What to Know About the Newest Migraine Drug

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Our primary care concierge doctors in Jupiter have a great deal of sympathy for our patients who suffer from migraines. It can be a debilitating condition and is often difficult to treat. So we welcome any new drug that can help relieve the pain. 

The latest such treatment is a new nasal spray that the U.S. Food and Drug Administration (FDA) approved earlier this month. In a clinical trial, the drug was found to provide relief from migraine pain in as little as 15 minutes.

According to health experts, nearly 40 million Americans suffer from migraines.

“They often interfere with daily functioning, keeping patients away from their work and unable to enjoy time with their loved ones,” neurologist Leah Croll at the Lewis Katz School of Medicine at Temple University, told ABC News.

“The faster we can bring relief to people suffering from a migraine attack, the sooner we can give them back that lost time,” she said.

What is a Migraine?

A migraine is not technically a headache, but a neurological disorder that includes a constellation of symptoms, with a painful, long-lasting headache at the center. Its main symptom is a severe throbbing pain or pulsing sensation in the head, which feels like a very bad headache, usually on one side of the head, but in a third of migraine attacks, both sides are affected.

It is often—but not always—preceded by what is known as an “aura,” strange tricks of vision that can encompass anything from a blind spot in the vision to flashing or shimmering lights to wavy or zigzagging lines.

Migraines are also usually, but not always, associated with such symptoms as nausea, vomiting, and extreme sensitivity to lights and noises, and can also include a pins-and-needles sensation in the arms and legs or a weakness or numbness on one side of the face or body.

One or two days before the onset of a migraine, patients often experience subtle body signals (called “prodrome”) that can alert them to an upcoming migraine. These changes can include neck stiffness, constipation, increased thirst and urination, food cravings, frequent yawning, and mood swings from depression to euphoria.

It is also possible to have many migraine symptoms, especially the aura, without a headache. The primary signs of a migraine, however, are the extreme incapacitation associated with the headache pain involved.

The Nasal Spray Advantage

According to the National Institute of Neurological Disorders and Stroke, migraines are caused by the activation of nerve fibers in the wall of brain blood vessels. 

Calcitonin gene-related peptide (CGRP) is a chemical messenger in the brain that controls pain and inflammation. The newly approved drug, Zavzpret, works by blocking CGRP’s pain signals, according to its maker Pfizer.

Pfizer says Zavzpret (generic name “zavegepant”) is the “first and only” CGRP nasal spray for treating migraines with or without an aura. A March study published in the journal Lancet found the drug began working to treat symptoms in as little as 15 minutes, offer normal functioning in 30 minutes, and provided some relief for up to 48 hours for 24 percent of migraine sufferers.

The rapid relief Zavzpret provides offers an advantage over existing oral treatments, Dr. Emad Estemalik, a headache specialist at the Cleveland Clinic, told NBC News.

“A lot of patients, when they have migraines, they’re throwing up, for instance, so they may not be able to hold oral medication,” he said. “That’s where an intranasal comes as an advantage.”

Kate Mullin, a board-certified neurologist at the New England Institute for Neurology and Headache who helped conduct the trial for Pfizer, explained to ABC News that at least 60 percent of migraine sufferers also experience nausea, making it difficult to swallow pills.

“You can’t absorb oral medications when you’ve got what’s called gastroparesis of migraine,” she said.

“Your gut pretty much falls asleep and is not in a place to absorb mediations effectively for many migraine sufferers,” she added. “A nasal spray helps bypass the gut altogether to optimize absorption.”

Some Reservations

As with all drugs, of course, there are side effects to Zavzpret.

The FDA listed the following side effects reported by participants during the clinical trial:

  • taste disorders (18 percent)
  • nausea (four percent)
  • nasal discomfort (three percent)
  • vomiting (two percent)

Still, those who treat migraines welcomed the addition of the new drug to the migraine arsenal. 

Elizabeth Kraus, Phar.D., Neurology Clinical Pharmacy Specialist at Corewell Health, told Prevention that while she’s not overly impressed with the 24 percent success rate, Zavzpret may be better for those whose migraines tend to progress rapidly, those who don’t do well with oral medications, and individuals who struggle with severe nausea.

Amit Sachdev, M.D. M.S. medical director in the Department of Neurology at Michigan State University told Prevention that he, too, wasn’t happy with the 24 percent success rate.

“I would like to see a more broad effect, but the current trial results wouldn’t keep me from thinking of this medication [for patients],” he said.

Kraus concurred.

“If I can give someone something that will act fast and have a more lasting effect . . . That’s what I care about,” Kraus said.

The new drug is expected to be released in July of this year.

Live Longer with Blue Zone Foods

Environment, Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health, Uncategorized

Of all the diet trends available today, one our primary care concierge doctors in Jupiter can highly recommend is the Blue Zone way of eating: fresh, healthy, unprocessed food, from as close to its source as possible, in meals shared with family and friends.

The term “Blue Zone” was coined nearly 20 years ago by journalist and researcher Dan Buettner in a 2005 National Geographic cover story titled, “Secrets of Living Longer.”

His team of anthropologists, demographers, and scientists had traveled the world to find the world’s longest-living people, and to discover the secrets to their longevity.

Buettner’s team found five seemingly disparate places where the people live exceptionally long, healthy lives: on average, around 100. (The term “blue zone” came from the blue circles the researchers drew on a map during their quest.)

The five places are:

Okinawa, Japan
the Nicoyan Peninsula in Costa Rica
the Seventh Day Adventists in Loma Linda, California
Sardinia, Italy
Ikaria, Greece

More than Diet

Of course, healthy eating is key to a healthy body, but the Blue Zone residents had more than good food on their side. Genetics, as always, plays a big role in how long anyone will live no matter where they are.

Other factors the team found the Blue Zones had in common were:

Natural movement: no marathons or gym visits, just long walks, hiking, gardening, etc.
Hara Hachi Bu: an Okinawan term for eating until they’re about 80 percent full
Plant slant: a preference for plant foods over meat
Grapes of Life: one to two servings of red wine daily (except for the Seventh Day Adventists, who eschew alcohol)
Plan de Vida: or “why I wake up in the morning,” i.e., a sense of purpose
Downshift: controlling stress, a sense of serenity
Belong: participation in a spiritual community
Loved ones first: making family a priority
Close tribe: social connectedness

Blue Zone Meals

The Blue Zone diet, which Buettner details in his latest book, “The Blue Zones American Kitchen: 100 Recipes to Live to 100,” is a cornerstone of the Blue Zone program, and closely resembles the Mediterranean diet, but with even less emphasis on fish and meat.

“The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts, and beans. In fact, I argue the cornerstone of a longevity diet is beans,” he told CNN.

Legumes, in fact, are key, he told The Washington Post. They are rich in fiber, which is key to improving cholesterol and blood sugar levels.

“Figure out how to get a cup of beans into your diet every day,” he told the paper. “Just one cup gives you half of all the daily fiber you need.”

What Not to Eat

And even though the Mediterranean diet includes a certain amount of meat and fish, Blue Zone diets contain little, if any.

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only three ounces,” he told CNN. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.”

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino, he said.

In addition, “no more than three eggs are consumed per week,” he told NBC’s Today show.

“The Blue Zone eating pattern is 98 percent plant-based foods—whole food-based and high carbohydrate,” Buettner told CNN.

“But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop. You say carbohydrates and people are horrified, but the healthiest foods in our food system are complex carbohydrates,” he added.

Time and Place Count, too

In keeping with the other factors that affect longevity, sharing meals—especially with family—is another component. While our busy schedules might not often permit this, Buettner says it’s worth doing as often as possible.

“Families that eat together tend to each much more nutritiously, they eat slower, and there’s good research that children have fewer issues with disordered eating if they’re eating socially,” he told The Post.

And it turns out the recent trend toward intermittent fasting appears to have some validity. Buettner reports that people in Blue Zones tend to eat earlier in the day.

Okinawans, for instance, traditionally eat a big breakfast and a moderate lunch.

“They don’t even have dinner,” he told the paper.

And the Seventh Day Adventists in Loma Linda would eat a big breakfast at 10 a.m. and a moderate lunch at 4 p.m. “And then they’re done for the day,” he said.

Small Moves

Of course, there’s more to the Blue Zone lifestyle than just food, as we mentioned earlier. Three of the five Blue Zones are isolated, which forces tight social connections and a lot of walking.

“Walking is one of the best forms of exercise and you can do it without thinking about it,” Buettner told Today, suggesting that people think about adopting a dog as a strategy to encourage regular walks.

“We’re all looking for magic dietary pills or serums or supplements, but you see none of that in the Blue Zones,” he said. “It’s mostly small things driven by the right environment,” he said.

That includes social connections.

“We’re genetically hardwired to crave social interaction, and when you don’t have it, there’s a level of subconscious stress that grates away at you,” he added.

Nature Can Heal in More Ways Than One

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Humans evolved in the natural world. We may have retreated to caves or huts to protect ourselves from the elements, but we spent much of our time outdoors, hunting, gathering, cooking, telling stories, and so on. Our lives these days, though, are largely spent cut off from nature.

This way of life has sparked a wealth of studies showing that our loss of contact with nature—dubbed “nature deficit disorder”—has a real impact on our physical and mental health.

So our primary care concierge doctors in Jupiter weren’t too surprised to learn of a new study published this month in the journal Occupational & Environmental Medicine, which found that enjoying nature up to four times a week reduced the odds of needing mental health medications by 33 percent.

It also reduced the odds of using blood pressure pills by 36 percent and asthma medications by 26 percent.

The Study

Researchers interviewed about 6,000 people who live in large cities in Finland, asking about their access to and use of green and blue spaces, including parks, zoos, rivers, lakes, or the sea. 

They also asked subjects whether they could see views of nature from their homes, how often they spent time outdoors as well as how much they exercised while outdoors.

The study also accounted for other possible factors such as traffic-related outdoor air pollution and noise, which have been proven to have an adverse effect on health.

Respondents were then asked about their use of medications for depression, anxiety, high blood pressure, asthma, or insomnia, and correlated these with time spent in nature.

As noted above, the results were markedly better for those who were regularly exposed to green or blue spaces. Notably, those who lived in areas with a lot of green spaces or who simply looked at nature from their windows showed no improvement in any of these categories.

“Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive, and asthma medication in urban environments,” the study authors wrote.

Confirming Prior Research

Numerous earlier studies have found significant benefits from spending time in nature.

One meta-review of 143 other studies published in the journal Environmental Research, for example, found that people with access to green space generally had a slower heart rate, lower blood pressure, and fewer blood levels of the stress hormone cortisol. Researchers also found significantly fewer cases of diabetes and lower rates of mortality from heart disease in the group regularly exposed to nature.

An American Institutes for Research (AIR) study in 2005 found that sixth-grade students who attended three outdoor education programs showed marked improvement in conflict resolution skills.

Another study in China in 2013 involved 60,000 children between the ages of two and 17. It showed that regular exposure to nature, or “greenness” around their schools, reduced the incidence of attention deficit/hyperactivity disorder (ADHD). A more recent study at the University of Illinois produced similar results.

And a 2016 study of nearly 100,000 women conducted over eight years found that having access to the greenest space not only improved the subjects’ mental health but also reduced their death rate by 12 percent.

Nature Deprivation Hurts

Author Richard Louv coined the phrase Nature Deficit Disorder (NDD) in his 2005 book “Last Child in the Woods: Saving Our Children from Nature Deficit Disorder.” In it, he argued that elements of our urbanized lifestyle, including few natural spaces, a car-focused culture, more screen time, changes in the perception of risk (e.g., fear of “stranger danger”), less leisure time, and increased time pressure from work or school, combine to decrease or even eliminate contact with nature for both adults and children, according to the National Institutes for Health (NIH).

“The average young American now spends practically every minute—except for the time in school—using a smartphone, computer, television, or electronic device,” Tamar Lewin reported in a Kaiser Family Foundation study on the subject.

According to the Children and Nature Network (C-NN), which was co-founded by Louv, an expanding body of scientific evidence suggests that nature-deficit disorder contributes to:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity, and
  • higher rates of emotional and physical illnesses

Make the Connection

Unfortunately, to get back to nature, you may need to make a specific effort, because in our harried lives trapped indoors, focused on our screens, we have very little time for real relaxation.

Therefore, it’s often necessary to add nature breaks to our schedules the same way we schedule everything else.

One way is to undertake the Japanese practice known as “forest bathing,” or shinrin-yoku. As Kaiser Permanente’s’ online Thrive explains, “Heading out to a heavily wooded area isn’t required. You could take a trip to a nearby park, your favorite local trail, the beach, or any natural setting. Just be sure to turn off or silence your phone or other devices.”

Psychology Today explains, “Forest bathing is an antidote to pinging distractions, impending deadlines, and never-ending obligations . . . . The idea is to immerse yourself in a natural environment and soak up the many health benefits of being in the green woods.”

However, you manage it, for the sake of your overall health we recommend you take the time to reconnect with the natural world as often as possible.

One Way to Boost COVID-19 Vaccine Effectiveness: Exercise

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If you need another excuse to slip on your running shoes and head outdoors, our concierge primary care doctors in Jupiter have a good one for you: Exercise can increase the effectiveness of coronavirus vaccines.

That’s according to a large study published last month in the British Journal of Sports Medicine. Researchers found that fully vaccinated study participants who logged high levels of physical activity were nearly three times less likely to be admitted to the hospital than those who were vaccinated but had lower levels of physical activity.

Even those with lower levels of physical activity saw a benefit.

This confirms an earlier study conducted last winter, showing that even a single 90-minute session of aerobic exercise could increase antibodies in those who had just been vaccinated.

The New Study

Researchers in Johannesburg, South Africa reviewed anonymous medical records, gym visits, and wearable activity-tracker data for nearly 200,000 fully vaccinated healthcare workers between February and October of 2021. (The Johnson & Johnson vaccine was the only one available to the population at the time.)

Participants were categorized according to their average recorded activity levels over the previous two years. Those with the highest weekly levels of physical activity (150 minutes or more per week) were 86 percent less likely to be admitted to the hospital after testing positive for COVID-19 than participants with a low level of physical activity (less than 60 minutes per week).

But even those in the medium and low categories of physical activity saw some benefit, compared to the sedentary group. The medium-level exercisers (60 to 149 minutes per week) were 72 percent less likely to be hospitalized, while with the low-level exercisers (less than 60 minutes per week) the risk of needing hospitalization fell by 60 percent as opposed to those who never exercised.

“The findings suggest a possible dose-response where high levels of physical activity were associated with higher vaccine effectiveness,” the researchers said in a press release.

“This substantiates the [World Health Organization] recommendations for regular physical activity—namely, that 150-300 minutes of moderate-intensity physical activity per week have meaningful health benefits in preventing severe disease, in this context against a communicable viral infection,” they wrote.

Prior Research

This large study confirms an earlier one published last February in the journal Brain, Behavior, and Immunity, which found that even a single 90-minute session of exercise could boost the immune response in those who had just received the flu or COVID-19 vaccine.

The study also found that 45 minutes of exercise did not increase antibodies, making 90 minutes the preferred target to see results.

“As far as we know, our findings are the first of their kind for evaluating exercise response on the COVID-19 vaccine,” Marian Kohut, Ph.D., a professor of kinesiology at Iowa lead researcher, told Medical News Today at the time.

“[They are] the first to show that light [to moderate] intensity, long-duration exercise enhances antibody response for the COVID-19 vaccine,” she said.

The Exercise Dividend

Even before vaccines became available, however, numerous studies showed that being physically active substantially lowered the risk of becoming seriously ill or needing hospitalization following infection with the coronavirus.

Robert Sallis, a family, and sports medicine doctor at the Kaiser Permanente Fontana Medical Center in California and former president of the American College of Sports Medicine, led a 2021 study of 48,440 adults before vaccines became available.

This research found that physical inactivity was associated with a higher risk for severe COVID-19 outcomes, including hospitalization rates, intensive care unit (ICU) admissions, and death. Those who were engaging in some activity, or regularly meeting physical activity guidelines, were about half as likely to need hospitalization as patients who were mainly inactive.

An earlier review of 16 prior studies involving nearly two million people likewise found that those who were physically active were far less likely to experience adverse outcomes from the virus.

Sallis told The Washington Post that these findings make sense because we know “that immune function improves with regular physical activity,” as do lung health and inflammation levels, which have been proven to protect against the worst effects of COVID-19.

Free Medicine

No one is sure of the reasons for these results. One theory suggests that exercise boosts blood and lymph flow, promoting the circulation of immune cells. The researchers involved in the South African study wrote that it “may be a combination of enhanced antibody levels, improved T-cell immunosurveillance, and psychosocial factors.” 

The Centers for Disease Control and Prevention (CDC) maintains that physical activity can improve overall mental and physical health, and reduce the risk of many chronic diseases such as heart disease, cancer, and type 2 diabetes. One 2008 study found that physical inactivity is responsible for more than five million premature deaths every year.

So it makes sense that regular physical activity would confer benefits to our immune system.

And it’s never too late to get moving, even with just a 10-minute walk, according to Jon Patricios, a professor of clinical medicine and health sciences at the University of Witwatersrand in Johannesburg-Braamfontein, who oversaw the new study.

“Doing something mattered, even if people weren’t meeting the full guidelines,” he told The Post.

“It’s an idea we call ‘small steps, strong shield,’ ” he said. “Plus, you don’t need a prescription, and it’s free.”

antibiotics

Why We’re Careful About Using Antibiotics

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Among the many problems that resulted from the COVID-19 pandemic, one of the more serious was an increase in antibiotic resistance (AR), according to a new report from the Centers for Disease Control and Prevention (CDC). The agency estimates that in 2020, the first year of the pandemic, AR infections and deaths in hospitals increased at least 15 percent over 2019.

Our concierge primary care doctors in Jupiter were discouraged to hear this because concerted efforts by the medical community in the last ten years had succeeded in reducing these resistant infections by nearly 30 percent.

It’s worrisome news, because bacteria and other pathogens evolve, just as the coronavirus does to better ensure its survival. As bacteria mutate, they are able to resist the commonly used antibiotics used to treat them, meaning eventually our best weapons become useless and people die unnecessarily.

According to the CDC, at least two million people get an AR infection every year, and at least 23,000 die as a result.

What happened?

What was it about the pandemic that caused this jump in numbers?

For one thing, lack of knowledge; for another, sheer numbers. Medical staff facing patients with fevers and shortness of breath turned to antibiotics as one weapon in their frantic attempts to treat people with an illness they’d never encountered.

Second, whenever such invasive procedures as ventilators and catheters are used, they provide an opportunity for infections, which must then be treated by antibiotics, and the hundreds of thousands of hospitalized COVID-19 patients thus drove higher antibiotic use.

The CDC report says that from March 2020 to October 2020, nearly 80 percent of those hospitalized for COVID-19 received an antibiotic.

Finally, overwhelmed staff—desperately fighting to save lives—had less time to follow protocols normally used to prevent infections, the report says.

The problem with antibiotics

What’s wrong with using antibiotics if they might help?

According to the CDC, “If even one bacterium becomes resistant to antibiotics, it can then multiply and replace all the bacteria that were killed off. That means that exposure to antibiotics provides selective pressure, making the surviving bacteria more likely to be resistant.”

In addition, the CDC says, “When a patient (human or animal) receives an antibiotic they do not need, not only does the patient get no benefits, but they are also put at risk for side effects (e.g., allergic reactions, toxicity that affects organ function, C. diff). Evidence suggests that one in five hospitalized patients who receive an antibiotic has an adverse drug event.”

Antibiotics can cause such side effects as diarrhea when they destroy friendly bacteria, along with the invaders. Other possible side effects include stomach pain, rash, respiratory difficulties, nausea and vomiting, and joint swelling.

Other factors involved

But antibiotic overuse didn’t just happen during the pandemic and doesn’t just happen in hospitals.

One study by the CDC and the Pew Charitable Trust found that nearly a third of the antibiotics prescribed every year—whether in doctor’s offices, hospital-based clinics, or emergency rooms—are not needed and are ineffective for the illness they’re prescribed for.

This report found that at least a third of prescriptions were for conditions that didn’t warrant antibiotics. “An estimated half of antibiotic prescriptions given during pediatric ambulatory care visits are inappropriate,” the report found.

A large number of these prescriptions were provided at the request of patients, who demand their doctors “do something” for conditions that cannot be cured by antibiotics. These include the flu, colds, coughs, and sore throats not caused by strep. Other conditions for which antibiotics are not indicated include bronchitis, asthma, and allergies.

And not just doctors

Patients also play a role in the spread of AR by:

  • insisting on an antibiotic when the doctor has said it won’t help
  • sharing their leftover or unused antibiotics with friends or family members
  • not taking the full course of an antibiotic when one is prescribed

This last behavior, in fact, is a major contributor to the problem of antibiotic resistance. When a patient begins to feel better after a few days and stops taking the antibiotic, the bacteria may be weakened but not killed; their remaining numbers survive to mutate into a strain that can no longer be killed by the antibiotic.

Finally, animal agriculture also contributes to the problem. Antibiotics are used to feed livestock to accelerate growth and prevent disease in otherwise healthy animals that are kept in unnaturally confined conditions during their lifecycle.

A 2017 study by the Pew Charitable Trust confirmed that antibiotic use on farms and feedlots leads to the emergence of resistant bacteria and that these resistant bacteria are infecting humans, either through direct contact with the bacteria, with food produced from the animals, or through the environment.

How to help

These are the reasons why we’re very careful about when we prescribe antibiotics to our patients. You can do your part, as well, by:

  • not skipping doses of an antibiotic we have prescribed for you
  • not saving doses for the next time you get sick (different infections require different antibiotics)
  • never take an antibiotic prescribed for someone else
  • avoiding meat and animal products that have been treated with antibiotics during their lifecycle

Finally, it’s important to take steps in your daily life to prevent infections from taking hold in the first place. This includes frequent hand washing, getting all the vaccinations we recommend, and using safe sanitation practices when handling food.

monkeypox

Why Monkeypox Is Not Like COVID-19

COVID, Disease, Lifestyle, News, Uncategorized, Vaccinations

Last month, the World Health Organization (WHO) declared the newly spreading monkeypox virus a global health emergency.

This has prompted many to fear we’re heading into another coronavirus situation, as our concierge primary care doctors in Jupiter have found from talking with our patients.

While this is a debilitating, painful, and—occasionally—deadly virus, there are many reasons why it’s very dissimilar to the SARS-CoV-2 virus, the virus that causes COVID-19.

The history is different

Although both originated as “zoonotic” diseases—that it, they began in animals and spread to humans—we have a far longer history with monkeypox, meaning we know more about it than we did when the coronavirus first appeared.

According to the Centers for Disease Control and Prevention (CDC), monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, thereby giving the disease the name “monkeypox.” Its typical animal hosts, however, are rodents and other small mammals.

The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in humans in other central and western African countries.

Although relatively new to the U.S., a large monkeypox outbreak occurred here in 2003 as a result of imported rodents.

Transmission is different

Next, the ways the two viruses are transmitted are completely different.

Unlike the largely airborne transmission of SARS-CoV-2 through aerosols that linger in the air, the monkeypox virus can only be spread through close contact with an infected person or animal, or materials such as bedding or towels that are contaminated with the virus.

In addition, monkeypox appears to be far less transmissible than COVID-19. One study found that just three percent of those in close contact with an infected person would develop monkeypox.

It appears at this time to be spreading primarily among gay and bisexual men following sexual encounters, but anyone who comes into close and prolonged, direct contact with the pox sores can become infected.

Even women, and at least two children, have been reported to have contracted monkeypox, as a result of being in close proximity to men who have sex with other men.

The symptoms are different

Unlike the stealth infections of the coronavirus, it’s very apparent when a person is infected with monkeypox. As with COVID-19 and other viruses, they develop fever, headache or body aches, chills, muscle aches, and exhaustion.

These symptoms are also similar to those of smallpox, a cousin of monkeypox, with one difference:

“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the CDC says.

Otherwise, however, both smallpox and monkeypox exhibit the same signature fluid-filled lesions (the so-called “pox”), which the coronavirus doesn’t produce. Some individuals have these sores all over the body, while others may have only a single lesion. This rash can be extremely painful.

The vaccines are different

When COVID-19 first appeared two-and-a-half years ago, it was a brand new virus (i.e., “novel” coronavirus).

We knew nothing about it, and at the time had no way to combat it in the form of either effective treatments or vaccines.

Because of our long history with monkeypox, however, we do have vaccines and antiviral treatments. Monkeypox and smallpox come from the same family of viruses (although monkeypox is not as severe as smallpox). That has allowed us to utilize the stockpile of smallpox vaccines and antivirals to fight monkeypox.

And, unlike the coronavirus vaccines, the vaccines for monkeypox are effective even after infection, if given within four days of exposure. Even if the vaccine is given as late as two weeks after exposure, it can still lessen the likelihood of severe illness.

Not to worry?

Does all this mean we don’t have to panic about monkeypox? Panic is never a good idea because it prevents thoughtful responses in a crisis. But at this time the monkeypox outbreak still appears to be confined largely to men who have sex with men and those who are closest to them and who may come in contact with the open sore or infected linens.

If you fall into one of those categories, it’s important to take precautions until the supply of vaccines and antivirals becomes sufficient to cover everyone at high risk of exposure, because cases are spreading rapidly in the U.S. At the end of July, the Centers for Disease Control and Prevention (CDC) reported more than 3,500 confirmed cases but noted that is probably a significant undercount.

Experts advise that, if you’re at risk, you temporarily reduce your number of sexual partners, reconsider sex with new partners, and exchange contact details with any new partners to enable follow-up, if necessary.

Infected people are encouraged to self-isolate from other humans as well as pets, and to wear a mask and long clothing over any sores.

Although there is currently a limited supply of vaccines in the U.S., the government has purchased 2.5 million doses, which should be available in the coming weeks. This means it isn’t yet enough available to offer shots to all high-risk individuals.

So until there is, take precautions, and let us know if you think your symptoms might be those of monkeypox. It’s a painful, debilitating, and sometimes deadly disease, but we can treat it if it’s caught in time.

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