Dear USET/USET SPF Family,
Monkeypox is rare in the United States but is endemic in several countries in Central and West Africa. Monkeypox is caused by infection with the monkeypox virus, which is a Orthopoxvirus. In light of the recent monkeypox outbreak, USET TEC would like to share some valuable information regarding the current Monkeypox outbreak.
In May 2022, a resident of Massachusetts returning home from Canada was the first known monkeypox case in the United States during the current outbreak. Since then, there have been 4,357 cases identified in 48 countries as of June 27, 2022. There have been 243 cases reported in the United States. Monkeypox is rarely fatal, especially the West African strain in the current outbreak, and milder than smallpox. Clinicians providing services connected to primary care or sexually transmitted diseases, especially to populations with multiple sexual partners, need to remain vigilant. Groups at highest risk for serious illness or death are people with a weakened immune system, pregnant or breastfeeding, children under 8 years old, and those with a history of eczema.
Transmission
This monkeypox outbreak is different than previous outbreaks as it seems to be spread through close contact, sustained skin-to-skin contact (including sexual contact) with a person with monkeypox rash or lesions or contaminated fomites (surfaces), such as bedding. Many of the reported cases are among gay, bisexual, or other men who have sex with men. Any person, regardless of gender or sexual orientation, can get and transmit monkeypox. The current threat level in the United States currently is low.
Possible methods for person-to-person transmission include:
- Direct contact with infectious rash, scabs, or body fluids
- Respiratory secretions during prolonged face-to-face contact
- Intimate physical contact (kissing, cuddling, sex, etc.)
- Touching items that were in contact with infectious rash or body fluids
- Pregnant people to fetus through placenta
Monkeypox can spread from the time symptoms begin until the rash is fully healed with a fresh layer of skin. People without symptoms cannot spread the virus. It is currently unknown if monkeypox can spread through semen or vaginal fluid.
Symptoms, Treatment, & Vaccines
Symptoms in this outbreak also seem to be slightly different than previous outbreaks. General symptoms include fever, headache, muscle and backache, swollen lymph nodes, chills, exhaustion, and rash. For detailed information and pictures for clinical recognition please consult the CDC website. For complete case definitions and detailed histories of clinical presentations of confirmed cases in the current outbreak, please visit the CDC website. There have been cases of co-infections of similarly presenting infections such as chickenpox, syphilis, and herpes.
Testing is vital in identifying cases. Information on tests available can be found on the CDC website. Antivirals used for smallpox treatment, such as tecovirimat (TPOXX), may be recommended for those with a weakened immune system. A full guide on treatment options is available on the CDC website.
For clinicians, laboratory staff, or anyone whose job may expose them to orthopoxviruses, such as monkeypox, The Advisory Committee on Immunization Practices (ACIP), recommends getting vaccinated with ACAM2000 or JYNNEOS. For additional guidance on vaccines, information is on the CDC website.
Please refer to the list of associated sources for more in-depth information and additional guidance. We encourage you to read our full alert. If you have any questions, please reach out to usetepi@usetinc.org.
Resources:
Monkeypox FAQs
Map of Global Outbreak with Case Counts
Monkeypox in the U.S.: An Update (idsociety.org)
U.S. Monkeypox 2022: Situation Summary
CDC Monkeypox Website
Information For Healthcare Professionals
Information for Laboratory Personnel
Travelers’ Health Alert
Monkeypox: Get the Facts
Reducing Stigma in Monkeypox Communication and Community Engagement
Use of JYNNEOS (Smallpox and Monkeypox Vaccine, Live, Nonreplicating) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022
Building Healthy Online Communities Health Information and Messaging on Monkeypox
WHO Interim Rapid Response Guidance: Clinical Management and Infection Prevention and Control of Monkeypox
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