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Massachusetts Public Health Officials Confirm One Additional Case of Monkeypox

The Massachusetts Department of Public Health (DPH) today announced an additional case of monkeypox in an adult male, the fourth case in the past month. Initial testing was completed late Monday at the State Public Health Laboratory in Jamaica Plain; confirmatory testing will be done at the US Centers for Disease Control and Prevention (CDC). DPH is working with local health officials, the patient, and the healthcare providers to identify individuals who may have been in contact with the patient while he was infectious. The case is currently isolating to prevent spread to others.

Current data from CDC indicates that there have been 65 cases of monkeypox virus this year in US residents; this includes the first identified case in Massachusetts which was confirmed on May 18. There have been no deaths in the US or globally related to this outbreak and patients generally recover fully in 2-4 weeks. Although many of the early cases were associated with international travel, recent cases are not. Gay and bisexual men and other men who have sex with men make up a large proportion of the cases identified to date. However, the risk is not limited to the LGBT community, and anyone who has been in close contact with someone who has monkeypox is at risk.

While the virus does not spread easily between people, people can spread the infection once they develop symptoms. Transmission occurs through direct contact with body fluids and monkeypox sores, by touching items that have been contaminated with fluids or sores (clothing, bedding, etc.), or less commonly, through respiratory droplets following prolonged face-to-face contact. In many of the recent cases, the locations of the rash lesions suggest transmission during sexual contact. Examples where monkeypox can spread and where it does not:
Monkeypox can spread through:
– Direct skin-skin contact with rash lesions. Sexual/intimate contact, including kissing while a person is infected.
– Living in a house and sharing a bed with someone. Sharing towels or unwashed clothing.
– Respiratory secretions through face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox).

Monkeypox does not spread through:
– Casual conversations. Walking by someone with monkeypox in a grocery store. Touching items like doorknobs.

Clinicians are asked to be alert to the possibility of monkeypox virus infection in individuals who have rash illnesses consistent with monkeypox. Early symptoms of monkeypox can include fever, headache, sore throat, and swollen lymph nodes, but rash may be the first symptom. Rash lesions start flat, become raised, fill with clear fluid (vesicles), and then become pustules (filled with pus). A person with monkeypox can have many lesions or may have only a few. More complete information about how to recognize monkeypox is available here.

“While we are in this current outbreak, and even though monkeypox remains rare, people are encouraged to be mindful of their health,” said DPH State Epidemiologist Dr. Catherine Brown. “If you have any symptoms, and especially if you have a rash, it is best to avoid prolonged physical contact with anyone until you are well.”

Other things you can consider to help reduce the risk from monkeypox include:
– Avoid large gatherings like raves and dance parties where you may have lots of close body contact with others
– Ask any partner, especially new partners whose health status and recent travel history you are not familiar with, if they have any symptoms of monkeypox
– Stay informed by reading information available on the DPH and CDC websites

As the CDC advises, if you believe you may have monkeypox, you should contact your health care provider. If you need to leave your home, wear a mask and cover your rash or lesions when around others. Those who live with or care for someone who may have monkeypox should wear a mask and disposable gloves if they need to have any direct contact with lesions and when handling any clothes or bedding if the person cannot do it themselves. They should also wash their hands regularly, especially after contact with the person who is infected or with their clothes, bed sheets, towels and other items or surfaces they may have touched.

Clinicians should consult with the Massachusetts Department of Public Health at 617-983-6800 to determine if testing is indicated. Consultation is required before submitting specimens.

For more information about this virus, visit https://www.mass.gov/monkeypox and https://www.cdc.gov/poxvirus/monkeypox.

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