Sex, ‘Casual Touch’ and Pimples: A Guide to Separating Monkeypox Fact from Fiction | National

By Willie S. Morrissey Last updated Aug 7, 2022

LOS ANGELES – With local, state and national officials declaring emergencies over the monkeypox outbreak and a rush for vaccines causing long lines – and waits – in many US cities, the latest updates on the rare virus can seem overwhelming and, well, confusing.

But experts say it’s important to remember that monkeypox is a known disease that is rarely fatal (unlike 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, a rapid rise in infections, and the fact that one community — men who have sex with men — remains the most at risk.

According to experts, the first step in fighting this virus is education, so people can better understand their risks and know how the disease spreads and how to prevent transmission.

Can only gay or bisexual men get monkeypox?

No. Although the epidemic is mainly spreading among gay and bisexual men, as well as some transgender and non-binary people, anyone, regardless of gender or sexual orientation, can be infected.

“No individual or community is to blame for the spread of a virus,” said Dr. Tomás Aragón, California’s director of public health. “Monkey pox can affect anyone, and it is spread through skin-to-skin contact, as well as sharing objects such as clothing, bedding and towels.”

Dr Stuart Burstin, acting national director of infectious diseases for the AIDS Healthcare Foundation, said it was “by chance” that monkeypox first infected men who have sex with men. The virus continued to spread in this group, as transmission can easily occur through sexual intercourse.

Of the more than 400 confirmed and suspected cases of monkeypox in Los Angeles County, 99% were in men, about 90% of whom identified as LGBTQ, according to data from the Department of Public Health. Similar demographic data from state and national health authorities found the same trend, and for this reason, gay and bisexual men, as well as some other queer people, remain most at risk.

“The risk to the general public is low, but there is a chance — and I predict — that this virus will make inroads 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 is primarily spread through close skin-to-skin contact, but it can also be transmitted through infected linens or towels or through “respiratory secretions,” according to the Centers for Disease Control and Prevention.

Intimate contact should include direct and usually prolonged interaction with an infected wound, rash or lesion, but Burstin said such marks may not always be obvious, especially early in an infection.

“It’s possible someone has early disease that looks like a pimple or something in their anus that you can’t see,” Burstin said.

There is no evidence that monkeypox can spread through shared airspace like the coronavirus, experts say.

“I think it’s really important for people to recognize that monkeypox is not 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 Public Health, said people with monkeypox typically develop a flu-like illness, including fever, fatigue, muscle aches and pain. enlarged lymph nodes. These symptoms are then followed by a rash.

“In many cases with the current outbreak, people develop a rash with or without swollen lymph nodes which can also occur in the genital or anal area,” Moore said. “We are also seeing the rash occur all over the body, including the face.”

He said people usually develop symptoms within a week or two of being exposed, but it can take up to 21 days for the virus to show up and symptoms can last up to four weeks.

“The rash is not exactly the same on everyone,” LA County Public Health Director Barbara Ferrer said. That’s why it’s important to check yourself in and get tested if anything seems off, she said.

Symptoms are generally mild, although the 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 illness.

Who can receive a vaccine or treatment?

The two-dose Jynneos vaccine series, which has been approved by the Food and Drug Administration for monkeypox, can be used preventively and within two weeks of exposure. But doses are currently limited, prompting health officials to set eligibility criteria so those most at risk of infection can receive the first vaccines available.

In Los Angeles County, authorities recently expanded eligibility, but the focus is still only on those who have been directly exposed or on gay and bisexual men and transgender people who meet certain criteria, such as having several recent sexual partners.

When it comes to treatment, health experts say most patients can recover on their own, but there is an antiviral – tecovirimat, also known as Tpoxx – that can be given to help relieve symptoms. However, many healthcare providers have had difficulty accessing Tpoxx, which is only recommended for severe cases or for people with certain high-risk health factors. CDC officials said they are working to streamline the process so more people can get access to the drug.

As of this week, the California Department of Public Health said 1,144 TPOXX courses have been delivered and are ready for use at 71 sites across the state.

Can monkeypox spread asymptomatically?

“There does not appear, at this point, 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 delivering health care. to the LGBTQ community.

While this outbreak continues to be studied, Gladstein said transmission has so far only been linked to contact with virus-filled lesions.

But people should be aware that the virus can spread until the lesions are completely healed and covered with a new layer of skin, which can take weeks.

Are massage therapists or tattoo artists at risk?

Burstin said the risk remains very low for people who work in industries that come into contact with the skin, but he said it was important to watch for rashes or bumps.

“Security is really, really high,” Burstin said. “If you don’t see a lesion, the person is much more likely not to be contagious.”

He said to be safer, professionals should wear gloves and increase cleaning protocols, but he did not recommend drastically changing operations.

“The skin lesions are visible, and for people who have them, they’re painful, so hopefully people will notice that,” Gladstein said. He said there had been no outbreaks among healthcare workers providing care to patients with active monkeypox.

Should gyms, bars, swimming pools or public transport be a concern?

“What we don’t see is occasional spread. It really has to be very close contact,” Gladstein said. “The risk is going to be extremely low, close to zero.”

Moore said there are certain precautions people can take in crowded spaces, such as wearing long sleeves and pants to limit skin-to-skin contact. He recommended wiping down gym equipment and washing hands. But surface contact and short-term interactions are not how monkeypox is transmitted, experts say.

As for pools, Burstin said he wasn’t worried, given the chlorine and dilution of anything in the water.

He said there were scenarios, like being at a club with a gay men’s event where many people might be shirtless, that he would consider more risky. But most everyday interactions shouldn’t be about people. He said he wouldn’t worry about brushing against someone’s arm in a bar or on public transport.

“This type of contact disease is usually not transmitted that quickly,” Burstin said.

Can using condoms prevent the spread?

Unfortunately, condoms aren’t a surefire way to prevent monkeypox, but they can be protective, experts say. Researchers noticed in this outbreak that many patient lesions were concentrated on the genitals or anus – in which case a condom might provide protection – but just as many reported infectious lesions elsewhere on the body.

“A condom won’t be perfectly protective,” Burstin said. “That doesn’t mean people shouldn’t wear condoms; it can give some degree of protection.”

Monkeypox is not considered a sexually transmitted disease, but researchers are still trying to determine if it can be spread through semen or vaginal secretions. Some studies have indicated this possibility, so experts also recommend using a condom for a few weeks after recovering from the virus.

Does the smallpox vaccine provide protection?

Adults who may have received a smallpox vaccine might have some protection against monkeypox, but experts say it’s very limited.

“There is no significant protection that we know of,” Gladstein said. “They may end up with a slightly milder case of monkeypox, but that’s certainly not considered fully protective.”

As with all vaccines, he said, protection wanes over time, and with the end of the US smallpox vaccination campaign in the 1970s, no one should rely on this inoculation.

People who have received the smallpox vaccine are eligible for the Jynneos vaccine.