Ritu Jha-
California’s Department of Public Health (CDPH) announced May 24 that it is investigating the first suspected case of monkeypox infection in the state, triggering concern among people, but doctors say it has nothing to do with the Covid-19 pandemic that is still ravaging parts of the country.
The suspected case was found in Sacramento County in a person who had recently traveled abroad. The patient has been isolated and the CDPH is working with local and federal health officials to ensure appropriate care and response, including contact tracing and post-exposure prevention for close contacts.
“Monkeypox is not related to Covid-19,” Dr Monica Gandhi, professor of medicine and associate chief in the division of HIV, Infectious Diseases and Global Medicine at the University of California, San Francisco (UCSF), told indica.
While the California case came to light May 21, according to the World Health Organization (WHO), the first case in the U.S. was discovered in July 2021 in Dallas, Texas. WHO had noted at the time that it was the first time human monkeypox had been detected in a traveler to the USA, and the first case reported in the country since the original outbreak in 2003.
While the numbers worldwide are rising, the risk of monkeypox in the general population is very low, though health officials have been urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox.
Referring to the pea-sized rashes that a monkeypox patient develops, Dr Gandhi said it is usually a self-limited disease with symptoms lasting from two to four weeks. There are two distinct genetic clades of the monkeypox virus – the Central African (Congo basin) clade and the West African clade. The current outbreak seems to be caused by the milder West Africa variant.
Since May 13, more than 100 cases have been reported to the WHO from non-endemic regions, mostly in Europe and Canada. As of May 25, there were eight confirmed or suspected cases in the U.S., including one each in Massachusetts, New York, Florida, Washington state and California and two in Utah.
Many of those infected are men aged between 30 and 55 who have had sex with men, possibly linked to two large raves held in Spain and Belgium. However, sexual transmission of monkeypox has never been described and transmission is still thought to be from respiratory droplets during close contact, although lesions have been found in the genital and anal regions in some cases.
Patients are generally managed with supportive care and symptomatic treatment. The smallpox vaccine is a therapeutic option. One vaccine, JYNNEOSTM (also known as Imvamune or Imvanex), has been licensed in the U.S. to prevent or treat monkeypox.
Beyond administering the smallpox vaccine, there are various antiviral treatments that can be considered (based on in-vitro or animal studies), including Cidofovir, Brincidofovir and Tecovirimat.
The outbreak is likely to be contained and is not a threat to the general population; moreover, the cases so far have been mild. Contact tracing is highly effective for an infection that is not spread efficiently, that has characteristic features like monkeypox (unlike Covid-19) and when the affected community and medical doctors have been put on high alert as now.
