With local, state, and national officials declaring emergencies over the monkeypox outbreak and a scramble for vaccines causing long lines — and waits — in many US cities, the latest updates on the rare virus can be overwhelming and, well, appear confusing.
But experts say it’s important to remember that monkeypox is a known disease that is rarely fatal (unlike the coronavirus) and already has an approved vaccine and treatment.
That’s not to say there aren’t real concerns about the outbreak, including a shortage of vaccines, rapidly rising infections and the fact that one community – men who have sex with men – remains most at risk.
The first step in fighting this virus is education, experts say, so people can better understand their risks, how the disease spreads and how to prevent transmission.
Can only gay or bisexual men get monkeypox?
no While the outbreak is primarily spreading among gay and bisexual men, and some transgender and non-binary people, anyone — regardless of gender or sexual orientation — can become infected.
“No single person or community is responsible for the spread of a virus,” said Dr. Tomás Aragón, director of public health in California. “Monkeypox can affect anyone and is spread through skin contact and by sharing items such as clothing, bedding and towels.”
dr Stuart Burstin, the AIDS Healthcare Foundation’s interim national director of infectious diseases, said it was “accidental” that monkeypox first infected men who had sex with men. The virus has spread further in this group because transmission can easily occur during sexual encounters.
Of the more than 400 confirmed and suspected cases of monkeypox in Los Angeles County, 99% were men, of whom about 90% were identified as LGBTQ, according to Department of Health data. Similar demographics from state and national health officials have found the same trend, and because of this, gay and bisexual men, as well as some other queer people, remain most at risk.
“The risk to the general public is small, but there is a possibility – and I would predict – that this virus will make its way into the general public,” Burstin said. In very rare cases, this is already the case: at least five children in the United States and one pregnant woman have been infected, according to health officials.
How is monkeypox spread?
Monkeypox spreads primarily through close skin contact, but it can also be transmitted through infected bed sheets or towels, or through “respiratory secretions,” according to the Centers for Disease Control and Prevention.
Intimate contact must involve a direct and usually prolonged interaction with an infected sore, rash or lesion, but Burstin said such marks may not always be obvious, particularly early in an infection.
“It’s possible for someone to have an early illness that looks like a pimple or something in the anus that you can’t see,” Burstin said.
There’s no evidence monkeypox can spread across shared airspace like the coronavirus, experts say.
“I think it’s really important that people realize that monkeypox isn’t like COVID,” Aragón said. “[Monkeypox] is very different in terms of transmission; you really have to have close, physical contact.”
What are the typical symptoms?
dr Leo Moore, director of clinical services for the Los Angeles County Department of Health, said people with monkeypox typically develop a flu-like illness, including fever, fatigue, muscle pain and enlarged lymph nodes. These symptoms are then followed by a rash.
“In many cases, people with the current outbreak develop a rash with or without swollen lymph nodes, which can also appear in the genital or anal area,” Moore said. “We’re also seeing the rash appear all over the body, including the face.”
He said people usually develop symptoms a week or two after exposure, but it can take up to 21 days for evidence of the virus to appear and symptoms can last up to four weeks.
“The rash doesn’t look exactly the same on every person,” said LA County Public Health Director Barbara Ferrer. That’s why it’s important to check yourself and get tested if anything looks irregular, she said.
Symptoms are usually mild, although lesions can become quite painful for some patients, Moore said. No one has died from monkeypox in California, but at least 14 people have been hospitalized with the disease.
Who can be vaccinated or treated?
The Jynneos two-dose vaccine line, approved by the Food and Drug Administration for monkeypox, can be used prophylactically and within two weeks of exposure. However, doses are currently limited, prompting health authorities to set licensing requirements so those at greatest risk of infection can receive the first available vaccinations.
In Los Angeles County, officials recently expanded eligibility, but the focus is still only on those who were directly exposed, or gay and bisexual men and transgender people who meet certain criteria, such as being gay. B. Several recent sex partners.
In terms of treatment, health experts say most patients can recover on their own, but there is an antiviral – Tecovirimat, also known as Tpoxx – that can be administered to help relieve symptoms. However, many healthcare providers have had difficulty accessing Tpoxx, which is only recommended for use in severe cases or for those with certain high-risk health factors. CDC officials have said they are working to streamline the process so more people can have access to the drug.
As of this week, the California Department of Health announced that 1,144 TPOXX courses have been delivered and are ready for use at 71 locations across the state.
Can monkeypox spread? asymptomatic?
“At this point in time, it doesn’t appear that there is a risk of asymptomatic spread,” said Dr. Jay Gladstein, Chief Medical Officer of APLA Health, a Los Angeles-based group focused on healthcare for the LGBTQ community.
While this outbreak remains under investigation, Gladstein said transmission has so far only been linked to contact with virus-filled lesions.
But people should know that the virus can be spread until the lesions are fully healed and covered by a new layer of skin, which can take weeks.
Are massage therapists or tattoo artists a risk?
Burstin said the risk remains very low for people working in skin-contact industries, but he said it’s important to look out for any rashes or bumps.
“The security is really very high,” Burstin said. “If you don’t see a lesion, it’s much more likely that the person isn’t infectious.”
He said to be extra safe, professionals should wear gloves and increase cleaning protocols, but he didn’t recommend changing operations drastically.
“The skin lesions are visible, and for the people who have them, they’re painful, so hopefully people will notice,” Gladstein said. He said there have been no outbreaks among health care workers caring for patients with active monkeypox.
Should gyms, bars, swimming pools or public transport be a concern?
“What we don’t see is random spread. It really has to be a very close contact,” said Gladstein. “The risk will be negligible, close to zero.”
Moore said there are certain precautions people can take in crowded spaces, such as walking around. B. Wearing long sleeves and pants to limit skin contact. He recommended wiping down gym equipment and washing your hands. But surface contact and short-term interactions aren’t how monkeypox is transmitted, experts say.
Regarding swimming pools, Burstin said he wasn’t concerned about the chlorine and how everything in the water would be diluted.
He said there were scenarios, such as being in a club with a gay men’s event where a lot of people might be shirtless, which he thought would be riskier. But most day-to-day interactions shouldn’t be human business. He said he wouldn’t worry about brushing someone’s arm in a bar or on public transport.
“This type of contact disease doesn’t usually spread that quickly,” Burstin said.
Can Using Condoms Prevent Spread?
Unfortunately, condoms aren’t a foolproof way to prevent monkeypox, but they can protect, experts say. Researchers have noted in this outbreak that many patients’ lesions were concentrated on the genitals or anus – in which case a condom could offer protection – but just as many have reported infectious lesions elsewhere on the body.
“A condom isn’t going to provide perfect protection,” Burstin said. “That doesn’t mean people shouldn’t wear condoms; it can provide some level of protection.”
Monkeypox isn’t considered a sexually transmitted disease, but researchers are still trying to determine if it can spread through semen or vaginal fluid. Some studies have pointed to this possibility, so experts also recommend using a condom for a few weeks after recovering from the virus.
Does smallpox vaccination offer protection?
Adults who may have received a smallpox vaccine might have some protection against monkeypox, but experts say it’s very limited.
“As far as we know, there is no protection worth mentioning,” said Gladstein. “You could end up with a slightly milder case of monkeypox, but it’s certainly not considered fully protective.”
As with all vaccines, he said, protection wears off over time, and since the US smallpox vaccine campaign ended in the 1970s, no one should rely on this vaccine.
People who have received the smallpox vaccine are eligible for the Jynneos vaccine.
https://www.latimes.com/california/story/2022-08-05/a-guide-to-separating-monkeypox-facts-from-fiction A guide to separating monkeypox facts from fiction