Monkeypox can spread from humans to pets: What to know

• The World Health Organization called the recent monkeypox outbreak a “public health emergency of international concern.”
• There have been more than 40,000 confirmed cases of monkeypox worldwide, with 12 deaths reported.
• Until recently, the medical community believed monkeypox spread only from animal to human and human to human.
• Doctors from Pitié-Salpêtrière Hospital in Paris recently reported the first suspected case of a human-to-animal transmission of the virus.

The zoonotic virus monkeypox spreads from certain types of animals known to carry the virus to humans. From there, the virus transmits from an infected human to other humans.

Now a new report in The Lancet provides evidence of the first suspected case of a human transmitting the monkeypox virus to an animal. Doctors from Pitié-Salpêtrière Hospital in Paris recently reported the first case of a human transferring the virus to a pet dog.

Monkeypox symptoms and outbreak

On July 23, 2022, the World Health Organization (WHO) declared the recent monkeypox outbreak a “public health emergency of international concern (PHEIC).”

As of August, there have been more than 40,000 confirmed cases of monkeypox worldwide, with 12 deaths reported.

Monkeypox is a viral infection in the same virus family as smallpox. Symptoms of monkeypox may be similar to smallpox but not as severe, including:

• fever
• muscle aches
• fatigue
• headaches
• back pain
• swollen lymph nodes

A few days after having a fever, a rash will develop on a person who contracted the monkeypox virus. The rash normally looks similar to blisters or pimples and can appear on different body areas.

Certain animals, including species of monkeys and squirrels, carry the virus. A human bitten or scratched by an infected animal can contract monkeypox. Additionally, a human who eats undercooked meat or a byproduct of an infected animal can also contract the virus.

An infected human transfers the virus to other humans through close personal contact, including kissing, prolonged face-to-face contact, and sexual contact. Additionally, touching soft fabrics slept on or worn by a person with monkeypox can transmit the disease to another person.

Transmission from humans to pets

According to the study, doctors from Pitié-Salpêtrière Hospital reported two cohabitating male patients showing symptoms of monkeypox, including fever, headaches, and rash.

Twelve days following the onset of symptoms, the patient’s male Italian greyhound tested positive for the monkeypox virus. The dog also had lesions associated with the disease. The dog owners told doctors they slept with their dog in the same bed. Doctors reportedly compared skin lesion samples from both the dog and its owners and found it was the same virus strain.

According to Dr. Richard Silvera, associate program director of the Infectious Diseases Fellowship and assistant professor of medicine (infectious diseases) at the Icahn School of Medicine at Mount Sinai, it was not surprising to hear monkeypox could transmit to a dog. He inferred the same types of methods of human-to-human viral transmission — such as skin-to-skin contact or touching fabrics worn or slept in by someone with the disease — would also work with a human-to-animal transition.

“So I imagine if you had a lesion on your hand and you pet your dog, you could theoretically infect the dog that way,” Dr. Silvera explained. “Or if you have lesions on your body, you slept in a bed, and then the dog also slept in that bed, that would be a way of transmitting. And the report did note that the dog slept in the bed with the infected patients, so that may have been the way the dog contracted it.”

And Dr. Lori Teller, president of the American Veterinary Medical Association, stated that pets other than dogs may also be susceptible to catching monkeypox from a human owner.

“Under experimental conditions, rabbits and mice — but not guinea pigs and hamsters — have been found to develop signs of monkeypox following oral and intranasal exposure to the virus,” she told MNT. “Young (10-day-old) rabbits also appear capable of transmitting the virus to other rabbits. Whether cats are susceptible is unclear. However, given the available evidence concerning other orthopoxviruses, it would be prudent to assume cats might catch monkeypox and, accordingly, take appropriate measures to prevent infection or disease spread.”

“In the United States and other non-endemic regions, a significant concern is the potential for spillover of monkeypox to wildlife from infected people or domestic mammals, emphasizing the importance of infection control measures to contain the disease,” Dr. Teller added.

Protecting people and pets from monkeypox

While the human-to-human transmission of monkeypox is one thing to worry about, now people have a concern about giving it to their animals. What can people do to protect everyone in their household — including their pets — if they have monkeypox?

“I would apply the same kind of thinking we’re using for human-to-human transmission for animal transmission,” Dr. Silvera detailed. “If you have monkeypox and you’re living with other people or with other creatures like animals, try and isolate on a whole away from others, so not share linens, not to share a bed, even with a dog or a cat. I would not let them sleep in your bed if you have an active monkeypox infection.”

“Hand washing will be really important,” he continued. “Washing linens separately from ones that are used by the household. And if they’re going to be in close contact wearing a mask will be the way to protect both your pets and your household.”

Dr. Teller said initial signs of monkeypox in animals are similar to signs of other, much more common, infectious diseases. “These include fever, cough, reddened eyes, runny nose, lethargy, and low appetite,” she explained. “If you notice these signs in your pet, and the pet has had no known exposure to someone with monkeypox, the cause is likely to be something else. Even so, these signs signal your pet is sick and should be seen by a veterinarian.”

“If your pet develops at least two of these signs or a pimple- or blister-like rash within 21 days after possible contact with someone with monkeypox, immediately contact your veterinarian,” Dr. Teller continued. “They can advise you on next steps, including testing to confirm infection. Do not surrender, euthanize, or abandon your pet because of potential exposure to an infected person.”

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