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Monkeypox virus: Milwaukee Co. chief health policy advisor provides breakdown on what to know, what to do

Europe Monkeypox
Posted at 8:15 PM, May 23, 2022
and last updated 2022-05-23 21:15:45-04

Monkeypox virus is a typically rare disease, but potentially serious viral illness, and more cases have been popping up around the globe.

Two more suspected cases have been detected in the United States: one in Florida and another in New York City. A man in Massachusetts tested positive last week.

Monkeypox is usually found in west and central Africa. Common symptoms include fever, aches, and rashes all over the body.

Dr. Ben Weston, the Chief Health Policy Advisor for Milwaukee County, provided a breakdown of monkeypox in a series of tweets on Monday. As cases grow internationally, here is what we know, don't know, and what you should do.

Moneypox was first discovered in 1958 in monkeys and is typically spread by rodents, but there have been occasional cases seen in travelers around the world, Dr. Weston said.

"What's different now? There are cases popping up in people without travel history to endemic areas (Africa)," Dr. Weston tweeted Monday. "Human to human spread has occurred before, but not on this level or this broadly. That suggests unknowns about this usually rare virus (and) why it is spreading now."

According to Dr. Weston, there are nearly 250 suspected or confirmed cases and it is changing quickly. However, Dr. Weston said it is likely monkeypox will not become the next pandemic.

"(Covid-19) is far more contagious," Dr. Weston tweeted. "Historically, and likely now, (monkeypox) is spread by close contact (with) secretions, respiratory droplets, or mucus membranes, not aerosolized like COVID. But…As we learned with (Covid-19) we should be humble in our presumed understanding of how a virus can spread. Being a rare virus, we don’t have a ton of understanding of exactly what monkeypox can do or why it is now spreading like this."

A leading World Health Organization (WHO) adviser says the unprecedented outbreak of monkeypox in developed countries is “a random event” that might be explained by sexual behavior at two recent raves in Europe.

Dr. David Heymann formerly headed WHO’s emergencies department. He says the leading theory to explain the spread of the disease was sexual transmission at raves in Spain and Belgium. Monkeypox has not previously triggered widespread outbreaks beyond Africa.

Europe Monkeypox
FILE - 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, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. A leading doctor who chairs a World Health Organization expert group described the unprecedented outbreak of the rare disease monkeypox in developed countries as "a random event" that might be explained by risky sexual behavior at two recent mass events in Europe. (Cynthia S. Goldsmith, Russell Regner/CDC via AP, File)

Many of the European cases have been among men who have sex with men, but anyone can be infected through close contact with a sick person. Scientists say it will be difficult to disentangle whether the spread is being driven by sex or merely close contact.

Dr. Weston said to be careful with this information.

"It has been seen lately in pockets of gay or bisexual men. Be careful here," Dr. Weston tweeted. "Could it be detection at specific clinics? Certain cases of close contact? Another similar confounder? Lots of (bad) history of assuming that certain marginalized groups were more susceptible to diseases that created a lot of stigma, misunderstanding, and ultimately set back health efforts. Lots to learn here before we make assumptions."

The next big question people are wondering: Is monkeypox deadly? Dr. Weston explained there are two strains. The first is the Congo strain with a mortality rate of 10% and the other is the West Africa strain with a 1% mortality rate.

"Luckily, we're talking about the latter here. Importantly, mortality is typically recorded in low resource setting, so expect to be lower in higher resource settings," Dr. Weston tweeted.

According to Dr. Weston, monkeybox can be treated and there are effective vaccines. He said the vaccines are geared towards smallpox, but also work for monkeypox. He also said getting vaccinated after exposure is effective due to long incubation.

"In fact, 'Ring vaccination' was a key strategy of eliminating smallpox," Dr. Weston tweeted. "Close contacts of someone with smallpox would be vaccinated early in disease course to prevent spread to others, different from (Covid-19) vaccination strategy."

You might have to wait to get vaccinated though. Dr. Weston said while it is available and stockpiled in the United States, it is currently not widely available.

US Monkeypox
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows a monkeypox virion, obtained from a sample associated with the 2003 prairie dog outbreak. On Wednesday, May 18, 2022, Massachusetts has reported a rare case of monkeypox in a man who recently had traveled to Canada, and investigators are looking into whether it is connected to recent cases in Europe. (Cynthia S. Goldsmith, Russell Regner/CDC via AP)

So, now what should you be doing?

"All of the things that you should already be doing," Dr. Weston tweeted. "Wash your hands often, avoid close contact with people who are sick, seek medical attention if you have severe or concerning symptoms and follow (Covid-19) mitigation steps too."

As more cases rise, there will be more to learn, Dr. Weston said.

President Joe Biden said cases of monkeypox are “something that everybody should be concerned about.” The president made his first public comments on the disease after being asked about it during his visit to South Korea on Sunday.

He said there's work underway to identify an effective vaccine. And he added that if the disease were to spread "it would be consequential.”

Biden Asia
President Joe Biden speaks during a news conference with Japanese Prime Minister Fumio Kishida at Akasaka Palace, Monday, May 23, 2022, in Tokyo. (AP Photo/Evan Vucci)

However a day later, President Biden said he does not see the need to institute strict quarantine measures.

Biden told reporters on Monday that he doesn't think monkeypox rises to the level of concern that existed with COVID-19.

He added that the smallpox vaccine works for monkeypox and the U.S. has enough stockpile of that vaccine to handle it.

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