California updates monkeypox isolation guidelines; more cases reported in Riverside County

Riverside County Public Health reported an additional 15 confirmed or probable monkeypox cases on Friday as the state released new isolation guidelines meant to limit the spread of the virus.

No information was provided on the patients' age or gender. But a new monkeypox data dashboard showed that 98% of cases in the county have been among males and 2% among females.

There have been 124 confirmed and probable monkeypox cases in Riverside County as of Friday. The cities with the highest number of cases include Palm Springs (66), Cathedral City (21) and Desert Hot Springs and Riverside (five each), according to the dashboard.

Palm Springs and Cathedral City together have over 70% of the county's total cases so far, including eight of the 15 newly reported ones.

Monkeypox is a disease caused by the monkeypox virus. People usually become infected through close contact with skin lesions or bodily fluids of infected animals or humans (alive or dead), including droplets, or clothing and linens from an infected person. The virus can also be spread through sexual contact, but it is not classified as a sexually transmitted infection.

Health officials say the Palm Springs area is at high risk given its large number of LGBTQ+ residents and tourists. The virus can infect anyone, but during the current U.S. outbreak, it has disproportionately affected men who have sex with men, a group that includes people who identify as gay, bisexual, transgender and nonbinary.

Symptoms can occur five to 21 days after exposure, and include fever, headache, muscle aches, swollen lymph nodes, rash and lesions often in the genital and perianal region. Illness typically lasts for two to four weeks.

Anyone who believes they have been exposed to monkeypox should contact their healthcare provider.

New isolation guidelines

California Department of Public Health Director Dr. Tomás Aragón highlighted new state isolation guidelines for those with confirmed or suspected monkeypox cases during a media call on Friday.

In general, people should stay home, unless it is necessary to see a health care provider, until monkeypox infection has been ruled out or all monkeypox lesions are fully healed and a fresh layer of skin has formed at lesion sites and any other symptoms have been resolved for at least 48 hours.

People with a monkeypox infection who live with others should isolate from them, avoid close contact, keep lesions covered, wear a mask if they're in the same room, and clean and disinfect frequently touched items. Lesions should be covered with clothing or a piece of gauze.

Activities outside the home that do not involve high-risk settings or physical contact with other people may be resumed if any fever or respiratory symptoms have been resolved for at least 48 hours, no new lesions have appeared for at least 48 hours, and any lesions that can't be covered, such as those on the face, are fully healed (scabs have fallen off and a fresh layer of skin has formed). High-risk settings include homeless shelters, residential drug treatment facilities, health care sites, correctional facilities and detention centers, adult and senior care facilities and schools.

Once all skin lesions have healed, a person can resume normal activities. People are advised to wear a condom when engaging in sexual activities for at least 12 weeks after infection since there is limited data available for monkeypox transmission via genital excretions.

The guidelines can be found at https://tinyurl.com/5ah4xydp

There have been 2,660 confirmed and probable monkeypox cases in California as of Thursday. There have been 62 known hospitalizations and no known deaths.

Hispanics or Latinos have made up nearly 39% of reported cases, white people 38%, and Blacks or African Americans 12%.

Aragón said the distribution of cases among Hispanics and Latinos is "close to their representation in the state."

But he said it's important in areas with higher proportions of Latino people, such as Southern California, "that we do a really good job of reaching that community with culturally and linguistically appropriate services."

A new test method

As the number of cases grows, a free clinic in Palm Springs has announced it will be providing a new way to test for the virus.

PS Test, located at 555 E. Tachevah, Suite 1E-201, is collecting sputum, or saliva, for testing. It claims to be the first in Riverside County to be doing this type of test.

The accuracy of such "PCR tests" has been debated. The U.S. Food and Drug Administration is advising people to use swab samples taken directly from a lesion when testing for the monkeypox virus and says there isn't clinical data to show other types of tests, such as blood or saliva, are effective.

But Dr. Phyllis Ritchie, the founder and CEO of PS Test, said the method it's offering can help catch the disease earlier, since results are back in 24 to 48 hours and it can detect monkeypox in people who don't have lesions yet. A recent study found saliva-based monkeypox tests are "potential tools for outbreak control, and further evaluation of the performance of such tests is warranted." The results have not been peer reviewed yet, however.

Prior to utilizing the saliva-based test, Ritchie, a board-certified infectious disease specialist, said the clinic had two choices: "either send it to LabCorp for $76 a test, or take a picture of a lesion, send in patient demographics and what symptoms the patient is having, send it to Barbara Cole (the county's director of disease control), get it approved and then send in the specimen of the swab of the lesion." The wait time for results would typically be 48 to 72 hours, she added.

Having a number of fast and reliable methods available to test for monkeypox is important, Ritchie said, because "monkeypox may be here to stay."

"I fear that we're way too late in controlling it," she said. "I hate saying that, I hate hearing me say those words, but that's what I fear."

People who want a test at PS Test can call 760-299-6487 or walk in during its hours, 10 a.m. to 4 p.m. Tuesday through Thursday.

Ritchie would also like to provide the Jynneos vaccine, which has been used to protect those at high-risk of infection. Vaccines have been provided by Borrego Health, DAP Health and Eisenhower Health in the Coachella Valley, but have primarily been distributed among their most at-risk patients.

Ritchie said her clinic sees many people who aren't connected with those providers, and others who need the vaccine "fall in the cracks."

County spokesperson Jose Arballo Jr. said in an email the county encourages all primary health care facilities to provide monkeypox testing for patients they suspect could have the virus. The exact number of facilities that provide testing was not available because "new facilities and providers are regularly coming on across the county," he said.

Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at ema.sasic@desertsun.com or on Twitter @ema_sasic.

This article originally appeared on Palm Springs Desert Sun: New California monkeypox isolation rules; more Riverside County cases