In order to spread awareness of the increasing number of monkeypox cases worldwide, the World Health Organization declared the virus a public health emergency of international concern back in June.
With the increasing amount of misinformation about the virus and the recent arrival of monkeypox vaccines to the area, The Dominion Post spoke with Dr. Lee Smith of the Monongalia County Health Department and Dr. Michael Stevens, chief epidemiologist for WVU Hospitals, about the facts associated with monkeypox, as well as vaccine distribution plans.
What is it?
Monkeypox is an orthopoxvirus in the same family as smallpox and cowpox, although not as severe.
According to Smith, monkeypox was first acknowledged in central Africa in 1958 when scientists encountered it in some research monkeys, hence the name.
However, the actual source of the virus remains unclear, but is widely believed to reside in rodents like squirrels, rats and prairie dogs.
The course of the virus usually goes from two-to-four weeks, Smith said, and typically starts with a fever.
Somewhere between one-to-four days after the fever, a rash develops that starts in a central location, then spreads outward. Clear blisters then form where white blood cells gather, to form pustules that eventually break open, then scab over.
How is it spread?
“There are several ways [monkeypox] can be contracted,” Stevens said. “Probably the main way people are getting it in this current outbreak is through direct skin-to-skin contact, particularly with the rash of the lesions of monkeypox.”
Basically, if you touched a skin lesion or rash on somebody who had monkeypox, you are at risk for getting it.
Monkeypox can also be spread through saliva droplets — meaning if you’re within about 6 feet of somebody for a long enough period of time and they exhale the virus, you can inhale it and get it that way.
A few cases have also been passed through fomites — or inanimate objects that can carry or spread disease and infectious agents. These can be things like bed linens, towels and other objects that come in contact with the skin.
How infectious/contagious is it?
“[Monkeypox] is fairly infectious, but less contagious than COVID,” Smith said. “The overall fatality rate — meaning if you get it, what’s your chance of dying from it — is about 3% to 5%.”
Smith said research on when a person first becomes infectious is still early and not a lot of information is available, but the CDC is alluding to the fact that people can be shedding virus before the lesions and fever.
“Even if that is true, the vast majority of the spread is going to come when the liquid from the blister is present,” Smith said. “A person would be considered infectious until the last scab falls off.”
Who can get it?
Anybody can get monkeypox, just like anybody could get chickenpox, Stevens said. The virus doesn’t discriminate against anybody.
“It’s really important to avoid any kind of stigmatization of any kind of specific population of folks because anybody can get this,” he said. “The folks that are probably at highest risk right now are people who are having unprotected sex or sex with multiple or new sexual partners, particularly men who have sex with men.”
As of Friday, there were over 46,700 cases worldwide with nearly 17,000 of those cases being in the United States.
Smith said while there have only been four cases reported in West Virginia, surrounding states have numbers in the hundreds, and cases within the state could be underreported.
In the current outbreak, there haven’t been a lot of deaths, Smith said, but people can get quite ill with it, particularly those with other medical conditions. Younger kids, pregnant women, people who’ve got severe chronic skin issues, and people with low immune systems can get very sick with it, but even people who don’t have all those things can have a lot of pain.
What to do if you think you have it?
The first thing is to go to a doctor, urgent care or emergency room as soon as possible to get tested. You should wear a mask and immediately tell them you’re concerned you have monkeypox because they’ll isolate you, Stevens said.
Smith said the test involves withdrawing fluid from one of the pustules onto a cotton swab and sending it to the lab for testing.
If you do have these blisters, especially if they’re on your hand, it is important to not touch other stuff — particularly people, Smith said. Also be aware that you can put it on your cat or your dog’s fur and then they can carry that for a while.
It’s also important to not leave clothing and bed linens lying around on the floor in a pile for anybody to touch or come in contact with.
How is it treated?
There are really no specific treatments or standards of care for the monkeypox virus.
Stevens said most people will be treated symptomatically for things like pain and will need to be isolated for two-to-four weeks to prevent spreading.
There are antiviral medications, although hard to access, used to treat smallpox — and since monkeypox is genetically similar, those medications are being used to help treat people with weakened immune systems or who are likely to get ill.
However most people should make a full recovery within two-to-four weeks without needing medical treatment.
Prevention and Vaccination
Smith said the best way to prevent monkeypox is to practice safe sex. Having sex with multiple or anonymous partners greatly increases your chances of contracting the virus.
Monongalia County Health Department received a limited number of monkeypox vaccine doses earlier this week, and began administering them Friday.
Smith said the vaccines are being distributed to states based upon what they see is the population risk, which is why initial doses went to states like New York and California. He said the vaccine has been given EUA — emergency use authorization — from the Food and Drug Administration.
While the vaccine is now available, Smith said it is important to remember that numbers are limited and those at higher risk will take priority.
“In order to maximize the delivery of the vaccine, we’re doing it by appointment only,” he said.
“For people who have been exposed, we like to get them their first vaccine within 4-14 days of the exposure.”
Two separate shots are required to be considered immune. The second dose can be given 28 days or four weeks after the initial dose — two weeks after that you are considered to have immunity.
“So from start to finish it is a six-week process,” Smith said.
For more information about monkeypox or to find out if you are eligible for the vaccine, contact the Monongalia County Health Department at 304-598-5119 or visit their website monchd.org.
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