Monkeypox infections are continuing to climb in the United States. Illinois and California declared states of emergency Monday, and the World Health Organization says the outbreak is a global health emergency.
What does the disease look like here in Minnesota — and who is at risk? Dr. Beth Thielen, an assistant professor in the department of Pediatrics at the University of Minnesota who studies infectious diseases, spoke with Cathy Wurzer.
The following transcript has been edited for length and clarity. Click the audio player above to listen to their conversation.
Now remind folks, what is monkeypox?
Monkeypox is a viral infection, historically, meaning for over the last few decades we’ve known about this virus that is circulated primarily in Africa. Although we’ve seen cases that have resulted from export of animals or travel in parts of the world that don’t typically have monkeypox.
I think what’s really unique about this current outbreak is that we’re seeing many cases in parts of the world that don’t traditionally have monkeypox, all occurring simultaneously. And so I think right now we’re at over 21,000 cases, globally, and nearly 6,000 cases in the United States. So this is larger than any outbreak we’ve seen previously.
Correct. So it’s really close physical contact that spreads it and I think many people will know that it’s hard to have sexual contact without a component of close physical contact. So it certainly can spread through sexual activity.
But, the message we want to get out to people is that it doesn’t necessarily have to be sexual activity. It can be just other forms of close contact or even contact with bedding or other cloth fabric like that.
Certainly. That’s the concern based on experiences that we’ve had with other outbreaks. And I think there’s certain risks that do seem to be more common among men who have sex with men, that is primarily the population where we’ve seen this infection thus far. And certainly we want to get the word out to those communities so that they can take appropriate precautions.
We want to be aware that this actually isn’t spread just through sexual contact, and that we want to be looking and getting protective messages out to other communities as well. So I think vigilance, not panic, is kind of what we’re what we’re aiming for.
Are kids at risk?
We did see infections among children and some have severe infections. So I don’t want to downplay that risk. But at the same time, we’ve really not seen a large number of cases in the general population and it’s really relatively rare cases amongst children.
Certainly, there are other infections of children, things like hand foot and mouth disease that are more common. I think the chances that it is monkeypox at this point is less likely than it is one of the more common childhood infectious illnesses.
How are the cases in Minnesota?
The new data that was announced [Tuesday] by the Minnesota State Health Department said we have 38 confirmed cases morning here in Minnesota. It was maybe around 33 or so late last week. And it’s really been over the last few weeks that we’ve had cases coming up.
So adding a few new cases a day, but we haven’t really taken off to the same extent where we’ve seen, you know, 800 or so cases in New York and over 500 cases in Illinois. We’re not kind of on the same scale as some of the states with larger outbreaks. But we do have steadily accumulating cases here in Minnesota.
And how does someone know if they have it? Is it pretty obvious?
Yes and no. So really, the key feature that people are having is the rash. And it sort of changes over time over the course of the illness. So it may start as little spots on the skin and then progress to more blister like spots or filled with pus.
The issue is some of these rash illnesses can be fairly limited to small areas of the body. So particularly early in infection, or if there’s a very limited spread of the infection on the body, it may be possible that people may miss those signs of rash.
So I think really, rash illness is something for people to check in with their health care provider about and particularly if they’ve had known exposures to someone with the disease or have engaged in types of activities that are known to be risk factors.
So fever and fatigue were historically thought to precede the rash. I think what we’re learning with this current outbreak is that they may come later. I think the rash is probably the most important, that unique feature that people can kind of focus in on.
What is the best advice for how people can protect themselves?
I think being aware of where the disease is circulating and sort of taking precautions that are proportionate to the level of risk. So I think right now, we do know that this is spreading through sexual activity, and particularly sexual activity with multiple partners and partners met through some apps and websites and things like that. And so I think mitigating those risks at this point as much as possible while this is circulating.
We do have a vaccine available, and that vaccine has been fairly limited in its supply. So I think for people who are identifying as high risk, some of the typical locations where people seek sexual health care are really good places to check in with about vaccines and talk to the health care providers.
I think this situation is evolving so quickly, that many community practitioners may feel a bit lost and sort of have a hard time keeping up. And that’s really why infectious disease doctors, like myself, exist. So many of the health systems will have an infectious disease specialist. And I think we’re paying particularly close attention to how this is evolving and making sure that we’re getting accurate, timely information out to folks.
I will say that testing is really important. I think we’ve really scaled up our testing capacity. And so if people have rash or lesions, even if they don’t have traditional risk factors, it is very important to test for monkeypox so we really get a handle on how many cases are out there and how this disease circulation is changing over time and we can give people the most accurate up to date information about this outbreak.
How effective are treatments if you’re diagnosed with monkeypox?
We have a treatment that’s available but it hasn’t been widely used because this is such a new outbreak. We don’t have a lot of data about how this works, but certainly it’s something that’s available for people with severe disease. And that could be just skin rashes that are limiting the ability of people to function.
So particularly, we’re seeing this in the mouth and genital area — and that can be quite painful. People can get that treatment in consultation with their doctors who contract with public health authorities.
I think the most important thing is to seek medical attention if people are concerned, not all people with monkeypox will require treatment, but certainly it’s available if people need it.
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