Monkeypox: What is it and what are the University’s plans?

As monkeypox outbreaks continue to spread across the country, University of Washington medical professionals and administrators are preparing for a potential infection on campus.

On July 23, the World Health Organization declared monkeypox a public health emergency in the United States, about two months after the first confirmed case on May 18. Since then, more than 21,000 cases of the disease have been confirmed nationwide, the most of any country in the world, and two people have died from contracting it. Locally, there have been 14 confirmed cases in St. Louis County and 17 in the city of St. Louis. There have been no directly confirmed cases among faculty, staff and students in the university community.

CONTEXT

Monkeypox is a viral disease that was first discovered in 1958 and falls into the same category as smallpox. If rarely fatal, with the CDC reports that 99% of infected people survived, people with weakened immune systems and other risk groups are more likely to become seriously ill.

Dr. Rachel Presti, who is medical director of the University’s Infectious Diseases Clinical Research Unit, pointed out that monkeypox is not as infectious as COVID-19. Ten of the confirmed cases in St. Louis County were treated at the Infectious Diseases (ID) clinic, with a couple resulting in hospitalization and none resulting in death.

SPREAD

The disease is spread through respiratory transmission, such as sharing saliva or direct physical contact with physical symptoms such as rashes, lesions, sores, and scabs. As such, those who have been infected with monkeypox have primarily contracted it through intimate contact, such as kissing, cuddling, or sexual activity.

Dr Presti said social scenarios like parties are less likely to spread the disease due to a lower degree of exposure, however, direct contact with monkeypox lesions can lead to infection.

EMERGENCY PLANS

Although there were no positive cases on campus, the Habif Center for Health and Wellness worked with local public health entities to create contingency plans in the event of an infection.

If a student tests positive, the University will notify the St. Louis Public Health Department to perform contact tracing and treat the patient in conjunction with infectious disease experts from the medical department. People who contracted monkeypox would be quarantined in isolation accommodation, separate from the COVID-19 emergency accommodation, until they were no longer contagious.

According to the CDC, individuals can still be contagious as long as they have lesions or scabs, which can last two to four weeks.

“Usually it’s at least fourteen days before all the lesions crust and scab over,” Dr. Presti said. “Then the scabs fall off and they heal, when that’s all resolved, that’s when you won’t be considered contagious anymore.”

The isolation period can stretch over a month, requiring significantly longer time in isolation accommodation compared to COVID-19, which could pose a problem for students attending classes and keeping up to date with their work.

Cheri LeBlanc, director of student health and welfare, emphasized that the University understands the resources needed for longer-term quarantine accommodation.

“We have discussed the potential need for extended isolation with our colleagues at Dining and ResLife,” LeBlanc wrote. “They are ready to support isolated students if needed.”

TEST

Monkeypox testing is available through Habif for community members who have been exposed or are showing symptoms. However, unlike a COVID-19 test, samples must be sent off campus for testing, so the process for receiving results is longer, around a week.

“The biggest concern would be making sure people had information on what to look for,” Dr Presti said. “If they had consistent symptoms, they would receive medical evaluation and rapid testing so we could quarantine people quickly.”

Artwork by Adel Cynolter

VACCINE

The federal government began distributing monkeypox vaccines through local public health departments, which enabled the ID clinic to vaccinate members of the community who were exposed to the disease or who are considered “at risk”.

Dr Presti said that in this specific outbreak, populations at risk were typically men who have sex with men, as 99% of current cases have been found in men, 94% of whom said they had recently had sex with men. sex or sex between men. close intimate contact.

As part of a statement on the stigma surrounding monkeypox and sexual orientation, the University of Washington’s Pride Alliance stressed the importance of getting vaccinated if eligible.

“The University of Washington and the U.S. government must do more to expand access to vaccines for students,” the statement said. “Our community needs to remember that anyone can get monkeypox, not just LGBTQ+ people. To fight the spread, we need to encourage vaccinations, expand resources to access vaccination sites, and push the government to increase investment for additional vaccine doses.

LeBlanc said health information is kept in extremely strict confidentiality by Habif.

“Only those who need to know someone’s identity in order to support them during isolation would be notified,” LeBlanc wrote. “And they would also be reminded of the importance of confidentiality.”

STIGMA

Although the main demographic group currently contracting monkeypox is men who have sex with men, people of other genders and sexual identities have been infected and anyone could potentially contract it.

The Habif page for information on monkeypox states that “transmission is a function of behavior, not identities”.

Pride Alliance echoed this point in its statement.

“The rapid spread of monkeypox among men who have sex with men is similar to the start of the AIDS epidemic,” the statement said, “when our community was disproportionately vulnerable to contracting the disease. AIDS, a large base of LGBTQ+ patients does not make monkeypox a “gay disease” and we want to avoid generating stigma. Labeling a disease as “gay” can lead to feelings of shame or disgust at the idea of ​​accepting care as well as an increase in harmful language and actions towards those who contract the disease.

LeBlanc stressed that anyone who has been in close contact with an infected person may be at risk.

“The key here is to ensure that those most affected by this outbreak have better access to information, vaccines, testing and treatment,” LeBlanc wrote, “while taking care not to use language that could perpetuate stigma.”


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