GREENSBORO, N.C. (WGHP) – When the president says something is a “concern,” we are to take heed. So let’s see what we need to know about monkeypox.

You may have heard President Joe Biden, in remarks during his current trade trip, responded to questions about the virus and a case in the United States, first saying, “It is a concern in that if it were to spread it would be consequential.” Then on Monday in Belgium, asked about quarantines, he added that “I just don’t think it rises to the level of the kind of concern that existed with COVID-19, and the smallpox vaccine works for it.”

In this Centers for Disease Control and Prevention handout graphic, symptoms of one of the first known cases of the monkeypox virus are shown on a patient’s hand May 27, 2003. A recent case was found in the U.S. in a person who had traveled to Canada. (Photo Courtesy of CDC/Getty Images)

This came up because more than 100 cases of this horrible skin disease are being investigated in 12 countries, including the U.S. and Canada, the World Health Organization reported.

Robin Deacle, spokesperson for the North Carolina Department of Health & Human Services, confirmed there are no cases in North Carolina and that state health officials continue to monitor the situation.

“We have communicated with North Carolina health care providers on what to do if a patient is exhibiting symptoms of the virus,” Deacle said in an email. “We do have more questions from health officials and the media on the virus, which last appeared in the U.S. in 2003. We have not seen an uptick in public requests to DHHS.”

She referred to the CDC and local public officials for more information. For now, though, we thought you might be wondering about this disease and how it affects you. Here’s what we know.

What exactly is monkeypox?

Like smallpox, for which all of us were vaccinated as children, this disease causes a viral infection that leads to a severe and ugly rash over the entire body. One of two variants can be deadly. Initially a person may have fever, malaise, headache and weakness, the Centers for Disease Control and Prevention says, with swollen lymph nodes. Then lesions develop in the mouth, and blisters spread all over the body, including to the palms and soles. The rash lasts perhaps two or three weeks, and the infected person can transmit the disease until all the lesions have scabbed over. Scars can remain beyond the scabbing. There are two variants – West African and Central African – and there are fewer deaths and human transmission of the West African variant.

Where did it come from?

Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in monkeys being kept for research. The first human case was recorded in 1970 in the Democratic Republic of Congo, the CDC said. Since then monkeypox has been reported in humans in other central and western African countries.

Why did President Biden comment on monkeypox?

First, there are all those cases being investigated in countries that typically haven’t seen the virus, and then a U.S. resident tested positive for monkeypox last week after returning to the U.S. from Canada, prompting the CDC to work with the Massachusetts Department of Public Health to investigate that resident’s history. Because of that and the clusters of the disease that have been reported this month in several countries in North America and Europe that typically don’t report monkeypox and because the source of exposure in the U.S. case is unknown, the CDC alerted healthcare providers to be alert for rash-related illnesses that might be similar to monkeypox.

How is it transmitted?

A person comes into contact with contaminated animals, humans or other materials that may carry the virus. The virus enters through the respiratory tract or the mucous membranes. Animal contact can be through bites or scratches or contact with bodily fluids. Among humans the transmission is primarily through large respiratory droplets that don’t travel far, meaning prolonged face-to-face contact is required, the CDC said. The virus also can transmit through body fluids or exposure to lesions, even through clothing or bed linens that have contacted the lesions.

Have we seen monkeypox in the U.S. before now?

The CDC reported that in 2021 there were travel-related cases in Maryland and Texas. In 2003 there was an outbreak when the virus was found in imported mammals in six states (not North Carolina). Rodents imported into the U.S. – some species of squirrels, rats and porcupines, for instance – brought the virus into the U.S. Pet prairie dogs caught the disease when they were housed near infected mammals imported from Africa. These were the first known cases outside of Africa. Those animals were removed, and there was no human spread of the virus.