Several gay men in the U.S. and U.K. have told NBC News that contracting monkeypox created "the worst pain" of their lives.
For some, the pain was particularly intense when urinating or defecating.
One British man, Harun Tremblay, disclosed that he was unable to eat for days because of lesions in his mouth and swollen lymph nodes.
According to NBC News, Tremblay also said that he felt extreme pain all over his body, prompting doctors to prescribe opioids.
Similar stories have been told on other U.S. networks by Kyle Planck, a PhD student in New York.
But B.C.'s provincial health officer, Dr. Bonnie Henry, says that people have experienced "very mild symptoms" of this same viral disease in B.C.
In a July 29 interview with CKNW talk-show host Jas Johal, Henry said that B.C. patients with monkeypox have generally begun "feeling unwell for a couple of days", sometimes with "a little bit of fever" before lesions appear.
"So they start off as a raised bump—a blister—and then they crust over and new skin develops. And that can take a week to two weeks," Henry told Johal.
She added that some people are having very small numbers of these lesions.
"So they have very mild illness," Henry said.
She also noted that monkeypox is presenting "a little bit different" in British Columbians than how it appears in countries like Nigeria, where it's existed for a long time.
"They have one or two or maybe half a dozen lesions and not really recognize [it as monkeypox]," she said, "because they’re not painful the way some types of lesions are.”
Henry advised those who have lesions to make sure that they stay away from others so as not to pass along monkeypox.
The provincial health officer's comments have been met with derision by some on social media, including Oxford University professor of primary care Dr. Trisha Greenhalgh.
The B.C. Centre for Disease Control website says that people experiencing more serious disease may require medication to manage pain or skin infections. In "rare cases", they may need to be treated in hospital.
People are urged to see a health-care provider or to visit an urgent primary care centre or emergency department if they've tested positive for monkeypox and they're experiencing any of the following symptoms:
- worsening or new throat or rectal pain;
- severe fever or chills;
- shortness of breath or chest pain;
- or new pox lesions on multiple parts of the body.
In the first stage of monkeypox, symptoms can include fever, chills, intense headache, swollen lymph nodes, back or muscle pain, fatigue or exhaustion, and, less commonly, sore throat, cough, nausea, vomiting, or diarrhea.
A study published in June in Nature Medicine stated that the monkeypox virus in nonendemic countries has far more mutations than the virus that caused the outbreak in Nigeria in 2018 and 2019.
Researchers at the Department of Infectious Diseases in Portugal's National Institute of Health reported that monkeypox from clades 2 and 3, which are most common from western Cameroon to Sierra Leone, usually carry a fatality rate of less than one percent. Those from clade 1 (i.e. the Congo Basin), have a fatality rate of less than 10 percent.
"Although 2022 MPXV (lineage B.1) clustered with 2018–2019 cases linked to an endemic country, it segregates in a divergent phylogenetic branch, likely reflecting continuous accelerated evolution," they stated in their paper.