California has its first suspected monkeypox case

The California Department of Public Health said Tuesday it is investigating the state’s first suspected case of monkeypox, a milder cousin of the notorious smallpox, in a Sacramento County resident who recently traveled abroad, adding to the number of recent infections that has put world medical authorities on alert.

State officials who are investigating the case along with Sacramento County health authorities and the U.S. Centers for Disease Control and Prevention said the patient is isolating, and that they are notifying people the person was in close contact with.

But unlike with the highly contagious COVID-19 virus, “the risk of monkeypox in the general population is very low,” California State Epidemiologist Dr. Erica Pan said in a statement Tuesday.

How did it get here?

The CDC and Massachusetts Department of Public Health last week announced that a U.S. resident tested positive for monkeypox May 18 after returning to the U.S. from Canada. The CDC has been tracking clusters of monkeypox reported this month in European countries that seldom see the disease, and said Monday that there were four other suspected cases nationally, in New York, Florida and Utah.

Sacramento County and state health officials began investigating the California patient for possible monkeypox infection May 21, and said the person tested “preliminarily positive for an orthopox virus,” the virus family that also includes smallpox and cowpox. Monkeypox confirmation is pending CDC testing, state officials said.

The WHO on Friday said recent outbreaks reported across 11 countries have raised concerns because they have appeared in countries outside of Africa where the virus isn’t known to circulate. There were about 80 confirmed cases globally at the time with 50 others under investigation.

Around the Bay Area, health officials in Santa Clara, San Mateo, Contra Costa, Alameda San Francisco and Marin counties reported having no confirmed or suspected cases as of Tuesday.

What are the symptoms?

Monkeypox symptoms in humans are similar to but milder than those of smallpox, beginning with fever, headache, muscle aches, swollen lymph nodes and exhaustion, followed by a rash that often starts on the face and spreads to other parts of the body, the CDC said. The illness typically lasts for 2−4 weeks and most recover, the CDC said. The World Health Organization says 3-6% of cases are fatal. The CDC’s Capt. Jennifer McQuiston, deputy director of the Division of High Consequence Pathogens and PathologyMcQuiston, said recent cases involve the milder of two strains of the virus.

State and federal health authorities are urging healthcare providers in the U.S. to look out for patients who have rash illnesses consistent with monkeypox, especially if they have traveled to an area where the virus has been reported or have had close contact with a person suspected of having monkeypox.

The CDC has warned of a potential increased risk of exposure for gay and bisexual men.

Because monkeypox is rare, state health officials said that health care providers may not be familiar with its symptoms or consider the possibility of monkeypox transmission during intimate or sexual contact, Pan said.

How does it spread?

It remains unclear how people in the European clusters were exposed to the virus, but the CDC said cases include gay or bisexual men. The CDC said it primarily spreads through close contact with a person with an active rash or respiratory droplets from someone with lesions in the mouth.

“It’s not a situation where if you’re passing someone in the grocery store, they’re going to be at risk for monkeypox,” McQuiston said in a news briefing Monday.

The monkeypox outbreaks come as health officials continue to grapple with the pandemic of faster-spreading COVID-19, which has been increasing across the U.S.

“Monkeypox is not easily transmitted, and that’s great news,” Santa Clara County Assistant Medical Officer Dr. Monika Roy said.

What if I’m exposed?

Those with symptoms or possible exposure are urged to see a doctor right away. The U.S. has two licensed vaccines for smallpox and monkeypox in the Strategic National Stockpile, 1,000 doses of Jynneos, which uses a weakened live virus and is given in two doses, and ACAM2000, a single shot of a live pox-family vaccinia virus, of which 100 million doses are kept. It is unclear how long protection lasts from prior routine smallpox vaccination, which the U.S. ended in the 1970s.

Where did monkeypox originate?

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