There are now six cases of hMPXV, colloquially known as monkeypox, identified in Oregon.
Dr. Tim Menza, a senior health advisor with the Oregon Health Authority, said that the latest two cases, both in Washington County, were identified Thursday morning; health officials expect to identify potentially many more in the coming weeks.
Menza opened a press conference about the disease on Thursday by acknowledging the stress of facing yet “another public health emergency.”
In addition to the Washington County cases, there is currently one known case in Multnomah County and three in Lane County.
The good news is that hMPXV is far less contagious than COVID-19 and is spread by prolonged skin-to-skin or face-to-face contact, which is easier to avoid than, say, breathing. If the person next to you in the grocery store has the disease, they are unlikely to pass it to you.
“In relative terms, hMPXV is not very transmissible and will not spread like COVID-19,” Menza said.
Though the disease does not require sexual contact to spread, sexual activities that involve being naked with another person are among the behaviors Menza listed as higher risk. It is also possible to contract the disease by using towels or bedding shared with an infected person.
The hMPXV virus is common in many countries but is not usually present in notable numbers in the United States. Currently, there are 605 known cases in the U.S.in 34 states, including Oregon and Washington.
Menza said that number likely represents an undercount. Medical professionals here are unused to seeing symptoms of the disease and may be misdiagnosing. There is also not yet currently sufficient testing capacity.
The version of the disease spreading in the United States and Europe now also looks different than is typical in countries where it has long been more common. Usually, hMPXV presents as a blistering rash, most commonly found on the hands, face and mouth and only rarely on the genitals or anus. The rash is usually preceded by a fever and other flu-like symptoms. However, many patients are often not experiencing a fever at all and have only mild flu-like symptoms and the rash is more frequently showing up on the genitals and anus, but in a more mild form.
And while anyone with skin is at some risk of contracting the disease, Menza said the current risk is higher in some communities.
“While anyone can be affected by hMPXV, the current global outbreak of hMPXV has largely affected gay, bisexual and other men who have sex with men,” Menza said. “I point this out not to say that men who have sex with men are the only people at risk for hMPXV, but that right now our priority should be empowering men who have sex with men and the larger LGBTQIA+ and queer community and their health care providers with information, testing, prevention and treatment strategies.”
Oregonians who fit this description and who have had at least two sexual partners in the last two weeks should consider getting tested for hMPXV, Menza said. Anyone who is concerned can call their doctor or visit a clinic that provides health screenings.
Currently, there are no known pediatric cases in the United States and only three in Europe. Children younger than 8 are considered to be at higher risk of severe disease, as is anyone who is pregnant and anyone who has a blistering skin condition. Those with atopic dermatitis or compromised immune systems are also at higher risk. Severe disease can include a rash spread over a larger portion of the body, mouth sores that make drinking so difficult as to lead to dehydration, and, in rare cases, sepsis, which can be fatal. The disease typically has a 1% to 3% fatality rate, according to Menza.
Treatment consists of a post-exposure vaccine, which can be effective if given within 14 days of exposure. Pre-exposure vaccines can also be given to high-risk populations. And there is an effective antiviral for people experiencing severe disease. However, Oregon currently has just 193 doses of the vaccine and 25 doses of the antiviral. Menza expects to have more soon but said prevention through limiting high-risk behaviors was the best strategy for now.
The Oregon Health Authority released a statement on Thursday with additional information.