As if COVID-19, inflation and the financial system weren’t sufficient, the rise in monkeypox instances has given Californians yet one more factor to fret about.
The illness — characterised by a rash and lesions that may seem like pimples, bumps or blisters — primarily spreads by extended skin-to-skin contact with these lesions, which can be in hard-to-see locations on the physique or be mistaken for another pores and skin subject. Though hardly ever deadly, the illness might be fairly painful.
Monkeypox has gained a foothold amongst males and transgender folks within the LGBTQ neighborhood in Los Angeles. The Los Angeles County Division of Public Well being has obtained a restricted variety of doses of monkeypox vaccine from the federal authorities, and is providing them solely to folks at present deemed in danger.
Proper now, monkeypox instances are “approaching an exponential curve,” stated Dr. Peter Chin-Hong, an infectious-disease professional at UC San Francisco. However, for folks outdoors the affected communities, the danger of catching monkeypox appears to be low in the intervening time. And if present vaccination efforts are profitable, we could possibly wipe out monkeypox. But when it spreads to animals, the illness may turn into endemic in the USA.
How does monkeypox unfold? How harmful is it? How contagious is it? Can contaminated folks with no signs cross on the illness to others? Can it’s unfold by the air? Who can get a vaccine? What can folks do after they’re absolutely vaccinated? What ought to folks do to keep away from getting monkeypox?
You could have questions. We requested specialists for solutions.
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UPDATED Aug. 11, 2022 | 3:42 PM
Who’s eligible for a monkeypox vaccine in L.A. County?
You should be an 18-year-old or older homosexual or bisexual man or transgender individual and meet no less than one of many following standards to be eligible for the vaccination in L.A. County:
You’ve had a number of intercourse companions within the final 14 days, together with (however not restricted to) having intercourse in alternate for meals, shelter or different items or wants.
You’re on HIV PrEP treatment.
You’ve had nameless intercourse or intercourse with a number of folks throughout the final 21 days at a business intercourse venue or related location. (Ward Carpenter, director of well being companies for the Los Angeles LGBT Middle, stated that would come with such locations as a intercourse celebration; a membership, sauna or spa the place folks have a tendency to have interaction in sexual actions; or an institution the place folks pay cash to achieve entry and have intercourse.)
You’ve had excessive or intermediate publicity to monkeypox (the CDC has an inventory of what qualifies as publicity at these ranges).
You’ve attended an occasion or venue the place there was a excessive threat of publicity through skin-to-skin or sexual contact with individuals who have monkeypox.
You’re experiencing homelessness and interesting in high-risk behaviors.
You’ve had gonorrhea or early-stage syphilis within the final 12 months.
You’re in jail and have been recognized as high-risk by medical employees.
You’re severely immunocompromised — as an example, you’re present process chemotherapy, are on high-dose steroids or different immunosuppressants, or have superior or uncontrolled HIV.
Eligibility standards could change. The general public well being division‘s website maintains a list of the latest eligibility information.
How do I get a monkeypox vaccine if I’m eligible?
To get the monkeypox vaccination in Los Angeles County, you need to sign up through the public health department. When vaccine appointments are available, the department lets you pre-register for an appointment at a clinic. When you pre-register, you’ll have to enter your identify, telephone quantity and e mail tackle and reply some questions. The affirmation discover says it’ll place you on an inventory, and also you’ll be notified when it’s your flip to get vaccinated.
If there are not any spots out there, that pre-registration hyperlink shall be closed. The division has an e mail publication that may provide you with a warning as soon as extra appointments open up. The place to join the publication is on the yellow banner on the prime of this web page on the division’s web site. Enter your e mail tackle within the field and click on “submit.”
What do I do if I believe I’ve monkeypox or have been uncovered to it?
What are the early signs of monkeypox?
Signs of monkeypox usually start inside 5 to 21 days of publicity. Early indicators embody flu-like signs corresponding to fever, malaise, chills, muscle aches and swollen lymph nodes, adopted by a rash and the telltale monkeypox lesions. The division of public well being has photographs of what the blisters seem like and extra data on monkeypox signs.
“In many instances with the current outbreak, people are developing a rash with or without swollen lymph nodes that can occur in the genital region or anally as well,” stated Dr. Leo Moore, the director of medical companies for the Los Angeles County Division of Public Well being. “We’re also seeing the rash occur all over the body, including in the face.”
Signs are often gentle, though lesions can turn into fairly painful for some sufferers, he stated.
How harmful is monkeypox?
Monkeypox isn’t deadly, and there have been no deaths in the USA from monkeypox throughout this outbreak. Globally, as of Aug. 11, there have been 31,665 instances of monkeypox and 12 deaths from it since Could 2022, based on knowledge from the World Well being Group. Although signs are often gentle, 36 folks have been hospitalized for monkeypox as of Aug. 11 in California.
“Although we’re not seeing many deaths,” stated UC San Francisco infectious illnesses professional Dr. Peter Chin-Hong, monkeypox infections are “really causing a lot of suffering.” The ache might be excruciating and trigger sufferers to have bother sleeping, strolling, consuming, ingesting or going to the toilet. He stated about 10% of monkeypox instances lead to hospitalization, often for extreme ache or a super-infection (a second an infection on prime of an current one).
Can solely homosexual or bisexual males get monkeypox?
No. Whereas the outbreak is spreading primarily amongst homosexual and bisexual males, in addition to some transgender and nonbinary folks, anybody — no matter gender or sexual orientation — can turn into contaminated.
Dr. Stuart Burstin, the interim nationwide director of infectious illnesses for the AIDS Healthcare Basis, stated it was “by chance” that monkeypox first contaminated males who’ve intercourse with males. The virus has continued to unfold in that group, as transmission can simply happen throughout sexual encounters.
Of the simply over 700 confirmed and suspected monkeypox instances in Los Angeles County, 99% have been in males. 85% of individuals with a confirmed case of monkeypox recognized as homosexual, bisexual, lesbian or a unique time period, based on knowledge from the Division of Public Well being. (2% of respondents in that group recognized as straight or heterosexual, and for 14%, their sexual orientation was unknown.) State and nationwide well being officers have reported the identical demographic traits, and for that purpose, homosexual and bisexual males, in addition to another queer folks, stay most in danger.
How does monkeypox unfold?
“Its most efficient route of transmission is close, prolonged, skin-to-skin contact,” stated Anne Rimoin, a professor of epidemiology on the UCLA Fielding Faculty of Public Well being and a member of the World Well being Group’s emergency committee on monkeypox. Whereas the virus is able to spreading through respiratory secretions and floor transmission on contaminated objects,
“that’s not what we are seeing as the primary mode of transmission in this outbreak. What we’re seeing is the vast majority of cases are from prolonged skin-to-skin contact, generally in the context of sex,” she stated.
In contrast to the coronavirus that causes COVID-19, specialists say, there’s no proof that monkeypox can unfold by shared airspace.
“I think it’s really important for people to recognize monkeypox is not like COVID,” stated Dr. Tomás Aragón, California’s public well being director. “(Monkeypox) is very different in terms of transmission; you really have to have a close, physical contact.”
When will you know if you have monkeypox if you’ve been exposed, and how long does the infection last?
Symptoms can appear as early as five days after exposure. Dr. Leo Moore, director of clinical services for the Los Angeles County Department of Public Health, said people typically develop symptoms a week or two after being exposed, though it can take as long as three weeks for symptoms to appear.
Symptoms of monkeypox can last up to four weeks. The virus can be spread until lesions have healed completely and are covered by a new layer of skin, which can take weeks.
Can monkeypox spread asymptomatically?
“It does not, at this point, look like there’s risk from asymptomatic spread,” said Dr. Jay Gladstein, chief medical officer for APLA Health, an L.A. group focused on providing healthcare to the LGBTQ community.
But it’s possible that patients and clinicians may mistake early signs of a monkeypox rash for something like a pimple or an ingrown hair.
UC San Francisco infectious diseases expert Dr. Peter Chin-Hong said that even when there’s not a lot of skin disease, a person might have contagious legions in their rectum, urethra or mouth.
Is monkeypox considered an STD?
Not exactly. In this outbreak, monkeypox is spreading through prolonged skin-to-skin contact and shared clothing and bedding. Experts believe the current outbreak in North America and Europe likely started with people having sex at raves in Spain and Belgium. But it’s not a disease that specifically spreads through bodily fluids, like chlamydia or gonorrhea, and using a condom won’t prevent it from spreading.
So having sex is a very efficient avenue for the virus to spread, but not the only way. The San Francisco AIDS Foundation issued a safety warning about monkeypox noting that dancing and sex-adjacent activities including kissing could also be vectors for infection.
“There’s never been a better time to dress from top to bottom in latex or leather,” it reads.
What can I do after I get my monkeypox vaccine?
That’s unclear. You are not fully vaccinated until two weeks after your second dose. And right now, L.A. County is prioritizing getting first doses into arms over scheduling second shots.
The two-dose Jynneos vaccine has been tested for safety in humans, and it has proven effective in Petri dishes and in tests on animals. But we don’t have enough evidence yet to tell how effective it is at preventing monkeypox in humans.
“We just don’t have good data on vaccine effectiveness, especially as it relates to sexual transmission,” said Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health and a member of the World Health Organization’s emergency committee on monkeypox. “That’s not to say it won’t work, we just don’t have enough data to make definitive statements.”
So it’s hard to say if and how your behavior should change two weeks after getting your second dose of the vaccine. We should know more soon.
“Even with the vaccine, as a physician, I am absolutely going to continue to encourage people to take precautions around skin-to-skin contact” for now, said Ward Carpenter, director of health services for the Los Angeles LGBT Center. “In a month or two, we’ll have a lot better idea on how well this is working to keep people safe.”
How does the state of emergency change things?
The state of emergency proclamation issued Aug. 1 makes it easier for the state to coordinate its monkeypox outbreak response by ordering all state agencies to follow directions from the Office of Emergency Services and the California Department of Public Health. The order also allows EMS workers to administer vaccines.
“That is helpful in that it adds bodies to this effort, it adds hands that can give vaccines,” said Ward Carpenter, director of health services for the Los Angeles LGBT Center. “We’re limited by the (vaccine) supply and also the sheer human capacity to handle this.”
What if I already got the smallpox vaccine?
The last routine shots for smallpox were given in the 1970s in the U.S. Georges Benjamin, executive director of the American Public Health Assn., said you would probably have some degree of protection from monkeypox if you got the smallpox shot pre-1980, but you should still get the Jynneos vaccine if you’re exposed or are otherwise eligible.
“Unless you were recently vaccinated for smallpox, like the last two to three years, most likely you probably want to go ahead and get vaccinated if you’re exposed,” he said.
Both smallpox and monkeypox are caused by orthopoxviruses. The symptoms are similar, though monkeypox is rarely fatal. The diseases are so similar, in fact, that the same vaccine is used for both: Jynneos. So the monkeypox vaccine is the smallpox vaccine; they are not different shots, although the dosages may differ — the U.S. Food and Drug Administration just authorized giving much smaller doses of the vaccine to stretch the supply.
What do I need to do to avoid monkeypox?
If you are not a member of the currently affected community — gay and bisexual men and transgender people — experts say you don’t need to change anything about your behavior right now.
If you are a member of the community that’s currently experiencing a rise in cases, any time you are in prolonged skin-to-skin contact — in bed, at a sauna, on the dancefloor, or anywhere else — with an infected person, you are at risk of catching the virus. But a blanket call for abstinence is justifiably controversial. Ward Carpenter, director of health services for the Los Angeles LGBT Center, said he recommends people consider moderating their own behavior in a way that’s workable for their lifestyle.
“We always take this from a harm reduction lens. I’m not going to tell someone that they can or can’t have sex, or should or shouldn’t,” Carpenter said. “The fact is with monkeypox, if you’re unvaccinated and lying next to someone, hugging someone, and neither of you is wearing clothing, there’s risk there and that’s unavoidable. The more we can do to reduce that risk, the healthier we all become. For some people, that may mean swearing off sex, for others that may mean shrinking their sexual network so they’re only having sex with one or a couple of people. For others that may mean changing to on-camera sex. Things where we can still have human interaction, but in a safer way.”
Will everyone have to get vaccinated for monkeypox eventually?
Right now, it doesn’t seem like that will be necessary, said Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health and a member of the World Health Organization’s emergency committee on monkeypox.
“This is really spreading through specific sexual and social networks,” she said. “I would say that the risk to the general public right now is fairly low.”
With additional reporting by Rong-Gong Lin II, Luke Money, Taryn Luna and Melody Gutierrez.
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