Should laboratorians be concerned about monkeypox?

June 22, 2022

There has been a lot of global news lately about the resurgence of Monkeypox. According to the World Health Organization (WHO), monkeypox is a viral zoonotic disease that belongs to the Orthopoxvirus genus of the Poxviridae family. It was originally diagnosed in 1970 in the Democratic Republic of the Congo. Most of the cases since then have been reported across Central and West Africa. Until now.

The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. Previously, it was thought that it was only contracted through direct contact with someone who had the virus. However, that doesn’t appear to be the situation in a number of these new cases. According to the Centers for Disease Control and Prevention (CDC), the cases we are currently seeing in North America are not typical because the cases reported have not been from travelers from endemic countries or related to animals exported from endemic countries.1

As of June 10, 2022, there were 150 cases reported in the United States and Canada, according to the WHO situation update from June 10. In addition, it was reported that there were cases in an additional 10 countries that are non-endemic areas outside of Africa.2

Identifying patients that may have contracted monkeypox isn’t that easy as the monkeypox rash resembles other infectious diseases including varicella zoster virus (VZV, chickenpox), herpes simplex virus (HSV), primary or secondary syphilis, disseminated gonococcal infection (DGI), foot and mouth disease, chancroid, lymphogranuloma venereum (LGV), granuloma inguinale, molluscum contagiosum, measles, scabies, rickettsia pox, chikungunya, zika virus, dengue fever, vasculitis, and other bacterial skin and soft tissue infections.2

There is also speculation there may be waning immunity to smallpox vaccination over time as studies indicate that smallpox vaccination is approximately 85% effective in preventing monkeypox. Since prior smallpox vaccination may result in a milder disease course, it is important to ascertain vaccination status in any person exposed to monkeypox.

As laboratorians, we should be ready to handle this if it comes to our healthcare facilities. Our story on page 36, “Navigating the world of lab safety through standardized practices,” is a great reminder on the importance of best practices around collecting and handling patient samples. The hope by the CDC and WHO is that by raising awareness about monkeypox, it will help to stop further transmission. That means that our North American labs should be ready to test for monkeypox—and our clinical staff members should be aware of the symptoms to watch for in patients that warrant testing. See our related CDC monkeypox coverage on page 40.

I welcome your comments, questions, and opinions – please send them to me at [email protected].


CDC Monkeypox Response: Transmission. Accessed June 13, 2022.

Clinical management and infection prevention and control for monkeypox. Accessed June 13, 2022.

Kristine Russell, Publisher, Executive Editor

[email protected]