Rare Monkeypox virus pops up in US: What Michiganders should know
Kristen Jordan ShamusMonkeypox, 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."
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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 the U.S. and 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.
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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 high-consequence 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
- Headache
- Muscle aches
- Backache
- Swollen lymph nodes
- Chills
- Exhaustion
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.
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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 monkeypox cases been reported in the U.S. 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.
Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.