Monkeypox Update from the Cambridge Public Health Department

August 1, 2022

Monkeypox is a disease caused by a virus (monkeypox virus) that until recently was rarely seen in the United States. Monkeypox cases were first reported in the U.S. this year in May, followed by additional cases reported over the course of the summer. As of July 28, the CDC had reported 4,907 cases nationally, including 117 cases in Massachusetts.  At the present time, monkeypox is not widespread in Cambridge, although the public health department is monitoring the situation closely. Given that monkeypox has been detected in Massachusetts, it’s important for residents to recognize the symptoms and know how to prevent getting it. While anyone can catch monkeypox if they have close contact with someone who has monkeypox, regardless of gender identity or sexual orientation, many of those affected in the current outbreak are gay, bisexual, or other men who have sex with men. Anyone with close contact (see below) to a person who is known to have monkeypox should contact their primary care provider right away. 

Symptoms 
Symptoms of monkeypox can include:

• Fever
• Headache
• Muscle aches and backache
• Swollen lymph nodes
• Chills
• Exhaustion
• Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
• A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus. The rash goes through different stages before healing completely. 

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. People with monkeypox may experience all or only a few of these symptoms.  Most with monkeypox develop the rash or sores. Sometimes, people experience flu-like symptoms, followed by a rash. Some people have reported developing a rash or sores before (or without) the flu-like symptoms. The illness typically lasts 2-4 weeks.  Monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. This can take several weeks. If you believe you may have monkeypox, contact your healthcare provider for testing. 

How Monkeypox Spreads 
Monkeypox can spread to anyone through close, personal, often skin-to-skin contact including:

• Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox. (The CDC believes that this is currently the most common way that monkeypox is spreading in the U.S.)
• Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
• Contact with respiratory secretions.

This close contact can happen during intimate contact including oral, anal, and vaginal sex with a person who has monkeypox; hugging, massage, and kissing; prolonged face-to-face contact; and touching fabrics and objects during sex that were used by a person with monkeypox. 

Prevention 
Frequent hand washing, use of hand sanitizer, and avoiding close contact with individuals who may have infectious rashes or sores are good public health practices. To prevent monkeypox specifically, take the following steps:

• Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox.
• Do not touch the rash or scabs of a person with monkeypox.
• Do not kiss, hug, cuddle or have sex with someone with monkeypox.
• Do not share eating utensils or cups with a person with monkeypox.
• Do not handle or touch the bedding, towels, or clothing of a person with monkeypox.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer.

Vaccination 
CDC recommends vaccination for people who have been exposed to monkeypox and people who are at higher risk of being exposed to monkeypox, including:

• People who have been identified by public health officials as a contact of someone with monkeypox;
• People who may have been exposed to monkeypox, such as:
  • People who are aware that one of their sexual partners in the past 2 weeks has been diagnosed with monkeypox
  • People who had multiple sexual partners in the past 2 weeks in an area with known monkeypox;
• People whose jobs may expose them to orthopoxviruses.

There is currently a limited supply of the monkeypox vaccine, and vaccination is prioritized for individuals at highest risk of exposure to someone with monkeypox. Find locations offering the monkeypox vaccine in Massachusetts by visiting the state’s monkeypox vaccine information webpage. To learn more about monkeypox, visit the CDC’s Monkeypox webpage.  

Finally, it’s important to note that health departments reach out to people who may have been exposed to monkeypox to provide advice and assist with getting testing and vaccination. Please answer the phone and/or return calls if public health calls you!