Detroit Free Press

Rare Monkeypox virus cases pop up in US

Infections spotted in Mass., NY, but none lately in Mich.

- Kristen Jordan Shamus Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristensha­mus.

Monkeypox, a rare but serious virus closely related to smallpox, was identified this week in a man from Massachuse­tts and another infection is suspected in a person in New York City.

The virus is increasing­ly being reported in countries where it doesn’t ordinarily spread, raising global health concerns.

Possible cases were under investigat­ion in 11 countries as of Friday morning — the U.S., Canada, the United Kingdom, Spain, Portugal, Italy, Sweden, Belgium, France, Germany, and Australia.

The Michigan Department of Health and Human Services told the Free Press on Thursday evening that there are no suspected cases of the virus under investigat­ion in the state.

“Monkeypox in the United States is extremely rare,” said Chelsea Wuth, a spokespers­on for the state health department. “We are aware of the case in Massachuse­tts and are following the details closely. No associated cases have been detected in Michigan at this time. We will inform the public if the risk assessment changes or if we receive new informatio­n about the risk of transmissi­on of monkeypox in Michigan.”

The man from Massachuse­tts who contracted the virus was admitted May 12 to a Boston hospital and is in stable condition, Dr. Paul Biddinger, director of the Center for Disaster Medicine at Massachuse­tts General Hospital, said during a Wednesday news conference.

He is being isolated as health officials try to track his close contacts.

Dr. Erica Shenoy, associate chief of the Infection Control Unit at Mass General, said the man hadn’t been in contact with animals known to carry monkeypox and didn’t travel to central or western Africa, where the virus is more common.

However, as health officials investigat­ed his illness, they learned he had recently visited Canada. An outbreak of monkeypox is suspected in 17 people in the Montreal area of Quebec.

The Massachuse­tts Department of Public Health said the man’s case poses no risk to the public.

In New York City, a person suspected of having monkeypox is hospitaliz­ed at Bellevue Hospital, the city’s health department said Thursday in a Twitter post. Its lab is conducting preliminar­y tests, which — if positive — will be sent to @CDCgov for confirmato­ry testing.

“It’s very early yet — this virus been typically associated with travel or research exposure,” Dr. Linoj Samuel, division head of the microbiolo­gy and pathology laboratori­es at Henry Ford Health, told the Free Press. “So these recent cases are somewhat surprising because they indicate transmissi­on outside the normal endemic area of this virus.”

Most U.S. labs, he said, don’t have the diagnostic tools to detect monkeypox.

“At least for now, we will have to rely on the public health department labs and the CDC to provide testing,” Samuel said.

“We are still collecting informatio­n as the situation develops.”

What is monkeypox?

Monkeypox was first identified in 1958 in monkeys in the Democratic Republic of Congo. It wasn’t until 12 years later, in 1970, that the first human cases were identified.

It causes less severe disease than smallpox, but monkeypox infections still are serious.

There are two known types. The West African clade is estimated to be fatal in 1 in 100 people, but an infection with the Congo Basin clade is deadlier. Its mortality rate is about 1 in 10, according to the World Health Organizati­on.

The virus is more likely to be fatal in young children.

“While deaths can occur due this virus, with proper care there should be a high survival rate,” Samuel said.

Why are cases in US, Europe so unusual?

Monkeypox cases have been reported in the tropical rainforest areas of western and central Africa. Infections in people outside of Africa aren’t common and have been linked to internatio­nal travel or imported animals.

Health officials are trying to understand why the virus is spreading so quickly and so far afield now and they’re trying to determine whether the infections in Europe, Canada and the U.S. are related.

It has many concerned because it is the first time that such transmissi­on has been reported without known epidemiolo­gical links to west

and central Africa, according to the European Centre for Disease Prevention and Control.

The cases include people who self-identify as men who have sex with men, the CDC reported.

“Many of these global reports of monkeypox cases are occurring within sexual networks,” said Dr. Inger Damon, a poxvirus expert who is director of the CDC’s division of highconseq­uence pathogens and pathology. “However, health care providers should be alert to any rash that has features typical of monkeypox.

“We’re asking the public to contact their health care provider if they have a new rash and are concerned about monkeypox.”

What are the symptoms?

It can take up to 21 days for symptoms to develop after a person is infected, according to the CDC. But when symptoms appear, they are typically flu-like and include swelling of the lymph nodes. Common are:

Fever h

Headache h

Muscle aches h

Backache h

Swollen lymph nodes h

Chills h

Exhaustion h

From one to three days after the flu-like symptoms begin, people typically develop a rash and lesions that may start in one place on the body and spread to other parts.

Lesions progress through stages and scab before falling off.

The illness typically lasts two to four weeks, and could initially be confused with a sexually transmitte­d disease such as syphilis or herpes.

How does monkeypox spread?

The virus can spread from person-to-person if there’s contact with body fluids, monkeypox sores or contaminat­ed clothing and bedding, according to the CDC. In that way, monkeypox enters the body through broken skin, the respirator­y tract or the eyes, nose, or mouth.

It also can be transmitte­d through respirator­y droplets from prolonged exposure to an infected person who is coughing or sneezing.

In parts of central and west Africa, people can be exposed to monkeypox through bites or scratches from rodents and small mammals that are infected, when preparing wild game, or having contact with an infected animal or possibly animal products.

Is there a treatment for monkeypox?

There is no proven, safe treatment for monkeypox, according to the CDC.

However, a vaccine developed to prevent smallpox also has been approved for use against monkeypox. The vaccine can be used after exposure to monkeypox to prevent illness or make it less severe. However, the CDC says the sooner the vaccine is given after exposure, the better.

Ideally, a person who was exposed to monkeypox should get vaccinated within four days of exposure to prevent disease or 4-14 days after exposure to limit severity of disease.

Have cases been reported in US before?

Yes. Last year, two separate cases were confirmed in Texas and Maryland in people who had returned from traveling to Nigeria.

And in 2003, an outbreak occurred in six states — Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin — when 47 people were infected with monkeypox after coming into contact with pet prairie dogs. The pets had previously been housed near small mammals imported from Ghana that were infected with the virus.

 ?? AP ?? This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right.
AP This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right.

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