As monkeypox cases rise across the country and with 122 reported among six counties in the Bay Area as of Monday, the new virus is raising questions from a public weary of outbreaks.
And while experts try to figure out exactly how the virus spreads, the Bay Area is experiencing a severe lack of vaccine supply. San Francisco announced Friday that it would be receiving around 4,000 doses of the shot, far fewer than the 35,000 it had requested earlier in the week from the federal government. Other local Bay Area counties also are reporting shortages. The federal government plans to release around 1.6 million doses in the coming months.
So how worried should you be? We talked to Arthur Reingold, chair of UC Berkeley’s Epidemiology Division at the School of Public Health, about what risk monkeypox poses to the general public, what symptoms to watch out for and what to consider when it comes to a vaccine.
Q: Am I at risk for catching monkeypox?
A: Your risk depends to a certain extent on your behaviors and whom you spend time with. At the moment, the virus seems to be spreading largely among men who have sex with men.
Q: How does the virus spread?
A: Through physical contact, which might include sexual contact. It might also include non-sexual contact. Researchers don’t believe the virus is spread to any great extent through the air.
Q: Is it dangerous to get the virus?
A: By all reports, no one in the United States has died. I hope that the answer continues to be no. But people who have had it have been quite debilitated, often with very painful sores, and have had trouble getting any kind of antiviral treatment. But in Africa, people do die of monkeypox. We should not rule out the possibility that someone could die or be made quite ill.
Q: What are the symptoms I should be watching out for?
A: They’re pretty nonspecific and include fever, loss of appetite, fatigue, things like that. So they’re easily confused with many other diseases. The lesions on the skin, whether in the genital area or elsewhere, are the most important indication. On the other hand, there are other diseases that can produce skin rashes and lesions. So you need to be seen by a competent clinician who can consider other diagnoses and who can get a specimen to the right kind of laboratory for testing.
Q: Those lesions you’re referring to, can they permanently scar my body?
A: There can be residual scarring in the affected areas. Exactly what the long term significance of that scarring is, I don’t think we really know. But scarring certainly is a concern, yes.
Q: I’ve heard that the monkeypox is a cousin of smallpox. What does that mean?
A: Many different animals have their own pox viruses. There’s cowpox. There’s chickenpox. I think many people would say that monkeypox is misnamed, that it probably is more commonly found in various types of rodents in Africa. Monkeypox is not an intrinsically human virus. On the other hand, if you look at history, smallpox has been in human populations for thousands of years. There’s evidence of it in Egyptian mummies. At the moment, we don’t think monkeypox is going to produce the same kind of mortality. That could change, of course, but basically it’s a virus that hasn’t been present in human populations, and so we still have a lot to learn about it.
Q: Should I be worried about this virus?
A: I’m cautiously optimistic that we can put this back in the bottle through people getting appropriate care and through the use of the vaccines that we have available. So I’m hoping it doesn’t become a generalized, ongoing endemic problem in the United States, but we have a lot of work to do to make sure that doesn’t happen.
Q: What’s the deal with the vaccines right now?
A: There are actually a couple of vaccines that potentially can be helpful against monkeypox. We have a fairly large supply of one of them, which is basically smallpox vaccine (ACAM2000). But there are problems with that vaccine in terms of potentially causing inflammation of the heart. The newer vaccine (JYNNEOS), which we think doesn’t pose those risks, is in short supply. The demand is exceeding the supply at the moment, and health departments are having to be judicious in giving priority to people who would like to be vaccinated.
Q: How do I know if I should be getting the vaccine or considering it?
A: I think if you are a man who has sex with other men and potentially have physical contact with multiple other men, you may be at risk and you should potentially get vaccinated. I think for other individuals at the moment, their risk is really very low. I suppose there might be some health care providers or other groups we might consider vaccinating because of an occupational risk. But I don’t think the rest of the general population really should be seeking out monkeypox vaccine at the moment.
Q: I’m on the older side and got the smallpox vaccine. Do I still need the monkeypox vaccine?
A: It depends on how long ago you got it. Most likely you got it decades ago, and if that is the case, the answer is we just don’t know if you also need the monkeypox vaccine. I had a smallpox vaccine as an infant and again at age 15. At age 73, I don’t know whether I am still protected or not. No one should have had smallpox vaccine in the last few decades, except a handful of healthcare workers back post-9/11.
Q: Is it possible we’ll be seeing any public health restrictions related to this virus?
A: I don’t think so. I do think if there are large social or other types of gatherings for men who have sex with men, one should think carefully about those types of events and participation in those. But I think in terms of where we go on our regular business, I really don’t see that restrictions are likely to happen.
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