There are now six cases of hMPXV, colloquially known as monkeypox, identified in Oregon.
Dr. Tim Menza, senior health advisor for the Oregon Health Authority, said 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 news conference about the disease Thursday by acknowledging the stress of facing yet another “another public health emergency.”
In addition to the cases in Washington County, there is currently one known case in Multnomah County and three in Lane County.
The good news is that hMPXV is much less contagious than COVID-19 and is spread through prolonged skin-to-skin or face-to-face contact, which is easier to avoid than, say, breathing. If the person next to you at the grocery store has the disease, they are unlikely to pass it on to you.
“Relatively speaking, hMPXV is not very transmissible and will not spread like COVID-19,” Menza said.
Although the disease does not require sexual contact to spread, sexual activities that involve naked people with another person are among the behaviors that Menza cited as riskier. 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 significant numbers in the United States. There are currently 605 known cases in the US in 34 states, including Oregon and Washington.
Menza said that number likely represents an underestimate. Medical professionals here are not used to seeing symptoms of the disease and may misdiagnose. Also, there is currently not enough testing capacity yet.
The version of the disease’s spread in the United States and Europe now also looks different than is typical in countries where it has long been more prevalent. hMPXV usually presents as a blistering rash, most commonly 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 often have no fever at all and only mild flu-like symptoms, and the rash appears more often on the genitals and anus, but in a milder form.
And while anyone with skin is at some risk of contracting the disease, Menza said the current risk is higher in some communities.
“Although anyone can be affected by hMPXV, the current global hMPXV epidemic has largely affected gay, bisexual and other men who have sex with men,” Menza said. “I bring this up not to say that men who have sex with men are the only people at risk of hMPXV, but that right now our priority should be empowering men who have sex with men and the greater LGBTQIA+ and queer community and their health care providers of information, testing, prevention and treatment strategies.”
Oregonians who fit that description and who have had at least two sexual partners in the past two weeks should consider testing for hMPXV, Menza said. Anyone who is concerned can call their doctor or visit a clinic that provides health screenings.
There are currently no known pediatric cases in the United States and only three in Europe. Children under 8 are considered to be at higher risk of severe disease, as are anyone who is pregnant and anyone who has skin blisters. People with atopic dermatitis or a compromised immune system are also at higher risk. Severe disease can include a rash that spreads over a large part of the body, sores in the mouth that make drinking so difficult that it leads to dehydration, and in rare cases, sepsis, which can be fatal. The disease typically has a 1% to 3% mortality 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 suffering from severe disease. However, Oregon currently only has 193 doses of the vaccine and 25 doses of the antiviral. Menza expects there will be more soon, but said prevention by limiting high-risk behaviors is the best strategy for now.
Oregon health officials released a statement Thursday with additional information.