Monkeypox—who is at risk and what to do if you suspect you might have a case

Since early May 2022, when the first monkeypox cases appeared, there have been a total of almost 14,000 cases reported worldwide. Recently, Manhattan Borough President Mark Levine held a livestreamed public event with other elected officials and experts to discuss what New Yorkers can do to safeguard themselves against monkeypox and what resources are available.

Monkeypox (Orthopox Virus) is a viral disease that is infectious and produces symptoms such as a rash, swollen lymph nodes,  fever, tiredness, and headaches. Time from exposure to symptoms is anywhere from 7 days to 21 days. More severe cases can present in those with compromised immune systems, children and other medically vulnerable populations.

Levine started the public event by introducing State Senator Brad Hoylman who addressed basic questions that the public event was going to cover: “What does monkeypox even look like? How is it transmitted? Who is at risk and what do you do if you suspect you might have a case or know someone might have a case? These are basic fundamental questions that we asked around COVID as you recall of course and we need to start asking them now to be prepared and this could not be a more crucial time because of so many visitors to New York City.” 

Dr. Wafaa El-Sadr, university professor and Dr. Mathilde Krim-amfAR, chair of global health epidemiology at Columbia University Mailman School of Public Health added their perspectives as public health experts. Dr. El-Sadr first discussed the fact that monkeypox “has been recognized for several decades already and is…what we call endemic. It has been reported for decades largely from Central African and West African countries.” According to Dr. El-Sadr, one of the interesting aspects of this particular outbreak is that the cases reported are outside the region where monkeypox is usually detected. 

Regarding what individuals can do if they believe they may have been exposed to monkeypox, Dr. El-Sadr stressed, “It’s really important to seek health care if you suspect [you have] been in contact with somebody who has monkeypox or if you have symptoms yourself, to seek medical attention as quickly as possible. There are some [antiviral medications] that are available through consultation with CDC and contacts of the patients should monitor their health for 21 days and if you develop any symptom to immediately isolate.” 

Dr. Jay Varma, professor of population health sciences at Weill Cornell Medical College focussed on the issue of the “balance between making sure that people have the information they need to protect their health but also not generating a level of alarm that is disproportionate to the level of the problem…on the one hand I think the good news that…so far in the United States there have not been any severe complications of this disease.”

“At the same time, what is concerning is that this is an infection that is quite contagious when people have it and more importantly, it can be associated with other complications. Damage to your eyes, damage to your lungs, damage to your brain,” Varma added.

He also addressed concerns around bias and bigotry: “I also want to emphasize that the stigmatization of infectious diseases doesn’t just happen for LGBT people it, happens for people of color, it happens for sexually active people, it happens for women, it happens for Asians, it happens for Africans, happens for Haitians and so…when we talk about infectious diseases I would like to suggest that we move away from the kind of stigmatizing language that we’ve been having for the last more than 100 years.” 

Regarding next steps, Varma stated, “I think that we’re gonna we need to get tests to be closer to where people live, having the CDC have a monopoly on testing and treatment and vaccine supply is not good…one of the most effective ways that smallpox was eradicated was through a strategy called ring vaccination which is where you vaccinated everyone that was close to somebody that had been identified as having smallpox and that’s something that can be done with the existing vaccines.”  

Varma referenced the CDC fact sheet regarding monkeypox that he described as “quite helpful and useful in plain language” and providing “pragmatic practice advice.” The fact sheet has information including symptoms to be on the lookout for, what to do if you or your partner have monkeypox, as well as the CDC monkeypox webpage, for more information. 

The event was then opened to questions from the public. One question was about the available vaccines. Dr. El-Sadr discussed the two vaccines available for monkeypox. One is the smallpox vaccine, with the second approved specifically for monkeypox called the Jynneos vaccine, made by Bavarian Nordic.  

For additional resources around monkeypox, please visit: https://www1.nyc.gov/site/doh/health/health-topics/monkeypox.page or call 311 to learn where you can get tested and receive medication.

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