Since the beginning of May, 45 cases of smallpox have been reported in the United States, according to the Centers for Disease Control and Prevention.
The agency is asking health officials to look for rashes among patients, but more recently doctors have identified the nature of monkey smallpox in Africa – unlike where the virus is endemic in 11 countries, the CDC said.
In some new cases, smallpox has caused symptoms such as acne or blisters, not common rashes in humans, CDC Director Rochelle Valensky said at a briefing. In other cases, small bumps on the skin are the first or only sign of an infection, he said.
“We have seen a mild and rare form of monkey smallpox [in] “Limited areas of the body that are different from the classic presentations seen in endemic countries in West and Central Africa,” Valensky said. “This has raised concerns that some cases may go unrecognized or undetected.”
According to Valensky, patients have historically reported flu-like symptoms such as fever, body aches and swollen glands. Then, “typical, common rashes appear on several sides of the body, most often on the face, hands and arms.”
However, in recent times, Valensky continued, “before some patients experienced flu-like symptoms, they often developed rashes localized around the genitals or anus, and some did not develop flu-like symptoms.”
CDC officials reported that some patients in the U.S. reported proctitis or mucosal inflammation of the rectum, a symptom often unrelated to monkeys.
“If you notice any new rashes or skin diseases anywhere on your body, including your mouth, that you don’t know for sure, check them out,” said Demetre Daskalakis, director of the CDC’s HIV / AIDS unit. during a media call on Thursday. “It’s not the time to hold on, even if you think it’s not serious.”
Why the symptoms of smallpox in monkeys may be different from previous epidemics
The most common form of smallpox in the United States and other countries outside Africa is the West African herd. According to the World Health Organization, about 1 percent of people with this strain have died before, and up to 10 percent of people with the strain of the Congo Basin.
Monkey smallpox may be similar to smallpox, herpes or syphilis. In some cases, sores can be very painful and leave scars. Some patients in the current epidemic needed medication or even hospitalization to manage the disease.
In other cases, however, the rash did not cause much discomfort. Dr. Stuart Isaacs, an associate professor of medical sciences at the University of Pennsylvania, said the West African strain could have caused something more mild than its counterpart.
“You have very few of these local sores and the common rashes you see historically in the pictures,” Isaacs said.
He argued that exposure to monkey disease could also affect the way a person develops his symptoms.
Smallpox is spread through close physical contact through body fluids, respiratory droplets, rashes or sores caused by infection, or contaminated items such as clothing or bedding. The majority of patients in the U.S. are men who have had sex with men, and experts believe the effects may be during sexual activity.
“It is almost impossible to separate skin-to-skin contact from sexual intercourse as a cause of infection,” Valensky said.
However, he said that to date, there is no evidence that the virus is spread through the air or through interactions such as casual conversation in a grocery store or touching the same door handle.
Vaccines can protect against monkeys Smallpox vaccines work best against monkeys, Isaac said. Vaccines can even prevent the spread of the disease or cause symptoms if they are used shortly after infection.
There are enough doses in the United States to vaccinate millions of Americans against monkey disease, said Down O’Connell, assistant secretary of health and education at the Department of Health and Human Services. This includes more than 100 million doses of ACAM2000, an older generation vaccine against smallpox, and 72,000 doses of gin, which the U.S. government has approved for use against monkeys.
O’Connell said the CDC and HHS have delivered more than 1,400 vaccine courses to 16 states since the outbreak began.
The U.S. plans to receive an additional 300,000 Jynneos doses over the next few weeks, and vaccine maker Bavarian Nordic has kept the dose ready to ship another million to the U.S., O’Connell said. On Friday, U.S. officials also announced that the country had ordered an additional 500,000 doses of frozen Jynneos to be delivered by the end of this year.