in his house with flowers