5 of your questions about monkeypox, answered by an infectious disease expert
"It's not just an issue for men who have sex with men. It's a general public health issue."
The first case of monkeypox in the current outbreak was discovered in the United States in May, and since then, there have been more than 10,000 reported cases.
Both the World Health Organization and the Centers for Disease Control have declared the spread of the virus a public health emergency. Here in Massachusetts, where there are 202 known cases, public health officials are working to stop the outbreak as cases mount.
We asked readers what they wanted to know about the monkeypox outbreak and shared their questions with Dr. Daniel R. Kuritzkes, the chief of the division of infectious diseases at Brigham and Women’s Hospital. He explained how the virus is transmitted, what the general public should know about staying safe, and why it’s not time to panic.
How is monkeypox transmitted?
Most of the readers who responded to our poll wanted to what ways they could potentially contract the virus. One reader from Cambridge wanted to know if the virus could spread through the use of uncleaned gym equipment. Another Boston reader was curious how this might impact the use of public bathrooms.
“How will this affect travel, i.e. airports, planes, and hotels?” Ann from Boston asked. “Could the virus be transmitted by using the same bathroom, hotel room, or towels?”
Transmission typically requires skin-to-skin contact, according to Kuritzkes. Monkeypox is a virus that causes rashes, that look like pimples or blisters, to appear on the skin.
“The pox or blisters break out and contain the virus,” he said, adding that transmission can also happen through the air in close quarters, “if there was very close and prolonged contact.”
“Sharing a bedroom potentially could be a means of transmission, but certainly not in an airport, or a retail outlet, or in a restaurant.”
Even in a space like a gym where people are sweating and sharing equipment, Kuritzkes said if gym equipment is wiped down it’s “highly unlikely” that kind of contact would lead to transmission. But people should be careful not to share towels with others, he said.
It’s also important to note that monkeypox isn’t a sexually transmitted disease, although that is one of the ways it can spread. In West Africa, where the disease is endemic, monkeypox isn’t typically spread sexually, according to Kuritzkes.
How can you prevent yourself from contracting monkeypox?
The most important thing anyone can do to avoid monkeypox is to not have sex or intimate contact with people you don’t know well, or who may be presenting symptoms of the virus, like a fever, swollen glands, and rashes.
“I don’t think that there’s a need for people to mask to protect themselves against monkeypox unless you are in the same household or caring for a person who has monkeypox,” Kuritzkes said.
Although monkeypox is a virus, it doesn’t spread as easily as COVID. Current guidance from the Centers for Disease Control and Prevention is that people should regularly wash their hands and avoid touching and sharing eating utensils or cups, bedding, towels, or clothing with a person with monkeypox.
Monkeypox:
What should you do if you contract monkeypox?
Because early symptoms of the virus can be very mild and similar to other common viral infections, you may not initially know you’ve contracted monkeypox.
“In the case of monkeypox, swollen glands are often an early indicator, but then it’s really the rash that’s classic,” Kuritzkes said. “Blisters that form and then go on to crust over, looking a lot like chickenpox but fewer in number than chickenpox.”
The rash will usually appear a day or two after the initial symptoms of fever and fatigue, and once you notice it, Kuritzkes said it’s best to seek medical attention immediately.
“If you think you’ve been exposed to monkeypox, then fast vaccination is available to try to prevent the actual outbreak of the disease or to ameliorate it,” he said. “If you are having significant symptoms, there is treatment available in the form of tecovirimat [or TPOXX], the drug that’s authorized for the treatment of smallpox and monkeypox.”
Massachusetts is one of a handful of states giving out the vaccine, and you can get a dose at one of several vaccination sites in eight towns across the state.
What are public health officials doing to curb the spread?
Daniel from Somerville had a question about what the state is doing to address the outbreak.
“I’d like to know if the state is doing contact tracing and finding out anything about the transmission,” he asked. “Is the DPH not asking people? Is this only showing up in people who had close skin contact with people whose contact information they didn’t get?”
The Massachusetts Department of Health and Health Departments in Boston and Provincetown are doing contact tracing, according to Kuritzkes. Both cities make up a large share of the monkeypox cases in the state. There are currently 157 reported cases in Mass., but some experts believe that could be an undercount.
Beyond contact tracing, Kuritzkes said vaccine access is a key part of addressing the virus effectively.
“As we’ve seen in the news, recently, the FDA has modified the authorization for the vaccine to expand the availability in terms of reducing the dose needed and the mode of administration so that the doses that are available can be stretched much further,” he said.
Also important, according to Kuritzkes, is the outreach being done to make sure that communities at the greatest risk of infection are aware of the virus and how to get treatment.
Why should the general public be concerned about monkeypox?
Early data about the virus suggests that it is mainly transmitted by men who have sex with men, leading some readers to believe the virus is of little concern to those outside the gay community.
Kenneth M. from Randolph asked, “Who is most susceptible to contracting monkeypox?”
While it’s true that current cases are predominantly affecting men who have sex with men, any person who has intimate contact with a person who’s contracted monkeypox is susceptible to the virus, regardless of gender or sexual orientation.
“It’s not just an issue for men who have sex with men. It’s a general public health issue,” Kuritzkes emphasized. “There’s no reason why if somebody had sex with both men and women and contracted monkeypox, that they couldn’t spread the infection to a woman, and that person couldn’t then spread it to other men and so on. Just like we’ve seen herpes and HIV and other infections spread.”
Don’t panic
Monkeypox cases are on the rise in Massachusetts and nationwide, but Kuritzkes wants readers to remember this outbreak is not another COVID. There hasn’t been a single death from the current outbreak and most people who get the disease will be able to recover on their own, he said.
“This is not an outbreak that’s going to cause large numbers of fatalities or even hospitalizations,” Kuritzkes said. “This is not another COVID, this is certainly not Ebola. It’s important for people to keep this in perspective.”
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