CDC, Biden warn of monkeypox spread

The CDC recommends hand washing among other measures that can be taken to prevent infection with the monkeypox virus.

Monkeypox is in the U.S., the Centers for Disease Control and Prevention (CDC) declared on May 23, in a news conference. 

According to the CDC, “Monkeypox is a rare disease that is caused by infection with monkeypox virus” and “the monkeypox virus belongs to a genus that also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.”

President Biden had signaled his concerns the day before, stating that monkeypox is a virus “that everybody should be concerned about.”

At Osan Air Base in South Korea, Biden told reporters, “[The CDC] haven’t told me the level of exposure yet, but it is something that everybody should be concerned about.” 

Biden said,“We’re working on it hard to figure out what we do and what vaccine may be available.”

He added, referencing the strain on the U.S. healthcare system due to COVID and because a third of the U.S. population still refuses to vaccinate and only 40 percent is boosted, that monkeypox “is a concern in the sense that if it were to spread it would be consequential.”

Monkeypox is endemic to Africa, where there are thousands of cases annually. The virus is almost never seen outside Africa, prompting the current alarms from the CDC and the World Health Organization (WHO). Dozens of cases have shown up in recent weeks in the U.K., Europe, Australia and now the U.S. 

But the officials said global cases are rising. A tally by Johns Hopkins Center for Health Security put it at 240 confirmed for suspected cases in 15 countries. 

Monkeypox was first seen in the DRC (Democratic Republic of Congo) about 50 years ago. Media reports in the West have highlighted the most extreme cases, which mimic smallpox with pustules covering the body. But unlike COVID or the deadly Ebola virus, monkeypox is not easily transmitted. And according to epidemiologists and infectious disease specialists, monkeypox results in mild illness akin to chickenpox in the majority of people who catch it. Like chickenpox, the body blisters generally resolve in a few weeks.

Monkeypox is spread through bodily fluids, contaminated objects and skin-to-skin contact. It can also be spread through respiratory droplets from an infected person, but does not have the wide airborne spread potential of COVID.

An effective vaccine is available worldwide, including in the U.S.

The numbers are fluctuating as new cases are reported, but according to WHO, there are dozens of cases in 12 non-African countries with the largest outbreaks in the U.K., Spain, Portugal and Canada. Eight people in the U.S. are now confirmed or presumed to have monkeypox, with cases in Massachusetts, New York, Washington state, Utah, Florida and California.

On Monday, the CDC gave a news briefing with Capt. Jennifer McQuiston, DVM, MS, Deputy Director, Division of High Consequence Pathogens and Pathology and John Brooks, MD, Medical Epidemiologist, Division of HIV/AIDS Prevention, which PGN attended. The briefing was just under an hour long during which details of the symptomology of the virus, current cases, vaccine availability and “ramping up” of production of two vaccines as well as the overall threat levels were discussed. 

The virus is spread through close personal contact and sharing of bodilly fluids and while not a sexually transmitted disease, it can be transmitted during sexual contact. McQuiston said typically the symptoms are fever and rash and swollen lymph nodes. There is “no proven, safe treatment” for monkeypox, but CDC reports the Food and Drug Administration (FDA) has approved the use of smallpox vaccines and antiviral treatments to help control outbreaks.

“What we’re talking about here is close contact,” said McQuiston, “Someone passing someone in the grocery store wouldn’t be at risk for monkeypox.”

McQuiston told media that “risk remains low and there’s no evidence the virus has evolved to be more transmissible.”

She was succinct that the virus was not airborne: “This is not COVID.” 

McQuiston added, in discussing the fact that current cases have been reported in gay and bisexual men who are more personal-health aware than other demographics, “I think that we need to pay close attention to the communities in which this might be circulating, so that we can communicate effectively with them and help bring this outbreak under control.”

“Anyone — anyone can develop and spread monkeypox infection,” Brooks said.

The CDC warns people to watch out for a distinctive rash in the genital region, which could be confused with an STI. “They think it could be a STD, but we’d like the provider to consider it could be monekypox,” Brooks said.

The CDC said mass vaccination of the general public against monkeypox is unnecessary at this time and that “vaccines will be used among a small number people who have been exposed.”

However Brooks and McQuiston also noted that more cases are likely and stressed the need to inform men who identify as gay or bisexual or as having sex with other men.

Dr. Ashish Jha, the White House COVID-19 response coordinator, said in an interview on ABC’s “This Week” May 22 that “the U.S. has the resources, including the smallpox vaccines, to keep the virus at bay.”

Jha said, “I am confident we’re going to be able to keep our arms around it. We’re going to track it very closely and use the tools we have to make sure that we continue to prevent further spread and take care of the people who get infected.”

According to WHO, “Symptoms typically appear in six to 13 days but can take as long as three weeks after exposure. They can last for two to four weeks, with severe cases occurring more commonly among children.”

There was a monkeypox outbreak in the U.S. in 2003. The CDC director at that time was noted HIV/AIDS specialist Dr. Julie L. Gerberding. That outbreak was caused by exposure to infected animals, notably a Gambian giant rat imported from West Africa that infected other animals. There were 87 cases of monkeypox in 6 states, none of them fatal.More details about monkeypox are available from the CDC, which urges people who think they have been exposed to contact their doctor.

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Victoria A. Brownworth is a Pulitzer Prize-nominated award-winning journalist whose work has appeared in The New York Times, the Los Angeles Times, The Philadelphia Inquirer, Baltimore Sun, DAME, The Advocate, Bay Area Reporter and Curve among other publications. She was among the OUT 100 and is the author and editor of more than 20 books, including the Lambda Award-winning Coming Out of Cancer: Writings from the Lesbian Cancer Epidemic and Ordinary Mayhem: A Novel, and the award-winning From Where They Sit: Black Writers Write Black Youth and Too Queer: Essays from a Radical Life.