Some people recently diagnosed with sexually transmitted diseases may also have monkeypox, the Centers for Disease Control and Prevention has said, warning doctors they should monitor and test for both because monkeypox can look a lot like an STD. .
CDC Director Rochelle Walensky said some patients with monkeypox also have syphilis, herpes, gonorrhea, or chlamydia infections. The rash that characterizes monkeypox can resemble herpes or syphilis, Walensky said.
“It’s important to be aware that cases of monkeypox can resemble certain sexually transmitted infections and can be confused with other diagnoses,” Walensky said in a call with reporters Friday. Patients with symptoms should be evaluated for all sexually transmitted infections as well as monkeypox, she said.
“Health care providers shouldn’t rule out monkeypox just because a patient has another diagnosis or another STI,” Walensky told reporters.
The United States confirmed 45 cases of monkeypox in 15 states and Washington DC on Thursday, according to the CDC. No deaths have been reported. The current outbreak is unusual as the virus is spreading outside West and Central Africa, where the disease has been present for decades. More than 1,300 cases have been reported worldwide in 31 countries, according to the CDC.
Moneypox normally starts with flu-like symptoms including fever, headache, muscle aches, chills, exhaustion and swollen lymph nodes. The disease then progresses to a painful rash that can spread all over the body. Most patients recover in two to four weeks without specific medical treatment, according to the CDC.
However, some patients during the current outbreak developed a rash only on the genitals or anus before experiencing flu-like symptoms, Walensky said. In some cases, patients developed a rash without any flu-like symptoms, she said. In many cases, the localized rash has not spread to other parts of the body or only to a few areas, the CDC director said.
People diagnosed with smallpox during the current outbreak have reported close physical contact with others infected with the virus, Walensky said. The virus can be spread through direct contact with wounds, bodily fluids, or materials such as clothing or bedding.
Walensky said it was unclear whether the virus could be spread through semen or vaginal secretions as a sexually transmitted disease. The CDC also doesn’t know if the virus can spread from people who are infected but have no symptoms or mild symptoms.
At least 75% of monkeypox patients in the United States have reported exposure to the virus while traveling internationally, according to Dr. Jennifer McQuiston, a CDC official. The majority of cases have been reported in men who have sex with men, according to the CDC.
A few patients don’t know how they got monkeypox, suggesting the virus could be spreading in the United States at a low level, McQuiston said. However, the CDC has not identified any cities or regions in the United States where there is an outbreak, she said.
“There are only those occasional, sparse cases that don’t know how they got monkeypox,” McQuiston said. “In all likelihood they acquired it from someone who recently traveled, but they just aren’t sure,” she said.
Montreal, Canada’s third-largest city, has reported an outbreak, McQuiston said. Montreal is just across the border from New York State and New England.
Monkeypox can also be spread through respiratory droplets when people have direct, sustained face-to-face contact, Walensky said. The virus is not thought to persist in the air or be transmitted through short periods of shared airspace such as casual conversations at the grocery store, Walensky said. Monkeypox is also not thought to be spread by briefly touching the same object, such as a doorknob, she said.
Airborne transmission of mokeypox has not been reported, according to Dr. Raj Panjabi, who heads the White House Pandemic Preparedness Office. The difference is that respiratory droplets quickly fall to the ground while aerosol particles are much smaller and can linger in the air for a longer period, Panjabi said. Covid-19, for example, spreads through aerosol particles, which is one of the reasons it is so infectious.
The federal government has provided 1,400 vaccination courses and 110 antiviral treatments for people who have been exposed to high risk or monkeypox infections, according to Panjabi. The United States has also conducted 300 tests so far for orthopox, the family of viruses that includes monkeypox. When people test positive for orthopox, they are presumed to have monkeypox until the Atlanta CDC confirms the diagnosis.
“We are working to make testing in public health labs more convenient and to expand testing beyond public health labs through business partners,” Panjabi told reporters on the call Friday.
The United States currently has 72,000 doses of the Jynneos vaccine, a smallpox vaccine also approved to fight monkeypox, immediately available in the strategic national stockpile, according to Dawn O’Connell, who leads the health office. and social services responsible for the inventory. Manufacturer Bavarian Nordic is also sending an additional 300,000 doses to the United States, O’Connell told reporters.
Jynneos is a two-dose vaccine approved by the Food and Drug Administration to prevent monkeypox in people 18 years of age and older. The United States also has more than 100 million doses of an older generation smallpox vaccine, ACAM2000, which can also prevent monkeypox infection. Smallpox and monkeypox belong to the same family of viruses, although moneypox is much more benign.
The CDC generally recommends Jynneos over ACAM2000 because the latter vaccine can have serious side effects. The United States currently does not have enough doses of Jynneos in the supply chain to vaccinate everyone in the United States in the event of a public health emergency, McQuiston said. As a result, the Jynneos vaccine is only given to people who would benefit the most from it, she said. ACAM2000 has a role to play in vaccinating people who are not at risk for side effects from the vaccine to help maintain an adequate supply of Jynneos for those who need it, she said.
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