Suspected monkeypox cases rise in California; officials expect more to come

The number of confirmed and suspected monkeypox cases in California rose to six Monday as officials in LA County and San Francisco said they were ready to see more cases.

Officials said it’s crucial that people become aware of the symptoms and healthcare providers watch out for new cases, because the telltale rash – first seen in the genital area in some recent cases – can sometimes appear similar to more common sexually transmitted infections. Health officials say they hope to contain the monkeypox outbreak but say it’s possible the virus is already spreading in the community.

“While most cases resolve on their own, in rare cases, monkeypox can be serious and we want to prevent further spread in the community,” said Dr. Susan Philip, the San Francisco health officer who reported her first suspicion of monkeypox on Friday.

“We have to be prepared to see more cases,” said Los Angeles County Public Health Director Barbara Ferrer, although she added that there are currently no signs that there will be a massive outbreak of monkeypox locally .

LA County reported its first suspected case of monkeypox Thursday, and Sacramento County has reported one confirmed and two suspected cases. It wasn’t immediately clear Monday night which county was reporting the sixth confirmed or suspected case of monkeypox.

As of Monday afternoon, there were 31 confirmed and suspected cases of monkeypox nationwide, with the most cases in New York (seven), California (six), Florida (four), Colorado (three), and Illinois and Utah (two each). ).

The specific monkeypox variant found in most cases in the US has been linked to the variant that has occurred in Europe, Capt. Jennifer McQuiston, associate director of the Division of Serious-Impact Pathogens at the US Centers for Disease and Pathology Control and Prevention, said at a news conference Friday.

Nationally, most monkeypox cases known to the CDC involve people who have recently traveled or have been in close contact with someone who has been infected. But at least one of the recent cases in the US involves someone who doesn’t know how he or she was exposed to the virus, McQuiston said.

“This could happen in other parts of the United States — there could be community-level transmission. And that’s why we really want to step up our surveillance efforts,” McQuiston said. “We really want to encourage doctors, if they see a rash and are concerned it might be monkeypox, to go ahead and test for it.”

Health officials have noted that early data so far shows a large number of current monkeypox cases are in men who have sex with men; However, anyone can contract the virus, including medical workers and family members caring for the sick. According to McQuiston, a case recently occurred in a woman.

Monkeypox was first discovered in 1958 in monkey colonies kept for scientific research. Most human cases of monkeypox have historically been identified in the Democratic Republic of the Congo, where the first human case of infection was noted in 1970. The monkeypox virus occurs naturally in certain wild animals in this country; According to the CDC, rodents and nonhuman primates like monkeys can harbor the virus and infect humans.

For travelers from around the world, the CDC has issued a Level 2 Monkeypox Travel Advisory for U.S. travelers, warning of monkeypox cases associated with the current outbreak on every continent except Antarctica.

In the current outbreak, more than 1,000 confirmed and suspected cases of monkeypox have been reported from 29 countries, with most cases reported in Europe and North America. Britain has reported about 300 of them; Spain, about 200; Portugal, more than 150; and Canada, 80.

The CDC urged world travelers to avoid close contact with sick people, including those with skin and genital lesions; avoid contact with wild animals, dead or alive, such as small mammals and non-human primates such as monkeys and apes; avoid eating game meat or using products derived from wild animals from Africa, such as creams, powders and lotions; avoid contact with contaminated material used by sick people, such as B. Clothing; and wear a mask, which can provide further protection against many diseases, including monkeypox.

Health officials stressed that the threat to the general population is low because monkeypox is not nearly as contagious as other infectious diseases like COVID-19. Monkeypox can be transmitted between humans through close, prolonged skin-to-skin contact with someone who has an active rash and monkeypox skin sores. The virus can be spread through sexual and intimate contact and through shared bedding and clothing. It’s also possible that it can be spread by kissing and breathing at close range.

Monkeypox can also be transmitted from animals to humans through a bite or scratch from an infected animal, handling wildlife, or using products made by infected animals.

Airborne spread is not thought to be the main transmission route for monkeypox, as previous research into the disease has shown that people sharing the same plane flight as a person infected with monkeypox did not spread the virus to other passengers.

Health officials and experts have tried to strike a balance in their warnings, noting that people are generally recovering from the disease while underscoring the urgency of identifying cases and warning that the skin lesions are quite painful in some cases could be.

“It can be very painful and some patients have reported needing prescription pain medication to manage this pain. The wounds can also cause long-term scarring on the skin,” McQuiston said.

Traditionally, monkeypox is believed to begin with a fever and malaise, followed by a rash. But in some of the recent cases, the rash has appeared first. Other symptoms can include headaches, muscle aches, back pain, chills, fatigue, and swollen lymph nodes. Rare complications are lesions in the eye that can endanger vision.

The monkeypox rash results in well-rounded skin lesions, and as they progress they turn into papules, which are higher raised areas of skin that can look like a pencil eraser, McQuiston said. They can then fill with a clear liquid that turns into pus.

The rash can resemble syphilis and herpes, which are far more common than monkeypox. McQuiston said it can be confusing to first distinguish monkeypox from other diseases, so healthcare providers should be alert to possible cases and request a test if they think it might be monkeypox. In some recent cases in Europe, people have been infected with monkeypox and a sexually transmitted infection at the same time.

“They should test for monkeypox even if they think they might have a positive test for another, more common” sexually transmitted infection, McQuiston said.

According to McQuiston, no deaths have been reported worldwide in the current monkeypox outbreak. Patients whose cases were reviewed by the CDC on Friday are either recovering or have already recovered, “and those who still have a rash are advised to stay home and keep away from other people until they are fully recovered.” have recovered.”

Full recovery occurs “when all wounds have caked, the scabs fall off and new healthy skin has formed,” McQuiston said. A person is no longer contagious when all scabs have fallen off.

The most recent monkeypox cases in the United States known to CDC officials have involved adults, McQuiston said, and most reported international travel in the 21 days before their symptoms began. It generally takes seven to 14 days for a person to develop symptoms after exposure to monkeypox, but it can take up to 21 days.

McQuiston said authorities are working hard to contain the outbreak.

“Our containment strategy is focused on identifying cases, identifying their contacts and ensuring they are offered a vaccine and that cases are isolated to prevent further spread,” McQuiston said.

The latest outbreak is worrying because cases of monkeypox are not typically found in the United States, officials said.

The only previous outbreak of monkeypox in the US occurred in 2003 and resulted in 71 confirmed or suspected cases – mostly in Wisconsin, Indiana and Illinois. Those infected had been exposed to prairie dogs, obtained from a pet dealer in a suburb of Chicago, that were housed near Gambian giant rats and Ghanaian dormouse.

Although monkeypox can be fatal in countries with poor health care, the 2003 US outbreak resulted in no deaths.

https://www.latimes.com/california/story/2022-06-06/number-of-suspected-monkeypox-cases-in-california-rises Suspected monkeypox cases rise in California; officials expect more to come

Russell Falcon

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