What Should People with Cancer Know About Monkeypox?

By Pat Carragher - August 09, 2022

With the U.S. accounting for more monkeypox infections than any other country in the world, the Biden Administration formally declared monkeypox as a public health emergency last week. As of Monday, the Florida Department of Health reported 938 confirmed or probable cases of the virus, including 77 in Hillsborough, Pinellas and Pasco counties combined, according to its tracking website

With cases slowly becoming more prevalent, it’s important for patients with cancer who may have compromised immune systems to know how the virus can affect them.

According to Dr. John Greene, chair of the Infectious Diseases Program at Moffitt Cancer Center, the monkeypox virus primarily spreads through prolonged skin-to-skin contact, mainly through skin lesions. While there is little data available about how this virus affects patients with cancer, Greene believes that if monkeypox behaves like other viruses in the pox family, then immunocompromised patients carry an additional risk.

“If a patient on immunosuppressive therapy comes down with the virus, they have a higher chance of becoming severely ill or even death,” said Greene. “The skin lesions aren’t the main concern for these patients, it’s where the disease spreads in the body. If it goes to the lungs, patients risk contracting pneumonia. If it goes to the brain, you risk encephalitis.”

portrait of blockquote author

"The skin lesions aren’t the main concern for these patients, it’s where the disease spreads in the body."

- Dr. John Greene, Infectious Diseases Program

The monkeypox rash usually begins within a few days, before scabbing over. The rash typically develops on the face, hands and feet.

Symptoms include:

  • Fever
  • Headache
  • Muscle aches
  • Back pain
  • Low energy
  • Swollen glands (lymph nodes)
  • Skin rash

Greene says it’s rare for the virus to spread outside of direct contact. In general, people are safe to go out into public but should use caution when attending large events like concerts or sports games. If you see someone with any fluid filled bumps or open lesions, it’s recommended to keep a safe distance. Unlike COVID-19, monkeypox is not typically spread through the air, but can be spread through a cough or sneeze.

“The skin vesicles have tons of virus when they’re fluid filled,” said Greene. “Once they’re crusted over and covered with normal skin, that person is a lot less contagious. We’ve known that with chickenpox. You can visually tell the degree of contagion when the skin has crusted over.”

Monkeypox is not considered a traditional sexually transmitted disease but global data suggests skin-to-skin contact during sex is responsible for a majority of the recent cases. World Health Organization director General Tedros Adhanom Ghebreyesus said recently, “this is an outbreak that can be stopped” as long as people stay informed and protect themselves from the virus.”

There is a monkeypox vaccine available, but patients should check with their doctors before getting it. According to the American Cancer Society, live virus vaccines don’t cause problems in people with normal immune systems. But they might not be safe for people with weakened immune systems, so live virus vaccines typically are not recommended for patients with cancer.

“Unfortunately, there is currently no inactivated vaccine for monkeypox,” said Greene. “To get the vaccine you would need to be not severely immune suppressed. For those who are immune suppressed, there is a risk that the vaccine could cause patients to become severely ill or worse.”

If you think you have symptoms of monkeypox or have been in close contact with someone with monkeypox, tell your doctor, self-isolate if you can, and avoid close contact with others.

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