The Centers for Disease Control and Prevention believe five cases of monkeypox have been found in the United States — including one in New York City — according to an announcement Monday. The federal agency advises healthcare providers to treat these incidents as true positives as it conducts follow-up testing and visits to potentially at-risk populations.
The update follows an announcement Friday by the city’s health department and New York state health officials that one in two suspected monkeypox patients has tested positive for “orthopoxvirus, the family of viruses that monkeypox belongs to.” They said the incident is being treated as “presumptive positive,” meaning a second confirmation from the CDC is required.
“I would like to emphasize that we are still at the beginning with this reaction. More cases are likely to be reported in the United States,” said Dr. Jennifer McQuiston, veterinarian and associate director of the Division of Serious Infectious Diseases and Pathology at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, during a consultation Monday. “The CDC stands ready to help our state health partners learn more about how cases occur and how we can help control these outbreaks.”
When monkeypox spreads from person to person, it typically does so through close, prolonged skin contact with someone with an active rash — or through respiratory droplets from someone with lesions in their mouth. It can also spread from infected animals or contaminated materials. Monkeypox symptoms are flu-like and include fever, headache, and sore muscles. But it is characterized by swollen lymph nodes and rash-like lesions appearing all over the body
“We are talking about close contact here. It’s not a situation where you pass someone at the grocery store, [and] they will be at risk for monkeypox,” McQuiston said.
There is currently one confirmed case of monkeypox in Massachusetts. In addition to the alleged case in New York City, two others are suspected in Utah and one in Florida. The CDC expects to receive samples of the four possible cases for confirmatory testing between Monday and Tuesday.
During Monday’s briefing, CDC medical epidemiologist Dr. John Brooks that while anyone can contract monkeypox, many of those affected in the current outbreak identify as gay and bisexual men.
“Consciousness of this reality is critical to empowering people to make informed decisions about their personal health and the health of their communities,” said Dr. Brooks.
He said while monkeypox is not a sexually transmitted infection in the typical sense, it could be spread through intimate contact or shared bedding. He urged anyone with a new or unexplained rash to see their doctor or get checked out.
“Some groups may have a greater chance of being exposed at this time. But not at all [is] the current risk of exposure to monkeypox for only the gay and bisexual community in the US,” said Dr. Brooks.
These developments follow a series of outbreaks in Europe. The World Health Organization on Monday, without citing evidence, blamed sex for the European outbreaks at two major raves in Spain and Belgium, according to the Associated Press. The WHO says more than 90 cases have been reported worldwide since May 13, most of them in Europe. according to dr McQuiston, this outbreak differs from those in the past because there are no recent travel records for most cases to countries in west or central Africa where the disease is typically found.
The best way to deal with cases, according to health experts, is to isolate an infection and trace everyone who has come in close contact with a patient. Healthcare providers are advised to instruct close contacts to watch for symptoms and isolate them if they notice signs.
According to the CDC, people usually recover within 2 to 4 weeks without specific treatment. Antiviral drugs can stem infections that are already ongoing, and the CDC says it has more than 100 million doses of smallpox vaccine on hand to stem future outbreaks.
Aside from smallpox, which has been eradicated worldwide through vaccination, only monkeypox and cowpox belong to the orthopoxvirus family, which are thought to cause disease in humans. Smallpox vaccine provides cross protection against monkeypox. Cowpox has never been reported in the US and is not believed to spread from person to person.
This story has been updated with additional information.