I’ll start this off with “don’t freak out, overhype it or be paranoid about your dog”.  (I’ll probably end with that too).

A recent report in Lancet (Seang et al) describes a pretty solid case of suspected monkeypox virus (MPXV) transmission from people to their dog. Two people development moxkeypox and they owned a dog. The dog, an otherwise healthy Italian greyhound, had close contact with them, including sleeping in their bed. 12 days after the onset of MPX in the owners, the dog developed some mucocutaneous lesions (lesions at the junction of skin and mucous membranes, such as around the lips) as well as some pustules (zits) on the abdomen and anal ulceration. Samples from the skin, mouth and anus were collected and were PCR positive for MPXV. This mean genetic material from the virus was present, not necessarily that the dog was infectious, but it’s pretty suggesting that the dog posed some risk (more on that below). Not surprisingly gene sequencing of the virus from the owner and dog showed they had the same strain.

Is that surprising?

Yes and no. We’ve been saying from the start (as with COVID) that we need to assume that a virus can infect a range of speices until we know that it can’t. As I discussed before, we have very little understanding of what species MPXV can infect. As with COVID, some groups have stuck with the ‘we have no evidence that dogs can be infected’ without acknowledging we have no evidence either way. It’s important not to over-react but it’s also important to be clear, honest and not dismissive. That doesn’t help.

Does this mean the virus has changed?

Probably not. I haven’t seen any earlier studies that looked at susceptibility of dogs to MPXV and no surveillance of dogs in areas where the virus has been endemic. It’s possible this has been happening under the radar at a low level in the past.

Does this mean dogs pose a risk to people or other animals?

That’s the big question. The dog in this report had PCR positive skin lesions, as well as samples from its mouth and anus. As we know from COVID, PCR positivity doesn’t necessarily mean someone is infectious, it just means bits of genetic material are present. However, I suspect there is some risk here. PCR positive skin lesions, in particular, would seem to me to be a potential source of infection.

What do we do now?

Basically the same as we were saying before, when we were concerned about the potential for this.

If you have monkeypox or have been exposed, limit your contact with other individuals…human and animal. This includes trying to prevent any direct contact, as well as reducing time spent in close proximity (because of potential aerosol spread) and contact with potentially contaminated items (e.g. sheets, towels, furniture).

Should someone with monkeypox get rid of their pet?

No. Consideration could be given to temporarily re-homing the pet but that would only be reasonable if the pet hasn’t been exposed. Otherwise, it creates a potential transmission situation if the pet carries the virus to a new household. As with COVID, it’s probably best to keep the pet in the household and let the pet and owner(s) get through the situation together in isolation.

In this case report, the owners reported being careful to prevent contact with their dog after they developed signs of MPX. Yet, the dog still got infected, either because they couldn’t adequately isolate from the dog or because it was infected before they realized what was going on. Given the timeframe (the dog got skin lesions 12 days after the owners) the dog was probably infected very early given the likely incubation period of MPX in dogs.

Should someone be worried about getting monkeypox from their pet?

No. This is pretty much the same discussion as we had with COVID. Most of the risk is to, rather than from, the pet. If a pet has MPX, it likely got it from its owner. So, pets are unlikely to be the primary source of MPX for a household. The transmission risks are probably greatest if the pet is infected and then encounters people outside the household when it has skin lesions. That’s hopefully going to be rare and probably of greatest concern for vets.

Should I stay away from dog parks? I don’t know who’s going to be there.

That’s overkill. Yes, we can never guarantee any random dog doesn’t have MPX. But, we can never guarantee much in life, and the risk posed by random, short term, outdoor contacts at a dog park are presumably exceptionally low.

What is the animal needs to go to a vet?

Stay tuned. We’ll have more details out for that ASAP. CDC has some info here.

So….this isn’t overly surprising. It’s a bit concerning and something we definitely need to investigate more, but nothing to panic about.