Infectious disease doctor explains monkeypox, hepatitis and bird flu

Does the mere mention of the word “virus” send shivers down your spine? You’re likely not alone, as one of the lasting effects of the COVID-19 pandemic may be a world more sensitive than ever before to the news of some virus that may not have been on our radar. Think monkeypox.

“I think we all have to recognize that COVID-19 has taught us that there is going to be something else lurking on the horizon,” said Vincent Hsu, M.D., infectious disease specialist and infection control officer for AdventHealth. Dr. Hsu serves as the health system’s foremost expert on infectious diseases and has led the organization’s development and implementation of COVID-19 treatment and safety protocols throughout the pandemic.

“It’s always important to remain prepared. One of my jobs is to always be on the lookout for new or re-emerging infectious diseases,” Dr. Hsu said.

As AdventHealth clinicians across the health system keep close tabs on any and all developments around the three non-COVID-19, virus-related diseases that have been in the news in recent weeks – monkeypox, bird flu and hepatitis in children – Dr. Hsu offers guidance on what you need to know.

“Neither monkeypox nor the hepatitis outbreak are even close to being what COVID-19 has been here for the last two years,” Dr. Hsu assured. “Neither of them by nature of who they’ve affected and how they’re transmitted are expected to pose a problem such as a worldwide pandemic.”

On the lookout for monkeypox

Monkeypox, Dr. Hsu explained, is caused by a large DNA virus that does not mutate. It has remained stable since it was first identified in 1958 and is primarily spread through prolonged, close contact with other individuals who have the disease, which is characterized by lesions that may not appear until days after symptoms first develop.

“We don’t expect it to be a widely spread disease, but we are actively looking for cases,” Dr. Hsu said, adding that he already has sent notices to medical staff to be on the lookout. As for gauging the appropriate level of concern, he said, “You are not going to get it by walking by someone or shaking hands or hugging or brushing up against someone in a crowded subway.”

"I think we all have to recognize that COVID-19 has taught us that there is going to be something else lurking on the horizon."

Preventive measures for containing monkeypox, which typically lasts 2-4 weeks, are much the same as for COVID-19: Isolate the patient. While risk to the general public is low, the Centers for Disease Control and Prevention recommends seeking medical care if you develop new, unexplained skin rash (lesions on any part of the body), with or without fever and chills, and avoiding contact with others.

Hepatitis Is Puzzling

The outbreak of hepatitis in children “is the part we really know the least about.” The Centers for Disease Control and Prevention is currently investigating more than 100 cases, including several deaths, over the past seven months. It is suspected that adenovirus may play a role. Until more is known about what’s behind the cases, Dr. Hsu said, “Certainly the measures used to prevent transmission of COVID-19 or influenza would be effective against adenovirus,” including frequent hand washing, covering coughs and sneezes, and avoiding others who are sick.

However, he cautioned, anytime there is an unexplained illness in a child that includes vomiting, fever or abdominal pain, it is prudent to have the child checked out by a doctor. A trip to the Emergency Department may be in order if the child is experiencing weakness and high fever and is lethargic.

Bird flu and humans

Of these three diseases, bird flu, which primarily affects waterfowl and domestic poultry, “does have the potential to mix in with other types of human influenza and potentially cause disease in humans that could cause a worldwide pandemic,” Dr. Hsu said. “Right now, what’s going on in chickens is not expected to be a threat to humans.” For that to change, he explained, there would have to be “a mixing and shifting of the RNA viruses that would allow conditions to easily spread among humans. While we always want to be on the lookout for that, we have not seen that happen at all.”

And, he added, “There are systems in place to detect these outbreaks.”

In all these instances, the lessons learned from COVID-19 can help guide the way. “The ideal situation,” said Dr. Hsu, “is that we remember what’s been done, be on the lookout for future problems, be mindful of the daily activities that we participate in, but don’t be overly worried as we move forward.

“We are social beings. But we can also apply reasonable measures that can help prevent rapid transmission of viruses.”