Doctor: Monkeypox misdiagnosis, treatment access a ‘major problem’


(NewsNation) — As monkeypox concerns soar, one doctor in San Francisco is sounding the alarm. Dr. Graham Walker says about 1 in 4 of the monkeypox patients he is seeing were misdiagnosed and had their symptoms missed by other health care providers.

Walker said these patients often land in his emergency room in excruciating pain and discomfort. While appearing on “NewsNation Prime” Sunday evening, he explained that monkeypox symptoms are presenting differently than what doctors may have seen in textbooks from even five or 10 years ago.

“If you look in a textbook, you may see that patients always have a fever or lymph nodes or night sweats or fatigue prior to developing a rash, and that’s not really the case anymore,” Walker said. “So we’re just learning how to properly diagnose this and make sure we don’t miss it.”

The Centers for Disease Control and Prevention defines monkeypox as a “rare disease caused by infection with the monkeypox virus. Monkeypox virus is part of the same family of viruses as Variola virus, the virus that causes smallpox.”

The virus is spread through close skin-to-skin contact or sharing items like bedding, towels and clothes. Some symptoms include a rash that initially looks like pimples or blisters, fever, chills, swollen lymph nodes, exhaustion, aches and respiratory congestion.

Walker believes a treatment called Tecovirimat, also known as TPOXX, can be the difference between a patient being in agony for a month and having their lesions close in as little as three days. The problem comes in terms of accessing the treatment.

According to the CDC, TPOXX is FDA-approved for the treatment of human smallpox disease caused by Variola virus in adults and children. Its use for some other infections, including monkeypox, is not approved by the FDA at this time.

For now, the CDC holds a non-research expanded access Investigational New Drug (EA-IND) protocol that allows for the use of TPOXX in certain people with severe disease associated with monkeypox.

“I do not have access to the TPOXX that I need,” Walker said.

He said since TPOXX is still under review board requirements, accessing the medicine requires roughly 15 pages of paperwork, about 200 questions per patient and about two hours of his time each round.

“Right now it takes way too much paperwork for me to be able to get this medicine, which can reduce the amount of time that a patient has these symptoms, and theoretically also reduce the amount of time they are infectious or contagious and can spread this disease to other people,” Walker said.

He added: “These patients often have symptoms or lesions for three to four weeks. I don’t know anyone that has three to four weeks of sick or leave time to just be off and not working, let alone isolated from friends and family. It’s a major problem. I’m an emergency doctor. I work nights, weekends and holidays because I like fixing things and I really just love helping people. But it is so frustrating to be hamstrung by bureaucratic paperwork when I feel like I can very easily prescribe this medicine safely to the appropriate patients.”

Walker also expressed disgust of people recently taking pictures of those with skin conditions, speculating they have monkeypox and posting it on social media.

“People who suffer from skin conditions already have stigma and fear and anxiety because things are already publicly viewable on their bodies. We’re seeing this more and more. It’s simply got to stop,” Walker said. “I have not seen a single case that’s been posted on social media that actually looks like monkeypox. It’s almost always something else. People need to leave the diagnosing up to medical professionals.”

Walker’s concern comes as the U.S. declared monkeypox a public health emergency in an effort to make federal funding and resources available to fight the disease.

According to the latest data from the CDC, there are a total of 7,510 confirmed monkeypox cases in the U.S. On a global scale, the World Health Organization reports monkeypox cases in more than 70 countries.

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