Monkeypox cases rise in Austin area; health officials call on community to help fight spread

The number of monkeypox cases continues to grow in Central Texas.

Austin Public Health is now reporting nine confirmed cases of the virus and eight presumptive cases in Travis County. Williamson County and Cities Health District is investigating one presumptive case.

A presumptive case is one that has a positive test that is awaiting confirmation from the U.S. Centers for Disease Control and Prevention.

In the U.S., there are now 1,470 confirmed cases of monkeypox, which is a rare viral infection in humans that has a notable rash as its main symptom and a mild to severe flu-like illness.

Austin Public Health said on Wednesday that monkeypox has reached community spread stage. That means it is no longer confined to people who have traveled outside of the country or have been exposed to someone who has traveled.

"Monkeypox is a virus that is causing illness in our community and is a growing concern," said Dr. Desmar Walkes, the Austin-Travis County health authority.

The first presumptive case in Travis County was announced on June 24. Since then, each week more monkeypox cases have been identified. No one as of yet has needed to be hospitalized with monkeypox, she said.

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Who has been getting monkeypox?

In Travis County, the cases have been identified predominately in men ages 20 to 45. The cases have not been in clusters confined to any area of the county, Walkes said.

"It is disproportionately impacting gay and bisexual men," said Dr. Mike Stefanowicz, associate director of sexual health programs at CommUnityCare and who works at the David Powell Health Center, which specializes in HIV care. He said his clinic has diagnosed about half of the cases in Travis County.

"It's time to be both vocal and vigilant," Stefanowicz said. That means knowing it is in the community and taking precautions, he said. Monkeypox is primarily spread through skin-to-skin contact and fluids, including through sexual activities.

This is the time to ask questions of potential sexual partners, said Adrienne Sturrup, Austin Public Health director: "Know the facts before deciding to be intimate."

The numbers in Travis County are reflective of what has been seen nationally and what the CDC has been investigating.

"It's important to clarify it is not a disease of the gay community," Stefanowicz said. Anyone could get it if they were in contact with the virus, he said.

"There is spread in our community between people regardless of what group they come from," Walkes said. "We should take precautions at all demographic levels in our community."

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Who is most at risk?

Like COVID-19, people at higher risk for severe disease are those who are already immune-compromised. This includes people who have HIV.

Unlike with COVID-19, children younger than 8 also have a higher risk for severe disease.

Pregnant women are at risk for passing the disease to their fetuses and could be at risk miscarriage.

Health officials say that if you have monkeypox and touch your rash and then touch other areas of your skin, you could create multiple rash sites. If you touch your eyes, nose or mouth, the disease could create an eye infection or impact respiratory passages and lead to pneumonia. That level of disease could lead to hospitalization.

How dangerous is monkeypox?

There are two kinds of monkeypox. In the U.S., we have the West African version, which is less severe than the Central African version.

The West African version "is a really mild, self-limiting disease," said Dr. Kristin Mondy, chief of the division of infectious diseases at the University of Texas Dell Medical School.

With the West African version, there is less than 1% mortality, she said.

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How is monkeypox spread?

The disease spreads from person to person in these ways:

• Direct contact with the infectious rash, scabs or bodily fluids.

• Respiratory secretions with face-to-face contact during activities such as kissing, cuddling or having sex.

• Touching items such as clothing or linens that previously touched the infectious rash or body fluids.

• Pregnant people can spread the virus to their fetus through the placenta.

To prevent the spread, isolating a person with monkeypox is key as well as notifying anyone they have come in contact with of their exposure.

What are monkeypox's symptoms?

Symptoms of monkeypox can include:

• Fever.

• Headache.

• Muscle aches and backache.

• Swollen lymph nodes.

• Chills.

• Exhaustion.

• A rash that can look like pimples or blisters. It can be on the face, inside the mouth and on other parts of the body, like the hands/palms, feet, chest, genitals or anus.

The rash is key. Austin Public Health is not advising physicians to request monkeypox tests unless a patient has a rash.

Once a test is positive, there are antivirals to treat the virus and reduce the possibility of it becoming severe.

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How contagious is monkeypox?

It is thought that one person with monkeypox could infect two people, Mondy said. To put this in perspective, one person with the omicron variant of COVID-19 is thought to infect between five and 24 people.

Monkeypox, though, can take up to 21 days from being exposed to it to the rash developing, according to the CDC. Usually, the other symptoms will come first and the rash comes about one to two days later.

Once the rash develops, a person is usually infectious between two and four weeks, the CDC said. While you have the rash, you are contagious until the entire rash has gone away and new skin has formed. People should use condoms for 12 weeks after that, Mondy said.

"This requires personal responsibility," she said.

Monkeypox lives on surfaces

Monkeypox also lasts on surfaces for up to about 15 days, the CDC said. That's why it's important for an infected person to be isolated from other people and not share spaces.

A person with monkeypox should cover their rashes with bandages or clothing if they can and change their own bandages and clothing. They and everyone who has to be in contact with them should wear a mask.

If you or someone at home has monkeypox, you should wear gloves, protective eyewear and a mask when handling clothing, linens or towels of the infected person. You should wash all of that in a washing machine.

You should steam clean upholstery they have used.

Surfaces should be wiped with disinfectants. The CDC has a list of products that work. Some of the components include ethanol, citric acid and hydrogen peroxide.

Hand-washing is also key to avoiding the spread of the virus.

What is Austin Public Health doing to control the spread?

Currently, Austin Public Health is giving the vaccine to people who have been identified as having been exposed to the virus. It is following CDC and state recommendations about whom to prioritize for the vaccine. As it gets more vaccine doses, those restrictions will lessen.

It also is expanding monkeypox testing capacity. At first, all the tests were going through the state lab. It has now brought on one commercial lab and has others it is getting online.

Austin Public Health is beginning to talk to school districts about precautions for the school year, Walkes said.

It is also relying on the community.

"This is a call to action," Sturrup said. "Education is key to making informed decisions to keep your family safe."

Walkes said: "It can be controlled. We can effectively bring a stop to it."

This article originally appeared on Austin American-Statesman: Monkeypox in Austin: Who is getting it and how to avoid it