What Is Orthopox and What Does It Have to Do With Monkeypox?

Photo credit: kontekbrothers - Getty Images
Photo credit: kontekbrothers - Getty Images

Public health departments across the country are on high alert for monkeypox, and health officials in Washington, D.C., just revealed that they may have found a case—maybe.

DC Health shared in a press release Sunday that the DC Public Health Lab “confirmed the first positive Orthopoxvirus case in a District resident who reported recent travel to Europe.”

Samples from the patient have been sent to the Centers for Disease Control and Prevention (CDC) for more testing and confirmation to see if this could be monkeypox, the release says, before noting that “monkeypox is in the orthopox family of viruses.”

Naturally, people have questions about what, exactly, orthopox is, and whether this is something else to be concerned about. Here’s what you need to know.

What is orthopox?

Orthopox is a “family of viruses,” explains Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. “The family contains viruses such as smallpox, horsepox, cowpox, camelpox, and many other -pox viruses of animals,” he adds.

If you want to get technical, orthopox viruses are “enveloped brick-shaped viruses” that contain a “double-stranded DNA genome,” according to one study. These viruses are “closely related to each other with regard to antigens,” the study says. (Antigens, in case you’re not familiar with the term, are substances that produce an immune response in the body.)

“Each orthopox virus has its own personality,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “It’s the same way you might have a whole bunch of cousins—you’re related but each has its own characteristics.”

What are symptoms of orthopox?

Each orthopoxvirus has slightly different symptoms, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. But, he says, you can generally expect the following to happen with an orthopoxvirus:

  • Fever

  • Headache

  • Muscle aches

  • Chills

  • Fatigue

Within a few days, an infected person will develop a rash. “They all have these blistering skin lesions that evolve,” Dr. Russo says. “They’re more likely to occur in the head and neck area and spread, but sometimes people will just get them on their hands.”

How are orthopoxviruses treated?

Treatment for each orthopoxvirus can be different but, in general, they can be treated with an anti-viral called tecovirimat, Dr. Schaffner says. “There are antivirals that are active against smallpox and would be expected to have activity against other poxviruses if needed,” Dr. Adalja explains.

“We also have a couple of vaccines that can be used after people are exposed,” Dr. Schaffner says, noting that orthopoxvirus have “a long incubation period” which can be anywhere from a week to up to two weeks. “If someone has been exposed, you can give them a vaccine in the first five days that can prevent or substantially modify the course of illness,” he says.

The most common vaccine, he says, is one called Jynneos, which is given in two doses about four weeks apart. “Some health departments are starting to use this vaccine” to help prevent monkeypox, Dr. Schaffner says.

How concerned should you be about orthopox?

Monkeypox is the most pressing orthopoxvirus to be aware of at the moment, and even that is unlikely to be an issue for most people, Dr. Adalja says. “Monkeypox does not pose a general threat to the public and does not possess pandemic potential,” he says. “However it is important to get a handle on this outbreak and halt it by increasing case detection, contact tracing, and deployment of vaccine.”

Dr. Russo agrees. “We’re going to have some cases, but we will be OK,” he says.

This article is accurate as of press time. However, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC and WHO to stay informed on the latest news. Always talk to your doctor for professional medical advice.

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