The Benton Franklin Health District is investigating in the Tri-Cities area what likely is the first probable case of monkeypox in Eastern Washington.
The first case in the state was announced in King County, home to Seattle, May 27, and as of Thursday 53 cases had been confirmed in Washington state.
Cases in Washington state were initially in people who had traveled outside of Washington state, but in recent weeks cases in the state have been diagnosed in people who have not traveled recently, meaning they were likely exposed to monkeypox locally, according to the Washington state Department of Health.
Washington is one of only nine states in the nation to have more than 50 monkeypox cases, but some states have far more, including New York with 830, Illinois with 230 and Florida with 226.
Nationally, most cases are in men who have sex with men, but anyone who is sexually active with multiple partners or who has sex with someone with multiple partners is at increased risk, says the Department of Health.
However, not all cases are spread through sexual contact.
“Transmission generally requires close, skin-to-skin contact with someone who has symptoms of the disease,” said Dr. Scott Lindquist, Washington state epidemiologist for communicable diseases.
It can also spread through contact with fabric, such as shared towels or bedding contaminated with fluid or scabs from rash blisters, said Heather Hill, infectious disease supervisor for the Benton Franklin Health District, speaking Wednesday on the Kadlec on Call podcast.
“You don’t just get it casually passing someone in the supermarket or at the mall,” she said.
Painful rash among symptoms
Monkeypox is still considered a rare disease, according to the Centers for Disease Control and Prevention.
The monkeypox virus, discovered in 1958, is caused by the same family of viruses that causes smallpox and symptoms are similar, but milder. It is not related to chickenpox.
Monkeypox is rarely fatal, according to the CDC.
Rapid identification of monkeypox cases is key to bringing the 2022 outbreak in the United States under control, say public health officials. Vaccination is most effective in preventing the diseases when given within four days of exposure.
The Benton Franklin Health District is coordinating with the Washington state Department of Health and the CDC to provide vaccine to Tri-Cities area residents if they are identified as a close contact to someone who has been diagnosed with monkeypox.
Symptoms include a sometimes painful rash that can look like pimples or blisters that eventually scab over.
Before the rash is visible, people may have flu-like symptoms such as fever, headache, muscle aches and backaches, swollen lymph nodes, chills and exhaustion.
People with a new rash, sores or other symptoms should contact their doctor and avoid sex or intimate contact, says the Benton Franklin Health District.
The health district has gotten calls recently from parents concerned about a rash on their child. But they have not been the blistered rashes characteristic of monkeypox, and public health officials have been able to reassure them that their child is not infected, Hill said.
The time between infection with the virus and symptoms is usually seven to 14 days but can range from five to 21 days.
The CDC says that “monkeypox can spread at any time the symptoms start until sores have healed and a fresh layer of skin has formed after several weeks.”
Monkeypox vaccine
While the vaccine is most effective in preventing monkeypox when given within four days after exposure, it can be given within four to 14 days to reduce the symptoms of the disease, if not prevent it.
Washington state has initially been allocated enough vaccine doses for 398 people from the nation’s limited strategic stockpile. More doses are expected to be distributed to states late this month or in early August.
With the vaccine in extremely limited supply in the nation now, it is only being given to people after they are exposed, Hill said.
Since the monkeypox virus is closely related to the virus that causes smallpox, the smallpox vaccine also can provide some protection against monkeypox, according to the CDC.
Drugs may also be available again soon that once were used to treat smallpox, Hill said.
Anyone who suspects they have been exposed to monkeypox should isolate themselves at home while awaiting test results, says the CDC.
If they have a rash or other symptoms they should stay in a separate room from other family members and pets, if possible.
The infection can spread from both animals and humans. It was first identified in 1958 in monkeys.
The first known cases in the United States were in the 1970s when rodents imported from Africa for pets were discovered to be infected with the virus.
The local health district announced it was investigating a probable monkeypox case just before the close of business Thursday and may have more information to release on Friday.
