Monkeypox Cases Increase In Oregon

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Photo: Getty Images

Photo: Getty Images

Health officials are emphasizing information-sharing, testing, vaccination and treatment as part of Oregon’s response to a national outbreak of hMPXV (human monkeypox virus) that includes at least six cases in the state.

The cases in Oregon are all among men – one in Multnomah County, confirmed June 16; two confirmed July 1 and one confirmed July 6 in Lane County; and two in Washington County, confirmed July 6. There have been no deaths.

Tim Menza, M.D., Ph.D., senior health advisor for OHA’s hMPXV response, said the agency’s focus has been on communicating widely and often to communities at highest risk for hMPXV about preventing its spread, when to get tested and how to access vaccines and treatment. The agency is also sharing information with the medical community, including providing guidance on case definitions, testing procedures and how health care providers can recognize symptoms.

“While anyone can be affected by hMPXV, the current global outbreak of hMPXV has largely affected gay, bisexual and other men who have sex with men,” Menza said. “I point this out not to say that men who have sex with men are the only people at risk for hMPXV, but that right now our priority should be empowering men who have sex with men and the larger LGBTQIA+ and queer community and their health care providers with information, testing, prevention and treatment strategies.”

Communication has included a community letter that OHA, the Multnomah County Public Health infectious disease team and local providers jointly issued in advance of Pride events that began last month in Oregon. An OHA team also has begun working with community-based organizations to develop culturally tailored awareness and prevention messaging. And OHA’s public information team has provided regular updates of facts and data through social media platforms.

Globally, nationally and in Oregon, hMPXV was initially associated with travel to non-endemic countries with reported hMPXV cases. However, more recent cases do not have a history of travel, indicating transmission within the United States and within Oregon.

hMPXV is transmitted during direct, close, personal skin-to-skin contact with a person with symptoms. In addition, contact with towels, clothing, bedding or other objects used by a person with the virus can also transmit the virus. Additionally, hMPXV can be transmitted through large respiratory droplets or oral fluids via prolonged face-to-face contact. These types of contact may occur during activities such as sex, cuddling, massage, kissing, talking closely or caring for someone with hMPXV.

The virus can spread from the time symptoms start to when sores, including scabs, have healed with a fresh layer of skin.

Menza advised people planning to attend a festival, concert, party or other event to consider the amount of close, personal and skin-to-skin contact that may occur.

“We can think about risk on a spectrum,” he said. “For example, events like sporting events or concerts, where people are more likely to be fully clothed and unlikely to have skin-to-skin contact, are safer, compared to clubs and parties where people are wearing minimal clothing and there is often skin-to-skin contact or spaces like saunas, bathhouses or sex clubs, where there is minimal to no clothing and often sexual contact.”

Menza added that those thinking about sex should check in with their partners. “Tell them how you are feeling, whether you’ve had any recent illness or rashes, especially on the genitals or around the anus, and invite them to do the same,” he advised. “If you or your partner have been sick recently, are currently sick, or have any new rashes, avoid close, personal and skin-to-skin contact, and talk to a health care provider.”

OHA is working to make the testing process faster and easier. The turn-around time for health care providers to get test results is one to three days through a private laboratory. Other private labs will begin offering testing in the coming weeks. Providers can also send test samples directly to the Oregon State Public Health Laboratory “based on their clinical suspicion without prior approval from OHA.” That prior approval had been required early in the outbreak.

Vaccination involves two doses given subcutaneously (under the skin) four weeks apart and can be given within 14 days of exposure to prevent hMPXV infection. While Oregon’s supply of vaccines has been limited, federal allocations to OHA from the Strategic National Stockpile have been arriving over recent days and are expected to increase.

Menza said he hopes to expand vaccine availability to beyond just those who have been exposed to the virus. “When more vaccine becomes available, our goal is to offer vaccination to those at increased risk of exposure to hMPXV, including cisgender and transgender men who have sex with men and transgender women who have sex with men with more than one sex partner in the prior two weeks,” he said.

hMPXV disease can be severe, including hemorrhagic disease, severe rash over large areas of skin, infection of the central nervous system, eye infections or sepsis. Antiviral treatment is available for people with, or are at risk for, severe disease, including children younger than 8, pregnant people, people with compromised immune systems, people with atopic dermatitis or a blistering skin disease.

Source: Oregon Health Authority

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