According to the Centers for Disease Control and Prevention, 45 cases of monkeypox have been reported in the United States since May.
The CDC asked health care professionals to be aware of possible rashes among patients. However, the nature and severity of recent monkeypox rashes has been different from what was observed by doctors in Africa in the past.
In some cases, monkeypox may have caused people to develop what appears like a pimple, blister or rash rather than a generalized rash, CDC Director Rochelle Wilensky stated in a briefing. She said that small bumps on the skin can be a sign of infection in some cases.
Walensky stated that "we have seen mild cases of monkeypox, sometimes in very limited areas of the body." This is in contrast to the more severe presentations in West and Central Africa. This has raised concerns that certain cases might not be diagnosed or recognized.
Walensky stated that patients have experienced flu-like symptoms in the past, such as body aches, fever, and swelling glands. The characteristic, diffuse rash that appears on many sides of the body is often seen, often on the arms or hands.
Walensky said that in recent cases, some patients have developed a rash around their genitals and anus before experiencing any flu-like symptoms. Some haven't even experienced such flu-like symptoms.
According to the CDC, some patients in the United States have also reported proctitis (or painful inflammation of their rectum lining), a symptom that is not often associated with monkeypox.
"If you notice any new rash, skin condition, or symptom that you aren't sure about, get it checked out," Demetre Dakalakis, Director of the CDC Division of HIV/AIDS Prevention said during a Thursday media conference. Even if it seems serious, this is not the right time to be cautious.
The West African clade is the name given to the current strain of monkeypox found in the United States and other countries outside Africa. According to the World Health Organization, only 1% of those who have contracted this strain have died previously. This compares to as high as 10% for people who have contracted the Congo Basin strain.
Monkeypox can look like chickenpox, herpes, or syphilis. Some cases can cause severe pain and scarring. Patients with the current outbreak required prescription medication or hospital care to manage their pain.
In other cases, however, the rash is not causing much discomfort. Dr. Stuart Isaacs is an associate professor of medicine from the University of Pennsylvania. He believes that the West African strain might cause milder symptoms than the counterpart.
Isaacs stated, "You have these local lesions and very few of the extensive rash that you see historically on the photographs."
He speculated that the way someone is exposed might affect their symptoms.
Monkeypox seems to spread through close physical contact. This could be from either exposure to bodily fluids or respiratory droplets or via lesions or rashes that develop during an infection. Experts believe that the majority of U.S. victims are men who have had sex with other men.
Walensky stated that it is nearly impossible to distinguish the skin-toskin contact from sexual contact. He also said that the cause of transmission could be transmitted through contact with vaginal fluids or semen.
She said that there has been no evidence yet to show the virus spreading through the air, or through interactions like casual conversations at the grocery shop or touching the same doorknob.
Vaccines may protect against monkeypox. Isaacs stated that the existing smallpox vaccines are effective against monkeypox. If administered soon after exposure, the vaccines can prevent or reduce the risk of developing symptoms.
Dawn O'Connell from the Department of Health and Human Services, assistant secretary for preparedness and emergency response, stated that the U.S. has enough vaccines to protect millions of Americans against monkeypox. This includes over 100 million doses ACAM2000, an older generation smallpox vaccine, as well as 72,000 doses Jynneos which the U.S. government has specifically approved to be used against monkeypox.
O'Connell stated that the CDC and HHS had delivered more than 1,400 vaccinations to 16 states since the outbreak began.
