Atlanta – Georgia public health officials are working to confirm the state’s first case of rare monkeypox, a virus not usually seen outside of West and Central Africa.
The Georgia Department of Public Health says the man, who recently reported traveling, is at his home in Metro Atlanta under an isolation order after he tested positive for the Orthopox virus.
Both monkeypox and smallpox are orthopoxviruses, says Dr. Amish Adalja, a senior researcher at the Johns Hopkins Center for Health Security and an infectious disease physician.
“For all intents and purposes, if you had an orthopox, it would be monkeypox,” Adalja says.
A sample from the man is being tested at the Centers for Disease Control and Prevention headquarters in Atlanta, where Dr. Jennifer McCuston, deputy director of the agency’s division of pathogenesis and pathology, says her agency is now tracking 17 confirmed cases of monkeypox in nine states.
“Our first cases were reported on May 17, so since that day,” McQuiston says. “Many of the cases were said to have traveled to other countries. It is possible that they contracted the infection outside the United States, but not all of them.
“We have a strong scientific concern, and this is different from what we typically see with monkeypox,” McKeston says. “But, I would like to reiterate that there are only 17 cases reported in the United States at the moment. There may be more that we have not diagnosed yet, and there may be more cases that come from people who were exposed before I learned about this and took precautions to prevent acquire it.”
Most, but not all, cases in the United States involve men who have recently traveled to European countries or Canada, where monkeypox is persistently common.
The World Health Organization says 550 cases of monkeypox have been confirmed in 30 countries, including the United States, which does not usually have an outbreak of monkeypox.
“What happened is that a traveler from one of those areas in Africa, where monkeypox is common, for example in Nigeria, traveled to Europe. And that case, or that infection, got into a social network that allowed it to spread more widely than it had to before,” says Adalja.
The first cases seem to occur primarily in gay and bisexual men.
“It’s possible that this is something that has spread at least since April in Europe, without a lot of people knowing, because many of these people have been misdiagnosed or not recognized,” Dr. Adalja says.
Dr. McKeston warns anyone can get monkeypox.
“I think a lot of the media is talking about the prevalence of this in Europe, in a certain demographic, specifically men who identify as men who have sex with other men, or the gay community,” she says. “I really want to stress that we need to base this on science, not stigma. So, even if this is a community where the first cases have been seen, monkeypox can affect anyone, regardless of their gender or sexual orientation.”
The virus, which can cause flu-like symptoms, swollen lymph nodes and a live chickenpox rash, is usually spread through close contact with skin lesions.
“We talk about respiratory droplet transmission, but usually people are closely involved with each other, skin-to-skin contact, and they live in the same house,” Dr. Adalja says. “If you look at outbreaks in Africa, home attack rates haven’t been very high, which tells you it’s not officially transmitted in a respiratory way; it’s transmitted more directly through people with skin-to-skin contact.”
Because the virus does not spread easily, Dr. Adalja says, monkeypox is not an epidemic threat.
“It’s a very controllable disease, once you get an idea of how it’s spread in a particular community, and you roll out the smallpox vaccine, which is effective against monkeypox,” he says.