The Massachusetts Department of Public Health (DPH) today announced two cases of monkeypox in two adult men who had close contact with one another. Initial testing was completed late Saturday at the State Public Health Laboratory in Jamaica Plain; confirmatory testing will be done at the US Centers for Disease Control and Prevention (CDC). Neither case reports a known link to the first case identified in Massachusetts. The Boston Public Health Commission (BPHC) will lead the case investigations and work with DPH, the patients, and their healthcare providers to identify individuals who may have been in contact with the patients while they were infectious. The cases are currently isolating to prevent spread to others.
Current data from CDC indicates that there have been 49 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, 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.
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.
“Although monkeypox infections remain rare, and none of the close contacts from Massachusetts’ first case developed monkeypox during their monitoring period, the CDC is reporting that cases continue to rise across the United States,” said DPH State Epidemiologist Dr. Catherine Brown. “It is very important to be aware of the symptoms of monkeypox and to be vigilant. Individuals with concerning rashes should contact their healthcare provider.”
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.