Connecticut announces first case of monkeypox in state

The state Department of Public Health Tuesday announced the first case of monkeypox in a Connecticut resident.

The patient is a male between the ages of 40 and 49 and is a resident of New Haven County, according to the agency. The patient is isolating and has not been hospitalized. No other patient information will be released, the agency said.

“DPH believes that the risk to Connecticut residents from this case is low,” said Connecticut Department of Public Health commissioner Manisha Juthani.

“The clear message right now is that the risk to the general public is pretty low,’’ Juthani told reporters in Waterbury following an unrelated event. “I know a lot of people are tired of hearing about viruses. They’re tired of hearing about a new virus.’’

Noting cases in Massachusetts, Rhode Island and New York, she said that a case in Connecticut was inevitable.

“What the general population should know is that the main way that people are getting monkeypox is through close contact with skin — with direct lesions,’’ Juthani said.

“In terms of the general population, I don’t think you need to be overly concerned,’’ Juthani said with Gov. Ned Lamont standing next to her.

Dr. Ulysses Wu, chief epidemiologist at Hartford HealthCare, said Tuesday it’s important to be educated on monkeypox, but people should not have it at the top of their minds.

“They should know about it from a public health perspective, because the only way to stop this is being educated from the public health side,” Wu said. “So we don’t want to ostrich this, and by that I mean we don’t we shouldn’t put our heads in the sand, because this is certainly a disease that is affecting thousands of people around the world at this point.”

Juthani said the United States is experiencing a monkeypox outbreak, and “there will likely be additional cases in Connecticut in the weeks ahead.

“Monkeypox can spread through close prolonged contact with an infected person,” she said. “This might include coming into contact with skin lesions, or body fluids, sharing clothes or other materials that have been used by an infected person, or inhaling respiratory droplets during prolonged face-to-face contact.”

Dr. Scott Roberts, associate medical director for infection prevention at Yale New Haven Hospital, said he thinks the risk for the general public “remains quite low” at this time, but he does expect numbers to rise since there have been more cases detected in New York City.

“A lot of our efforts, at least at the hospital, and what we’re educating people who may be at risk for monkeypox is really to focus on good core practices at preventing the spread of infection through touch,” Roberts said. “So hand hygiene, washing your hands.”

Roberts advised that people avoid touching any open lesions or exposed rashes. If someone is around a person with monkeypox, it is best to wear a mask, he said. Anyone who is exposed should isolate and monitor symptoms and if they develop then seek medical attention.

DPH said that the agency has in the last month “raised awareness of monkeypox among higher risk populations, alerted and educated local medical professionals, and informed local health departments throughout the state to monitor for cases.”

“For Connecticut residents that are concerned about fever, swollen glands, and a new rash, please contact your health care provider for evaluation,” the agency said.

The agency said that health care providers should request orthopoxvirus testing for patients at the state public health laboratory by calling the DPH Epidemiology Program at (860) 509-7994.

Monkeypox is a viral disease that occurs mostly in central and western Africa. It got its name because it was first identified in laboratory monkeys in the early 1950s. The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox.

The virus is closely related to the smallpox virus which was eradicated from the United States in the 1970s and officially declared eradicated by the World Health Assembly in 1980.

“This is not an unknown virus. This is a well understood pathogen and it’s doing exactly what we expected it would do,” said Dr. Anne Rimoin, UCLA Fielding School of Public Health, speaking during a panel discussion hosted by the Yale Institute for Global Health last month. “Our African colleagues have been seeing monkeypox for a while in places that it is endemic. Now we’re just seeing it on a larger scale. We know where it comes from but it’s just always been low on the list of priorities. The squeaky wheel gets the grease but monkeypox was never high enough on the list.”

People become infected with the monkeypox virus through contact with the bodily fluids of infected animals or humans, including respiratory droplets, or through contact with materials contaminated with the virus.

Monkeypox spreads most easily through direct contact with infectious sores, scabs, or body fluids but it also can be spread by respiratory secretions during prolonged, face-to-face contact.

“While touch is the primary way it spreads, it can spread through droplet transmission as well,” Roberts said. “The good news is that it does not transmit as well as COVID. We have all heard of the 6-foot, 15-minute rule of transmissibility for COVID-19 but for monkeypox it is more like 6-foot, three hours. So it really requires prolonged contact.”

The CDC has also warned that it can be transmissible during intimate contact between people, including during sex, as well as activities like kissing, cuddling, or touching.

The CDC estimated the incubation period (time from infection to symptoms) for monkeypox is usually four to seven days but can range from five to 21 days.

“This can make it difficult for someone to know if they have the virus,” Roberts said last month. “But usually symptoms begin as a fever and turn into a rash within a few days. Once you start experiencing symptoms it is important to see your medical provider right away.”

Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell while smallpox does not. Within 1 to 3 days after the appearance of fever, the patient develops a rash, often beginning on the face then spreading to other parts of the body.

Roberts said he’s already seen this disease begin to get stigmatized in a similar way to how HIV/AIDS was. He emphasized that there is not only one population that is at risk and there are questions about whether it is sexually transmitted.

“It’s really critical if you do think you have monkeypox, seek evaluation with your health care provider because we do have testing available,” Roberts said to those who may not seek medical attention due to possible stigmatization of monkeypox. “Importantly, we want to know if you’re positive because if you’ve had other close contacts that can be vaccinated and really prevent disease entirely if you’re vaccinated soon enough.”

Wu also highlighted that this disease is not only transmitted through sexual contact and there are other ways to get it. Even with this, though, people should take the similar public health measures that they would to avoid sexually transmitted diseases such as gonorrhea, chlamydia, HIV and others, he said.

For more information about monkeypox, visit Monkeypox | Poxvirus | CDC at https://www.cdc.gov/poxvirus/monkeypox/index.html.

Christopher Keating contributed to this story.