Tippecanoe County health official: Monkeypox 'no threat at this time'
LAFAYETTE, Ind. — Just as anxiety over one pandemic seems to lessen, monkeypox – an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox – has become the latest health concern.
Globally, the latest virus began to emerge in non-endemic countries in early May 2022 and has since spread to around 42 countries with 3,308 confirmed cases, according to the Centers for Disease Control and Prevention.
As of Thursday afternoon, the United States has 155 confirmed cases, two of which have occurred in Indiana. Health officials in Gary, Ind., reported the state's second case of monkeypox on Tuesday.
“This is not anything to at all be worried about. We have these outbreaks all the time in Africa. They happen every year. We haven’t had one in the United States since I think it was around 2003. It happened here in the Midwest,” said Dr. Gregory Loomis, the Tippecanoe County Health Department health officer.
Prior to the 2022 outbreak, nearly all monkeypox cases in those outside of Africa were linked to international travel where the disease commonly occurs, or through exposure to imported animals, according to the Indiana Department of Health.
This drastic increase in cases called for the World Health Organization to schedule an emergency committee meeting on Thursday to determine if the global outbreak of monkeypox should be considered a pandemic-level emergency.
More: WHO 'not concerned' monkeypox will become global pandemic; few US cases reported
This comes only a day after the World Health Network, a coalition of scientists from around the world initially formed to battle the COVID-19 threat, declared the global spread of monkeypox as a pandemic.
“The essential purpose of declaring a pandemic is to achieve a concerted effort across multiple countries or over the world to prevent widespread harm," the WHN said in a statement. "The definition of a pandemic is an infectious disease growing over a wide area, crossing international boundaries, and usually affecting a large number of people.
"The accelerating growth across multiple continents, and the need for a concerted action to stop it, meets both the criteria, and the essential purpose, for declaration of a pandemic. Concerted global action is needed."
Threat to general public 'is low'
The urgency conveyed by the WHN and WHO comes in sharp contrast compared to how some officials at both the state and the Tippecanoe County Health Department levels describe the threat of monkeypox.
“The risk of monkeypox among the general public continues to be extremely low,” said State Health Commissioner Kris Box in a press release in response to Indiana’s first case of monkeypox.
“Monkeypox is rare and does not easily spread through brief casual contact. Please continue to take the same steps you do to protect against any infection, including washing your hands frequently and thoroughly, and check with a healthcare provider if you have any new signs or symptoms.”
Not a sexually transmitted disease
Although concerned, many health officials in Indiana believe that the risk of monkeypox spreading amongst the general population is low, mainly because the disease requires long exposure of person-to-person contact to transmit.
“It’s transmitted through body contact. In other words, you have to be within about six feet to three feet of somebody for three hours to get it and you also have to exchange bodily fluids and perspiration sweat for an extended length of time,” said Loomis.
In Europe, a large portion of the cases were found to have been in men who are gay or bisexual, which gave the misconception early on that this was a sexually transmitted disease.
Dr. Loomis emphasized that the disease is not an STD and that monkeypox spreads through person-to-person contact.
“I want to make it very clear. This is not a sexually transmitted disease. It just happens to be that it’s affecting men having sex with men, and that is not necessarily an STD."
Dr. Loomis said patients who go into the hospital with symptoms of monkeypox sometimes get mistaken as having an STD, which is presented with a fever, an extensive characteristic rash around the groin area, and usually swollen lymph nodes.
Smallpox vaccine a key barrier to monkeypox
Dr. Loomis believes that the reason why monkeypox has been able to spread across the nation is due to a mutation amongst monkeypox, and a growing population that has not been vaccinated for the smallpox virus.
“The (monkeypox) virus has had a chance to mutate. This is a DNA virus. DNA viruses don’t usually mutate, and if they do, it’s a very slow mutation because the DNA molecule is a fairly stable molecule.
“So, what’s happened since the late 1970s, when a bunch of us all had our smallpox vaccines, we have about an 84 percent coverage. But in the last 50 years, nobody has gotten smallpox and smallpox is a cousin to monkeypox.
“So, those of us that got smallpox vaccinations are also covered with the monkeypox for the most part. But the people that haven’t since the last 50 years, are the ones that are getting (monkeypox). And during that time period, the virus has had a chance to mutate ever so slowly, so we're seeing different variances come out.”
Per his request, the Journal & Courier updated the quote above to reflect Dr. Loomis' intent to say monkeypox.
These mutations in the DNA molecule have begun to emerge in the way monkeypox currently presents itself in symptomatic patients.
“What we’re seeing is atypical, meaning unusual presentation of monkeypox. Usually, it's not just the pustules, they’re coming with a rash in the groin area, which is unusual for that disease, but you’re still seeing the swelling of the lymph nodes, which is different from smallpox.”
Dr. Loomis also wanted to reassure Hoosier that the spread of monkeypox is rare amongst the general public and advises folks to remain calm regarding the issue.
"From the information that we're getting from the state and the CDC, the monkeypox outbreak is no threat at this time to the general population," said Dr. Loomis.
Noe Padilla is a reporter for the Journal & Courier. Email him at Npadilla@jconline.com and follow him on Twitter at 1NoePadilla.
This article originally appeared on Lafayette Journal & Courier: Monkeypox 'no threat at this time': Tippecanoe County health official
