COVID-19 vs. monkeypox

Amber Hoy | Oct 19, 2022

Key comparison points

Takeaway: Is a monkeypox pandemic brewing on the heels of the global COVID-19 pandemic? Epidemiological experts are saying no. Here we’ll contrast both pathogens to help explain why.

With the impact of the COVID-19 pandemic still rippling through communities around the world, it comes as no surprise that there is a growing concern over the uncharacteristic spread of the monkeypox virus. Across news outlets many are asking: Are we entering another pandemic? Experts say no, and here’s why.

By the numbers

As of September 7, 2022, the following statistics have been recorded:

COVID-19 cases: Within 228 countries and territories there have been 603,711,760 global cases, including 6,484,136 deaths reported to the World Health Organization.

Monkeypox 2022 cases: The US Centers for Disease Control and Prevention denote 56,609 global cases in 103 locations.

Discovery, origin, and molecular structure

SARS-CoV-2: The virus causing COVID-19’s many variants, SARS-CoV-2, was first identified in 2019, demarking a novel variant from the SARS family of viruses. While debates are still active, much of the science community considers the original zoonotic leap to have stemmed from bats. A single-stranded RNA virus, SARS-CoV-2 is small, spherical and covered with spike proteins that facilitate attachment to host cells during infection.

Monkeypox: Monkeypox virus (MPV) was first discovered in 1958 and is a member of the Poxviridae family. Virus origin for monkeypox remains unclear. However, the name stems from two pox-like outbreaks in 1958 among monkey research colonies in Demark. In contrast to SARS-CoV-2, MPV’s structure is brick-shaped and large, and is comprised of double-stranded DNA encased in core enzymes used for replication and evasion of the immune system. MPV does have surface proteins to aid in its efforts to enter host cells, but it uses 11-12 variations of transmembrane proteins.

The role of variants and transmission path

What does the cellular make up of the virus mean for mutations and transmissions?

SARS-CoV-2: As we saw with the COVID-19 pandemic, the RNA of SARS viruses can mutate quickly, in large part due to the nature of RNA, which replicates rapidly but with less precision. SARS-CoV-2 ultimately became a great example of how this process can result in numerous variants. Virologists have classified COVID-19 as a respiratory virus that spreads when an infected person exhales respiratory droplets into the air. Infection is facilitated by contact with these droplets by inhalation, or contact with sclera or other tissues. This airborne element, combined high rates of asymptomatic infection, made controlling the COVID-19 pandemic extremely difficult.

Monkeypox: Historically, there have only been two viral clades of monekypox: Clade I (formerly Congo Basin) and Clade II (formerly West African). Unlike the SARS family, the enzymes necessary to replicate MPV are derived from DNA, not RNA, which is less error prone during replication. Though MPV can be contracted through respiratory secretions, it is not classified as a respiratory virus. Rather, it spreads through direct and prolonged contact with monkeypox rashes, scabs, or bodily fluids of an infected person.

Signs and symptoms

SARS-CoV-2: As outlined by the CDC, symptoms across variants have consisted of varying degrees of the following:

Fever and/or chills
Cough, shortness of breath
Fatigue, muscle/body aches
Headache

New loss of taste and/or smell
Congestion, sore throat, and/or runny nose
Nausea, vomiting, or diarrhea

Monkeypox: The CDC notes a handful of common symptoms and while some overlap with what many experienced with COVID-19, the hallmark lesions associated with monkeypox are a distinguishing element for comparison.

Fever and/or chills
Head, muscle, and backaches
Swollen lymph nodes (commonly in the neck, armpits, or groin)
Overall feelings of exhaustion
A rash, often resembling pimples or blisters that appear on the face, inside of the mouth, and are common on other parts of the body, including hands, feet, chest, genitals, or anus; while the rash has been noted to go through various stages throughout the illness, on average the infection lasts two to four weeks before healing completely.

Risk of contraction

SARS-CoV-2: As noted above, the airborne nature of COVID-19 increases the contraction risk for an average individual. Overall degree of risk can increase or decrease based on the following: type of variant, mask wearing, the degree of air ventilation, length of time in exposed environment, vaccination status, and physical proximity to an infected person or people. With the availability of highly effective vaccines, the risk of severe illness has significantly decreased for otherwise healthy individuals. Those who are elderly, immunocompromised, disabled, or have underlying health concerns remain at a heightened risk.

Monkeypox: General day-to-day activities are considered low risk. Progressing into intermediate and high-risk levels is dependent on the degree of direct and prolonged exposure to an infected individual’s broken skin, mucous membranes, skin lesions, or bodily fluids.

Learn more about how IDT is enabling researchers to sequence SARS-CoV-2 or monkeypox today.