Gay Community Most Vulnerable to Monkeypox Threat, Vaccines Available Soon: CDC
At a Monday media briefing, U.S. public health officials said they are tracking a handful of travel-related monkeypox cases that have been reported across the country.
Anyone can catch monkeypox, but at this time it appears to be "circulating globally in some parts of the gay community," Dr. John Brooks, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention's Division of HIV/AIDS Prevention, said during the briefing.
Contact tracing is being done for the first confirmed case, a Massachusetts man who recently traveled to Canada, added Capt. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology at the CDC.
Four more presumed monkeypox cases have also been reported in various parts of the United States, McQuiston said -- one in New York City, one in Florida and two in Utah.
All reported cases are in men, whom the CDC believes were exposed to the virus while visiting other countries.
Monkeypox causes a rash with skin lesions, and it can be concentrated on certain body parts or spread more widely across the body, McQuiston said during the briefing. It begins with flu-like symptoms like fever and swollen lymph nodes.
The illness is very seldom life-threatening.
"The strain in the identified cases, both in the United States and globally, is West African strain, which is the milder of the two strains of monkeypox virus," McQuiston said. "Most people who are infected with monkeypox recover within two to four weeks without specific treatment."
A person could catch monkeypox if they come into contact with an active rash, respiratory droplets or body fluids from an infected patient, Brooks explained.
"Monkeypox is spread by close personal contact," Brooks said. "Monkeypox is not a sexually transmitted infection in the typical sense, but it can be transmitted during sexual and intimate contact, as well as with personal contact and shared bedding and clothing."
Serious complications generally occur if the monkeypox rash spreads to certain parts of the body, McQuiston said. For example, a lesion on an eye could endanger vision, and swollen lymph nodes could compromise breathing.
Effective vaccines available
There are already a couple of smallpox vaccines that can help protect people against monkeypox infection, the CDC experts noted, and they are being readied for distribution. Fears of a potential smallpox outbreak long ago prompted the U.S. federal government to stockpile a vast quantity of these vaccines, McQuiston explained.
"Right now we are hoping to maximize vaccine distribution to those that we know would benefit from it," she said. "So those are people who've had contact with a known monkeypox patient, health care workers, very close personal contacts and those in particular who might be at high risk for severe disease. I can report that there has been a request for release of the Jynneos vaccine from the national stockpile for some of the high-risk contacts of some of the early patients. So that is actively happening right now."
Public health officials are tracking more than 200 contacts related to the first case in Massachusetts, McQuiston said. Most of those contacts are health care workers.
There also are antiviral drugs for smallpox that could be used to treat severe cases of monkeypox if necessary, added Dr. Brett Petersen, a medical officer with the CDC's Poxvirus and Rabies Branch.
One, tecovirimat, already has expanded access approval by the U.S. Food and Drug Administration to treat monkeypox, Petersen said. The CDC is working to get similar emergency access approval for a newer smallpox medication, brincidofovir.
No need to panic, just empower
Gay Pride Week kicks off this coming Friday, Brooks said, and public health workers are pushing out information through the media and LGBTQ+ organizations to warn participants in upcoming events about this outbreak.
"I don't think at the present time there is sufficient evidence of spread of spread occurring so rapidly that we want to shut down any events or recommend they be postponed," Brooks said. "On the contrary, what we want to do is empower people to take the initiative to hold themselves back from participating if they're feeling ill and to see evaluation."
Gay men attending Pride events should "be cognizant of the fact that if you're feeling ill and have a rash, it might be a good time to step back," Brooks said. "And if you after an event find that you have developed some symptoms or a rash that's suspicious for possible monkeypox, seek evaluation."
As of Saturday, 92 confirmed cases of the illness, and 28 more suspected cases, have been reported across 12 countries, according to the World Health Organization.
France, Germany, Belgium and Australia confirmed their first cases on Friday, the Associated Press reported.
"I'm stunned by this. Every day I wake up and there are more countries infected," said virologist Oyewale Tomori, who sits on several World Health Organization advisory boards.
"This is not the kind of spread we've seen in West Africa, so there may be something new happening in the West," he told the AP.
No new mutation
There's currently no evidence that the monkeypox that's spreading globally represents a new or more dangerous strain of the virus, McQuiston said.
"All the evidence that we have to date suggests that the monkeypox virus that is circulating in these communities is closely related to the monkeypox viruses that we've seen circulating in West Africa over the last several years," McQuiston said. "The sequence data that we have from the Massachusetts case, which matches the sequence data from the Portugal case, shows they are very closely linked to the viruses that we've seen out of West Africa."
The virus was first discovered in 1958 when two outbreaks of a pox-like disease occurred in monkeys. The first known human case occurred in 1970 in the Democratic Republic of the Congo, and it has since been reported in humans in other central and western African countries, according to the CDC.
While it does not occur naturally in the United States, this is not the first time monkeypox has been seen in the nation. A 2003 outbreak was linked to infected prairie dogs imported as pets.
The U.S. Centers for Disease Control and Prevention has more about monkeypox.
SOURCES: Capt. Jennifer McQuiston, DVM, deputy director, Division of High Consequence Pathogens and Pathology, U.S. Centers for Disease Control and Prevention; John Brooks, MD, medical epidemiologist, Division of HIV/AIDS Prevention, CDC; Brett Petersen, MD, medical officer, Poxvirus and Rabies Branch, CDC; Associated Press