Frequently Asked Questions and Answers (FAQ) on Monkeypox and Animals issued by World Organisation for Animal Health
What is monkeypox?
Monkeypox is a viral zoonotic disease caused by infection with monkeypox virus that occurs in animals primarily in tropical rainforest areas of Central and West Africa and is occasionally exported to other regions. Monkeypox virus belongs to the Orthopoxvirus genus in the family Poxviridae.
The Orthopoxvirus genus also includes variola virus (which caused smallpox, an eradicated disease), vaccinia virus (used in the smallpox vaccine), and cowpox virus.
In areas where monkeypox is endemic in animals, the virus is thought to be maintained in nature through circulation among a number of susceptible mammals, namely wild rodents (including squirrels and rats), with occasional spill-over to non-human primates and humans.
Monkeypox has been reported in animals outside of endemic areas, in imported primates, and in pet prairie dogs (rodents of the genus Cynomys) where infection was initially introduced to North America through imported rodents.
More recently monkeypox infection was reported in a pet domestic dog (genus Canis) most likely as a result of human to animal transmission following close direct contact with its owners who were symptomatic with monkeypox. This was the first documented case of human to animal transmission of monkeypox virus.
How is monkeypox transmitted?
Transmission of monkeypox virus can occur when a person or susceptible animal comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through skin lesions (even if not visible to the naked eye), respiratory tract, or mucous membranes.
Monkeypox virus is transmitted from infected animals to humans or other susceptible animals by direct inoculation via bites, scratches or by direct contact with the body fluids and/or the meat of an infected animal during hunting and other activities involving susceptible animal species.
Human-to-human transmission occurs mainly through close physical contact (e.g., face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-skin contact including during sex). Ulcers, lesions or sores present in the mouth or throat can be infectious, meaning the virus can spread through saliva and respiratory droplets (and possibly short-range aerosols), in some cases. More studies are needed on whether the virus can spread from breathing and talking.
Human to animal transmission has been reported in the case of a pet domestic dog which had close contact with its owners who were symptomatic. The dog showed mucocutaneous lesions and tested positive on PCR.
Can animals be affected?
Various wild mammals have been identified as susceptible to monkeypox virus. This includes rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates, among others. Although it may depend on the route of transmission and infectious dose, some species are asymptomatic, especially species suspected of being reservoirs (rodents). Other mammals, such as monkeys and great apes, show skin rashes similar to those experienced by humans.
Monkeypox infection has also been reported in pet prairie dogs (rodents of the genus Cynomys), which were initially infected by imported rodents, and most recently in a pet domestic dog (genus Canis) as a result of human to animal transmission.
What to do when coming across a suspected animal case?
– Ensure good coordination and communication, using a One Health approach, between wildlife services, veterinary services and public health services.
– Use personal protective equipment including gloves, masks, and disposable protective clothing.
– Take samples if possible (see sample types below) for testing for the presence of virus or evidence of exposure to the virus and send them to the national veterinary or reference laboratory.
– Notify WOAH – countries are encouraged to report cases of monkeypox in animals to WOAH (by email to information.dept@woah.org) as significant animal health information as described in Article 1.1.5 of the Terrestrial Animal Health Code.
– In addition, cases of infection of wild animals with monkeypox virus are reportable through the voluntary report on non-WOAH listed diseases in wildlife under the disease name “Pox viruses (other than those listed by WOAH) (Infection with)”.
How to reduce the potential risk of humans infecting animals?
– Monkeypox is a zoonotic disease, and there is a risk of spillback to susceptible animals.
– Therefore, collaboration between public health and veterinary authorities is important when managing the risk of human to animal transmission. This will help to prevent the disease from being transmitted from humans to susceptible animals at home, in zoos and wildlife reserves, and also to peri-domestic animals, especially rodents.
– Ensure that all waste, including medical waste is disposed of in a safe manner and that it is not accessible to rodent and other scavenger animals.
– People who are suspected or confirmed to be infected with monkeypox virus should avoid close direct contact with animals, including domestic animals (such as cats, dogs, hamsters, ferrets, gerbils, etc.), livestock and other captive animals, as well as wildlife. People should be particularly vigilant around animals known to be susceptible, such as rodents, non-human primates etc.
How can monkeypox virus be detected in animals?
The appearance of clinical signs, including the presence of visible skin lesions, will depend on the species and age of the animal, as well as on the clade of monkeypox virus causing the infection. Species known as possible “reservoirs” will likely not present any clinical signs of infection. Detailed clinical signs per animal species can be consulted HERE .
In species that present clinical signs of infection with monkeypox virus, animal health professionals should be on the lookout for:
– Increase in body temperature
– Appetite changes
– Conjunctivitis and/or ocular discharge
– Coughing or sneezing
– Abnormal sounds during auscultation of the lungs (this is not possible with the required PPE)
– Skin lesions with or without pruritus
– Palpable lymph nodes
Samples:
– Swabs taken from lesions
– Scabs
– Conjunctival swabs and/or oral and nasal secretions swabs and/or anal swabs
– Blood
Tests:
– Virus Neutralisation Test (VNT) is the recommended diagnostic test for detecting poxvirus antibodies. It takes 2-3 days to do an Orthopoxvirus VNT and a fluorescently tagged VACV strain can be used to make identification easier.
– PCR: a pan-pox PCR may be easier to find. However, a specific one to show which strain is causing the infection would be preferable.
– Serology: Orthopoxvirus ELISAs
What is WOAH doing?
WOAH is working with its experts and partners, such as WHO, to gather the latest scientific information and reports from the field. WOAH collates this information and shares it transparently with its members and the general public, aiming to help decision makers to make risk-based decisions considering the latest scientific evidence and avoid unnecessary barriers to trade.
What messages should be conveyed to at-risk communities to reduce risk of spillover events?
– As a general principle, wash hands after handling wild animals
– Take precautions to avoid being bitten or scratched by animals
– Avoid contact with susceptible animals
– Do not touch wild animals that are sick or have died of unknown causes
– Do not eat raw wild animal meat, uncooked or undercooked food, and food made with wild animal blood
– Immediately inform the Veterinary or Wildlife Services if you find a sick or dead wild animal
– Visit a health centre as soon as possible in case of a scratch or bite from a wild animal
– People who are suspected or confirmed to be infected with monkeypox virus should seek medical attention and avoid close direct contact with animals, including domestic pets, livestock, and other captive animals, as well as wildlife
How do we prevent future monkeypox virus spillovers?
Current outbreaks of monkeypox in humans outside of areas where the virus is known to be endemic in animals appear to be driven by human-to-human transmission.
However, the virus has an animal origin. In areas where the virus is endemic in animals good practices in interacting with wildlife, as described above, can reduce the risk of future spillover events from animals to humans. In fact, these practices should always be followed to avoid risks from a number of pathogens and to protect both humans and wildlife.
To avoid spillover from humans to animals, people who are suspected or confirmed to be infected with monkeypox virus should avoid close direct contact with animals, including domestic animals (such as cats, dogs, hamsters, ferrets, gerbils, etc.), livestock and other captive animals, as well as wildlife. People should be particularly vigilant around animals known to be susceptible, such as rodents, non-human primates etc.
WOAH highlights that unregulated trade in wildlife (including wildlife meat and products) and other mammals can lead to the international spread of diseases such as monkeypox.
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