Monkeypox vs. Smallpox: What Your Practice Needs To Know

You may have heard about the connection between monkeypox vs smallpox, but how exactly is monkeypox related to smallpox? Understanding the similarities and differences between these two viruses is essential for correctly diagnosing and treating patients.  

The World Health Organization (WHO) declared smallpox eradicated in 1980, but other viruses from the smallpox family continue to infect humans and animals. Monkeypox is one of those viruses. Here is what your practice needs to know about the monkeypox vs smallpox viruses.

Is Monkeypox Related to Smallpox? 

Yes, monkeypox is related to smallpox. Both come from the orthopoxvirus family. The variola virus, or smallpox, infected humans for thousands of years until a vaccine was developed. Widespread vaccination around the world eradicated smallpox, saving countless lives. The last smallpox outbreak in the US was in 1949, so the US no longer routinely vaccinates children or adults for smallpox.  

However, eliminating smallpox did not stop the rise of related viruses like cowpox and monkeypox. Monkeypox was first discovered in captive monkeys in 1958, and the first recorded human case occurred in 1970. Until the 2022 outbreak, though, monkeypox infection in humans was rare — typically only concentrated among people in close contact with infected animals.   

Both the smallpox and monkeypox viruses spread through intimate, prolonged contact with an infected person. The primary routes of transmission are skin-to-skin contact and respiratory droplets. However, neither monkeypox nor smallpox spread as quickly as respiratory viruses like COVID-19. 

Monkeypox vs. Smallpox Symptoms

Monkeypox and smallpox can have similar symptoms, but smallpox symptoms are far more severe. Smallpox generally causes a high fever, followed by a rash in the mouth and throat. Once the rash appears, the infected patient is highly contagious. The rash usually spreads across the entire body before scabbing over. On average, it takes about four weeks for smallpox symptoms to resolve.   

Monkeypox also causes a rash that looks similar to smallpox. However, the monkeypox rash is generally confined to the skin instead of the mouth and throat. In addition, monkeypox only sometimes causes fevers and other flu-like symptoms. Even without treatment, most monkeypox symptoms resolve within two to four weeks after the rash first appears.   

Overall, monkeypox is far less likely to be fatal than smallpox. On average, about 30 percent of those infected with smallpox died, and many survivors were left blind or heavily scarred. Monkeypox, in contrast, is rarely fatal. The variant currently spreading in the US is mild, and 99 percent of infected patients recover. 

Monkeypox vs. Smallpox Vaccines

Smallpox's long history and high fatality rate made vaccines and treatments a high priority. In 1801, an English doctor recommended exposure to cowpox as an early vaccine for smallpox. Modern smallpox vaccines are made from the vaccinia virus, not cowpox, but the principle remains the same. ACAM2000, an FDA-approved smallpox vaccine, contains a live vaccinia virus that can replicate and spread. The newest smallpox vaccine, JYNNEOS, is the first to have the non-replicating virus.  

Vaccination for smallpox protects against monkeypox, but routine smallpox vaccination no longer happens since smallpox was eradicated. This lack of routine immunization has left many people with no protection against monkeypox, one reason the virus was able to spread rapidly in 2022. Fortunately, the JYNNEOS vaccine is approved to prevent and treat both smallpox and monkeypox. As supplies increase, broader vaccination should help slow the monkeypox spread.

Monkeypox vs Smallpox Treatment

For monkeypox vs smallpox, both viruses have long incubation times. Smallpox symptoms tend to appear 10 to 14 days after infection, while monkeypox symptoms appear within three weeks. The CDC recommends post-exposure vaccination to prevent or lessen symptoms of both monkeypox.  

The FDA has approved several antiviral treatments for smallpox for use in case of an outbreak. These drugs were not tested in people with smallpox, so their effectiveness is unknown. However, antiviral medications may be helpful for monkeypox patients. These drugs are expected to lower the risk of severe disease and death in monkeypox patients with weakened immune systems.    Monkeypox generally resolves without treatment in two to four weeks. Over-the-counter medications like pain relievers and rash creams can help your patients manage their symptoms. People can also prevent the further spread of monkeypox by avoiding close contact, covering their rash, and disinfecting any shared surfaces. 

How TempDev Can Help Your Practice Prepare for Monkeypox

TempDev's developers and consultants can help your practice get ready to diagnose and treat monkeypox. With your NextGen EHR, you can transition from wondering is monkeypox related to smallpox to streamlining efforts to vaccinate and test your patients. TempDev's NextGen EHR Monkeypox Vaccine Clinic Template lets you document and bill for vaccines without opening individual patients' charts, saving you time.   

Call us at 888.TEMP.DEV or contact us here for help preparing your NextGen EHR for monkeypox testing and vaccination.