Monkeypox in NC: What you should know about how the emerging virus spreads
Durham confirmed its first case of monkeypox in mid-July, just weeks after the first case was reported in North Carolina.
On July 24, the World Health Organization (WHO) officially declared the monkeypox outbreak a global public health emergency. In the United States, the Centers for Disease Control and Prevention recently confirmed the first two cases of monkeypox in children.
North Carolina has 34 confirmed monkeypox infections as of July 25, according to the state division of public health, and there are more than 2,500 cases in the U.S., according to recent data from the Centers for Disease Control and Prevention (CDC).
How does the virus spread and who is at highest risk of getting infected?
Here are answers The News & Observer obtained during recent conversations with with Dr. Cameron Wolfe (infectious disease expert at Duke Health) and Dave Wessner (a viral pathogenesis expert at Davidson College).
Responses have been edited for length and clarity.
What do we know about monkeypox’s spread?
Wessner:
“The important point is that it’s transmitted through close physical contact, and right now, we’re seeing it in men who have sex with men. But that doesn’t mean it can only be contracted and spread by men who have sex with men.
“This is the same issue we saw 40 years ago with HIV. It first appeared primarily within the gay community, and it was deemed a ‘gay disease.’ Women, and men who don’t have sex with men, shouldn’t say, ‘It’s impossible for me to get monkeypox.’”
“The virus is present in large amounts in pustules that appear on the body, and direct contact with those pustules is the primary way of transmitting the virus.”
Wolfe:
“It is most readily transmitted through skin-to-skin touch. It is spreading steadily amongst sexually active men especially, but women also.”
Should we be concerned about monkeypox in NC?
Wolfe:
“It’s key to remember this is considerably different to COVID. It’s so much harder to spread. So for the average citizen, this won’t likely impact them. …
“The lesions themselves can either be limited (e.g., genitals, or around the mouth or hands) or much more extensive across the body. They’re often painful, turn into pustules and can ultimately scar. More disseminated disease, where it impacts the internal organs is, fortunately, much more rare.
“Hospitalization is very uncommon. [Those] with painful blistering skin rashes, or with direct contact with anyone they know who has had such lesions, should contact their healthcare provider to ask about testing.”
Wessner:
“Most importantly, at the individual healthcare level and public health level, this is something we need to be aware of and something we need to be watching. It’s not something the average person needs to panic over.”
Will monkeypox spread through NC or stay contained?
Wolfe:
“I think we have to be realistic that this will continue to spread. Not at the same rate we saw with COVID, but certainly for the short- to medium-term while we learn more about it, and as people become familiar with treating and recognizing it. We would expect more cases to be identified in NC.”
Wessner:
“It appears it’s transmitted through direct skin-to-skin contact, or large droplets from your mouth or nose. That’s different from airborne transmission like we see with SARS-CoV-2. Yelling at each other face-to-face? Yes. Just being in the same room at someone? Very low chance, but the chance isn’t zero. Transmission may be possible, but not very likely. ...
“For the general public doing day-to-day activities, getting infected with monkeypox is pretty low risk at this point in time.”
What should we do to take precautions against monkeypox?
Wolfe:
“For the average citizen, nothing different needs to be done. People should be aware of sexually transmitted infections in general, especially any blistering skin rash (sometimes preceded by a flu-like febrile illness before the rash appears).
“If they’re nervous at all, call their doctor to see if they need testing. If someone develops skin lesions or a febrile illness, avoiding sexual contact during that time is crucial to controlling the spread. The CDC now has a good list of pointers on this that are being reviewed.”
What’s the most important thing we should know about monkeypox in NC?
Wolfe:
“If you’re nervous, seek out some care. Unlike COVID, where the spread was rapid and extensive, here it is a slower disease, transmits less quickly, and therefore allows us to carefully test and contact trace.
“But we can only do that if people identify if they’ve been at risk. If they feel sick or think they’ve been exposed, let us know.”
This story was originally published June 24, 2022 at 4:07 PM.
