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Should You Change Your Travel Plans Because of Monkeypox?

A case was also reported in the U.S.

Over the past few days, Portugal, Spain, France, the U.K., Italy, and Canada have reported cases of monkeypox. On May 18, a U.S. resident in the Massachusettes also tested positive after returning from Canada. The CDC is currently investigating the situation and the World Health Organization has scheduled an emergency meeting.

What Is Monkeypox and How Does It Spread?

Monkeypox is a rare infection caused by the monkeypox virus. It was first discovered in 1958 in monkeys kept for research, but the first case of human monkeypox was reported in 1970 in the Democratic Republic of the Congo. Ten other African countries have also identified cases of human monkeypox, including South Sudan, Cameroon, Benin, Gabon, Liberia, Nigeria, the Republic of the Congo, the Central African Republic, Sierra Leone, and Cote d’Ivoire. Non-endemic countries such as Israel, Singapore, the U.S., and the U.K. have had a few cases, too.

According to the CDC, the main carrier (natural reservoir) of monkeypox isn’t known, but African rodents and monkeys may host the virus and infect people. A person can contract monkeypox if they come in contact with a sick animal. Animal bites and scratches, touching blood or bodily fluids, eating meat from an infected animal, or coming in contact with contaminated bedding can cause animal-to-human transmission. 

Human-to-human transmission is much less likely. The CDC website says, “Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required. Other human-to-human methods of transmission include direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens.” 

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In simple terms, if you touch an infected person’s scabs or blisters or get too close if they’re sneezing and coughing, or touch their clothing or bedding, you can catch it.   

Scientists are studying how easily the virus can be transmitted through sexual contact. The U.K. Health Security Agency (UKHSA) said in a statement, “Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex.” 

Monkeypox is related to smallpox, but it is milder and less contagious. The symptoms include fever, headache, swollen lymph nodes, muscle aches, and smallpox-like rashes. There is no safe, known treatment for the infection. However, most people recover from the illness in two to four weeks. In Africa, it causes death in 1 in 10 cases.

Is There a Vaccine?

Smallpox vaccines work against monkeypox, too. But kids aren’t vaccinated against smallpox anymore since it has been eradicated. Hence, immunity to monkeypox is low. The U.K. government has bought stocks of the smallpox vaccine to protect citizens against monkeypox, and Spain is planning to order doses, too.

In the U.S., there is an approved vaccine to prevent monkeypox. According to the CDC, “The Advisory Committee on Immunization Practices (ACIP) is currently evaluating JYNNEOS for the protection of people at risk of occupational exposure to orthopoxviruses such as smallpox and monkeypox in a pre-event setting.” 

Have There Been Cases in the U.S. in the Past?

Yes. In July 2021, someone who had traveled from Nigeria tested positive in Texas. There was another case confirmed in November 2021 in a Maryland resident who had also returned from Nigeria. No additional cases were identified. 

In 2003, 47 non-fatal cases of human monkeypox were reported in the U.S. in Indiana, Illinois, Kansas, Ohio, Missouri, and Wisconsin. This was the first time human monkeypox was reported outside of Africa. These cases were not travel-related. A shipment of animals was imported from Ghana to Texas, including rodents that were infected with the monkeypox virus. In an Illinois facility of an animal vendor, these rodents transferred the virus to prairie dogs that were sold as pets and these dogs infected humans. The CDC mentions that human-to-human infections weren’t the cause of the spread.

How Bad Is the Current Outbreak?

The outbreak is small with 68 suspected cases around the world so far. 

Virologist Dr. Angela Rasmussen explained in a series of tweets that it is “not easily transmissible person-to-person and requires close proximity over an extended period of time.” She also said that monkeypox is not new—it is endemic in parts of Africa and can cause human infections. However, “what’s new is this unprecedented global spread, via travel and potentially sexual networks,” she tweeted.

Health officials are trying to determine the cause of the spread. The U.K. Health Security Agency (UKHSA) confirmed that the earliest known person to be identified with the rare infection on May 7 had recently traveled to Nigeria. However, the new cases have had no travel history to countries endemic to monkeypox. Dr. Susan Hopkins, the chief medical advisor to UKHSA, said, “These latest cases, together with reports of cases in countries across Europe, confirms our initial concerns that there could be spread of monkeypox within our communities.”

The agency has been reiterating that the virus doesn’t easily spread between people, so the risk to the general population remains low.

Should You Change Your Travel Plans?

At this point, no. But the CDC recommends travelers to endemic countries avoid contact with sick animals and avoid eating or handling bushmeat. Hand hygiene and the use of sanitizers are emphasized. If you get sick after returning from a country where monkeypox exists, talk to your healthcare provider and pay attention to any rash or lesions.