Two men that eventually became America’s first two monkeypox cases had sought out treatment for rashes and warts multiple times before doctors finally tested them for the virus in mid-May, after an outbreak had begun in Europe, the CDC reveals.
A report released by the Centers for Disease Control and Prevention (CDC) Friday lays out a timeline for how these early cases were initially missed by local doctors, and the gap between patients noticing symptoms and finally being told they were infected.
The first patient, in the Boston, Massachusetts area, had first experienced a rash around his anus and genitals on May 4, days before cases of the virus were first popping up around Europe. He was not tested for monkeypox until he was hospitalized due to severe pain.
A New York City man had experienced a rash on May 4 as well. Doctors thought it was a sexually transmitted infection (STI), and did not consider the rare virus until the case in Massachusetts was announced.
The CDC report published Friday considers most recent data as of May 31. This includes 17 confirmed cases of the virus, with 16 in men who have sex with other men.
Officials said during a briefing Friday that they had now confirmed 20 cases in America, and over 700 across the world. There have also been no deaths from the virus tied to this outbreak.
All American patients are either in recovery or have fully recovered already. Patients who have the virus are told to remain isolated until their scabs from the lesion fall off and are replaced by new skin.
The outlier case that is not in a gay or bisexual male comes from the Northern Virginia region, where officials confirmed a case in a woman that had recently traveled abroad.
Two different strains have been found in the U.S., with a vast majority of cases matching the same strain that has been found across Europe in recent weeks.
Both strains are of the less-severe Western African variant. Two different strains implies that there were multiple animal-to-human transfers of the virus that eventually led to U.S. cases, though.
Last year, two monkeypox cases were detected in the U.S. – one in Texas and one in Maryland – were also of different strains, and the same two strains that are currently circulating in America.
One U.S. case has not been tied to international travel, or a known human-to-human transmission. The CDC did not reveal where that case was detected.
Monkeypox will display itself as small lesions that appear on a person’s body, though officials warn that they could be subtle and easy to miss (file photo)
CDC officials assured the public that the country has a large enough stockpile of monkeypox vaccines to deal with an oncoming surge of the rare virus (file photo)
Monkeypox was first detected outside of West and Central Africa – regions where it is endemic – on May 7 in a person in the UK that had recently traveled to Nigeria.
Days earlier, on May 4 a man in Massachusetts that had recently returned from international travel developed an anogenital rash.
This rash eventually spread to his face. Over the next week, he would seek out medical care four times, and each time common causes for these types of lesions were ruled out.
On May 12, the man was hospitalized due to unbearable pain caused by his rash. Shortly after, on May 17, local officials notified the CDC of this man’s condition – having seen coverage of a similar case in the UK.
He tested positive for the orthopox family of viruses on May 17, and a day later the CDC confirmed that he had monkeypox.
Also on May 4, a New York City man with recent international travel history developed an oral lesion and a painful rash.
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Dr Hans Kluge, the head of WHO’s European division, has warned the current outbreak of the tropical disease ‘may not be containable’.
He warned Europe had become the new epicenter of the virus, with the outbreak linked to sexual transmission at raves and festivals on the continent.
Dr Kluge insisted the virus ‘will not require the same extensive population measures’ as Covid but said ‘significant and urgent’ action was needed to prevent more cases.
He added that while cases have been concentrated in men who have sex with men, there was nothing stopping it from spreading to other groups.
When he sought out medical care, he was tested for STIs and sent home. The rash began to spread, and other STI tests continued to comeback negative.
Upon hearing about the case in Massachusetts, New York City officials notified the CDC of this case. In the coming days he would test positive for monkeypox and go into isolation.
In the days following, cases of the virus would erupt around America, including at least three others in New York City, three in Sacramento County and others spread across eleven U.S. states.
At least one of these patients was treated with tecovirimat, an antiviral agent developed to fight smallpox but also effective against monkeypox, out the nation’s strategic stockpile.
Because smallpox – a virus that has been eradicated for decades – and monkeypox are both orthopox viruses, many treatments against the former also work against the latter.
Contact tracing efforts started in order to control the spread of the virus, and officials have detected hundreds of exposed people across regions where confirmed cases have been found.
These include 56 people considered to be of high risk of catching the virus, 117 at a moderate risk and 235 at low risk based on potential levels of exposure.
There are two available vaccines for the virus, which are being distributed to close contacts of the infected and people who work in healthcare that may be exposed to the virus.
One is JYNNEOS, a vaccine that can be administered both before and after exposure to the virus to be effective. Last week, CDC officials laid out plans to distribute the shots to health workers and the exposed.
It is believe that America has around 1,000 doses of the two-dose vaccine, though CDC officials say this figure has shifted since they last revealed numbers last week – implying the country has purchased more of the shots. It is the preferred vaccine for fighting the rare virus.
ACAM2000 is an older vaccine which was designed to prevent smallpox – just like JYNNEOS – and is only effective post-exposure to the virus. The U.S. is reportedly sitting on a stockpile of over 100 million doses of the jabs, a figure which may have also changed according to the CDC.
It also has a higher reported risk of adverse events tied to it.
The CDC reports that one state with detected cases of the virus has chosen to request ACAM2000 instead of the preferred JYNNEOS to treat their close contacts.
Officials reiterated that the country has ‘more than enough’ vaccine doses to deal with the current outbreak.