U.S. public health officials are tracking a handful of monkeypox infections that appear to be travel-related, and have warned gay and bisexual men to be on alert for possible symptoms.
Speaking at a Monday media briefing, Dr. John Brooks, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention’s Division of HIV/AIDS Prevention, said that anyone can catch monkeypox, but at this time it appears to be “circulating globally in some parts of the gay community.”
In the United States, five possible cases have been reported.
The first case, which has been confirmed, involves a Massachusetts man who recently traveled to Canada, where five cases of monkeypox have been confirmed in Quebec, reports the Canadian Broadcasting Corporation.
Canadian health authorities are also continuing to investigate “a couple dozen” possible cases throughout the country, including several in the Montreal area.
Of the four remaining presumed cases of monkeypox in the United States, two have been reported in Utah, one case has been reported in New York City, and one case in Florida. All four cases were reported in men, whom the CDC believes were exposed to the virus while visiting other countries.
Capt. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and Pathology at the CDC, also said health officials are tracking more than 200 contacts related to the Massachusetts case, most of whom are health care workers.
McQuiston noted during the CDC briefing that there is no evidence to suggest the number of infections — 92 confirmed cases, as well as more than two dozen additional suspected cases in 12 different countries — indicates a new or more virulent strain of the virus.
McQuiston said the sequence data from the Massachusetts cases matches sequence data from infected individuals in Portugal, where the number of confirmed cases has risen to 23, and is closely linked to the West African strain of monkeypox.
The West African strain is less severe than the Central African strain of the virus, with infected people generally recovering “within two to four weeks without specific treatment,” she said.
Monkeypox is typically spread through close personal contact with an infected person, often through contact with an active rash, respiratory droplets, or body fluids from an infected patient, or, in some cases, through contact with an infected person’s bedding or clothing.
The disease causes a rash with skin lesions, flu-like symptoms, fever, and swollen lymph nodes. It is seldom life-threatening, though complications can develop if lesions develop on certain parts of the body, or if swollen lymph nodes compromise a person’s breathing.
McQuiston said that there are smallpox vaccines that can help protect people against monkeypox infection, which are being readied for distribution, according to U.S. News & World Report.
“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.”
CDC officials said there are antiviral drugs for smallpox that could be used to treat severe cases of monkeypox. One drug, tecovirimat, also known as TPOXX, already has expanded access approval by the U.S. Food and Drug Administration to treat monkeypox in cases where patients have life-threatening conditions or serious diseases and no other treatment options are available.
The CDC is working to get similar emergency access approval for a second smallpox medication, brincidofovir, according to Dr. Brett Petersen, a medical officer with the CDC’s Poxvirus and Rabies Branch.
Because many of those infected with monkeypox during this latest outbreak have been men who have sex with men, public health officials are warning LGBTQ organizations and media to warn gay and bisexual men, in particular, about the potential risk at a time when Pride festivities are held throughout the world.
Dr. David Heymann, the chairman of the World Health Organization Emergency Committee, told reporters that WHO researchers had traced monkeypox cases in Spain and Germany to sexual activity stemming from LGBTQ events, including a Gay Pride celebration in Spain’s Canary Islands, and the Darklands Festival, a large-scale fetish festival held in Antwerp, Belgium, reports the New York Post.
“We know monkeypox can spread when there is close contact with the lesions of someone who is infected,” Heymann said. “And it looks like the sexual contact has now amplified that transmission.”
Meanwhile, according to Reuters, Spanish health authorities have also traced several suspected cases to a sauna in Madrid, which has since been shut down by the government to cut down on potential spread.
However, public health officials are not recommending shutdowns or postponements of major events at this time.
Instead, they are recommending that people who develop rashes or other symptoms avoid contact with others in order to reduce the potential for transmission.
Gay men 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” from attending large-scale gatherings, Brooks said during the CDC briefing.
“And if you after an event find that you have developed some symptoms or a rash that’s suspicious for possible monkeypox, seek evaluation.”
Health officials in the United Kingdom will start offering monkeypox vaccines to some men who have sex with men in response to the relatively rapid spread of the disease, with the number of confirmed cases exceeding 3,000 in total, affecting individuals in 42 different countries.
Doctors in Great Britain will be able to offer the Imvanex vaccine to men who have the highest risk of exposure, the UK Health Security Agency said in a statement on Tuesday.
While anyone can contract monkeypox, data from the latest outbreak, involving the West African strain of the virus that causes the disease, shows higher levels of transmission within -- but not exclusively among -- gay and bisexual-identifying men and men who, regardless of their sexual orientation, have sex with other men.
Health authorities in Europe, the United States, and Australia are investigating a recent outbreak of monkeypox, a rare viral disease typically found in Africa.
Germany reported its first case of the virus on Friday, becoming the 11th country to confirm a case of infection. Other countries with confirmed cases are Australia, Belgium, Canada, France, Italy, Portugal, Spain, Sweden, the United Kingdom, and the United States -- with more than 100 confirmed or suspected cases in total.
The breadth of the infections, and their seemingly rapid spread, have health experts looking into their root cause.
On Monday, the D.C. Department of Health began offering a limited amount of appointments for monkeypox vaccinations to eligible District residents.
Less than 20 minutes after appointment slots were made available starting at 1 p.m., all appointments for Tuesday and Thursday had been reserved. According to the DC Health website, additional appointments for Sunday, July 3, will be made available when the appointment portal opens again on Wednesday, June 29.
Dr. Anil Mangla, the state epidemiologist for the D.C. Department of Health, told Metro Weekly that DC Health will be providing the Jynneos smallpox vaccine, which is offered in two doses two weeks apart, to at-risk populations, based on supply provided by the department by the Centers for Disease Control and Prevention.
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