Monkeypox continues to spread in Washington, with cases doubling roughly every week. At the end of July, 109 cases were identified statewide.
Currently, a majority of confirmed cases in Washington are through local transmission, rather than contact travel, the Department of Health said. King County, the state’s most populous area, has about 90% of cases.
Yakima Health District Confirms County’s First Case of Monkeypox
Monkeypox is a viral zoonosis, a disease transmitted from animals to humans, with symptoms similar to smallpox, albeit less severe.
Monkeypox, endemic to Central and West Africa, has been spreading rapidly and widely since May through human-to-human transmission — especially sexual contact — in countries where it is uncommon. On July 23, with more than 3,000 cases discovered in 47 countries, the World Health Organization declared it a global emergency.
The increasing spread of the virus in the community is now the real concern, said Dr. Shireesha Dhanireddy, an infectious disease expert at UW Medicine. She added that greater local access to testing could also contribute to the growing number of cases.
In early July, UW Medicine’s virology lab, the largest genomic sequencing lab in the state, became one of the few in the country to prepare PCR tests for monkeypox.
How does monkeypox spread? Who gets infected?
Monkeypox can affect anyone – regardless of gender or sexual orientation – who has close contact with an infected person.
This may include direct contact, whether sexual or otherwise, with respiratory secretions, skin lesions, or bodily fluids of an infected person, or contact with virus-contaminated items such as dishes, cutlery, clothing, bedding, or electronics.
Following current global trends, cases in Washington have so far been concentrated among men who have sex with men and those with multiple partners. Previous outbreaks did not disproportionately affect men who had sex with men. Healthcare professionals are working on this new trend without discriminating or stigmatizing.
“I saw my first case at the end of May and then started treatment and since the Pride weekend I feel like we have seen significant growth in the number of cases,” said Dhanireddy.
It is not clear whether monkey pox can be sexually transmitted. The CDC is still investigating whether the virus could be present in semen, vaginal fluid, or stool.
The risk is more common in places where there is close, intimate skin-to-skin contact, regardless of sexual orientation, Dhanireddy said. Kissing with the mouth open also increased the risk of exposure.
“Instead of saying it’s all gay men, or queer or transgender, it really thinks about the epidemiological risk in those kinds of sexual contact events and just the sheer number of partners that means a higher risk of exposure,” Dhanireddy said.
People with multiple sex partners in recent months are at greater risk of exposure.
“If you’ve had more than 10 partners in the past three months, and if you’ve had gonorrhea or syphilis, which indicates you have a high risk of exposure, those are also risk factors,” Dhanireddy said.
Just as infected animals can spread the monkeypox virus to humans, it is possible that infected people can spread the virus through close contact to animals. This includes petting, cuddling, or sleeping on the same bed.
Symptoms and Signs
Symptoms usually begin within three weeks of exposure to the virus. While in past outbreaks of monkeypox, a rash developed shortly after the infected person had flu-like symptoms, in the current outbreak, the rash precedes other symptoms. Swollen lymph nodes are another sign of monkey pox.
The rash may look like pimples or blisters and may be painful or itchy. It can appear on or near the genitals, as well as other areas such as the hands, feet, chest, or face.
As a preventative measure, the CDC recommends avoiding close skin-to-skin contact or sharing objects with people who may be infected or have a rash that resembles monkey pox.
Wash your hands often with soap and water or use an alcohol-based hand sanitizer, and use EPA-approved cleaning products to wipe and disinfect surfaces you share with someone who has monkey pox.
For people diagnosed with monkey pox, the CDC recommends isolation and abstinence from sex while they are healing. Avoid any contact with pets and other animals.
Monkeypox is contagious from the time symptoms begin until the rash has healed, all the scabs have fallen off and a new layer of skin has formed, which can take several weeks.
“If you can’t isolate completely, make sure to cover your lesions and try to sleep separately from roommates,” Dhanireddy said.
Infectious disease experts say the monkeypox virus is unlikely to affect people at airports or on public transport, like the coronavirus.
“It’s really just close intimate contact,” Dhanireddy said. “So if someone’s lesions are covered and they’re on public transportation, wearing a mask and practicing hand hygiene, the risk is very low.”
To care for lesions, the WHO recommends keeping them dry and uncovered when alone, cleaning your hands before and after touching the rash, rinsing the skin with antiseptic soap and mouth with salt water. To manage discomfort, the WHO recommends taking warm baths with baking soda or Epsom salt and taking over-the-counter acetaminophen pain relievers. Regularly disinfect touched surfaces and keep windows open for good air circulation.
While sex with condoms can help, condoms alone probably aren’t enough to prevent monkey pox, the CDC said.
For people who have had close exposure to an infected person, are asymptomatic and contact your health care provider within the two week period as you may be eligible for the vaccine.
Further guidelines from the CDC for sexually active people who may have been exposed to the virus are available here.
Here you will find guidelines on caring for pets and monkey pox.
Once restoration and isolation are complete, the CDC recommends a thorough cleaning and disinfection of all areas in the home in the following order:
1. Collect all dirty waste such as bandages, paper towels, food packaging and other waste in a sealable bag.
2. Collect contaminated clothing and bedding before cleaning everything else in the room. Do not shake the bedding as this can spread infectious particles. Wash them with standard detergent.
3. Use EPA-approved disinfectants to clean hard surfaces and household items. Then move on to upholstered furniture and other furnishings with surface-appropriate cleaners. Steam cleaning can be considered.
4. Finally, work on the carpet and floor and remove all contaminated waste.
If the cleaning is performed by someone other than the person with monkey pox, they should wear full clothing that covers the entire skin, disposable medical gloves, and a respirator or well-fitting mask.
Do not dry or wipe off dust as this can spread infectious particles, although vacuuming with a highly efficient air filter is acceptable. Wet cleaning methods such as disinfectant wipes, sprays and mops are better.
More guidelines for cleaning and disinfecting the household after recovery are available here.
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