Questions about Monkeypox

Questions about Monkeypox?

The Virginia Department of Health (VDH) and the Roanoke City and Alleghany Health Districts are responding to an outbreak of monkeypox that has spread across several countries that don’t normally report monkeypox, including the United States. For information on monkeypox in Virginia, please visit the VDH monkeypox website. If you are a healthcare provider, please visit the monkeypox website for healthcare providers. 

The Roanoke City and Alleghany Health Districts are working to ensure that residents who have been exposed or are at high risk of being exposed to monkeypox receive a vaccination. In Virginia, a two-dose series of a monkeypox vaccine (JYNNEOS) is recommended for individuals who identify with any of the following groups:

 All people, of any sexual orientation or gender, who have had either anonymous or multiple (more than one) sexual partners in the last 2 weeks; or

 Sex workers (of any sexual orientation or gender); or

 Staff (of any sexual orientation or gender) at establishments where sexual activity occurs (such as bathhouses, sex clubs)

 Person of any sexual orientation or gender who has attended a sex-on-premises venue in the last 14 days

 Close contact with anyone suspect or confirmed to have monkeypox in the last 14 days

 People of any sexual orientation of gender who:

 Are living with HIV/AIDS

 Has been diagnosed with any sexually transmitted infection in the past three months

Qualifying individuals interested in receiving a monkeypox vaccination may call us at 540-283-5050.

What is monkeypox?

Monkeypox is a disease caused by the monkeypox virus, an orthopox virus which belongs to the same group of viruses as smallpox. The virus causes a distinctive rash

A monkeypox rash may initially appear similar to pimples, blisters, or raised bumps that appear on the face, hands or other parts of the body, and may be accompanied by fever and chills. The illness typically lasts 2-4 weeks, is usually self-limited, and is rarely fatal. If you are concerned that you have a rash that may be monkeypox, please contact your healthcare professional. Close contacts to someone who has been diagnosed with the virus should contact their local health department, even if they don’t have symptoms.

How is monkeypox spread?

Monkeypox is spread through:

  direct contact with the infectious rash, scabs, or body fluids

  respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex

  touching items (such as clothing or linens) previously touched the infectious rash or body fluids

Anyone can get monkeypox, although the majority of individuals recently diagnosed with monkeypox self-identify as being men who have sex with other men. The virus does not spread exclusively through any one gender, sexual, or social network.

What is being done in Virginia?

The Virginia Department of Health (VDH) is investigating every suspected case; facilitating laboratory testing at the Virginia state laboratory and the Centers for Disease Control and Prevention (CDC); and assisting with access to treatment for those identified with the disease. VDH also is conducting contact tracing and monitoring contacts for 21 days after exposure.

Am I eligible to receive a vaccine?

At present, the monkeypox vaccine is only recommended for adults at high risk of exposure. Individuals eligible for vaccine must meet at least one of the following high-risk criteria:

  • Gay, bisexual, or other man who has sex with men and has had multiple sexual partners or anonymous sexual partners in the last 14 days.
  • Transgender woman or nonbinary person assigned male at birth who has sex with men and has had multiple sexual partners or anonymous sexual partners in the last 14 days.
  • Sex worker of any sexual orientation or gender.
  • Person of any sexual orientation or gender who works at an establishment where sexual activity occurs.
  • Person of any sexual orientation or gender who has attended a sex-on-premises venue in the last 14 days.
  • Close contact with anyone suspect or confirmed to have monkeypox in the last 14 days.

What else can I do to keep myself and others safe from monkeypox?

Know the symptoms and seek medical care if you experience any. Symptoms of monkeypox typically include a rash or lesions (fluid-filled spots) anywhere on the body, often on the face, arms, legs, or genitals. Other symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills, exhaustion. For more information about symptoms, click here.

General prevention tips: 

There are things you can do to reduce your chances of getting or spreading monkeypox:

  • If you have symptoms or a new rash, stay home and call your healthcare provider. 
  • Avoid close, skin-to-skin contact with anyone with a rash. Do not touch another person’s rash or scabs. 
  • If someone you know has been infected, avoid kissing, hugging, cuddling or having sex with that individual. Do not share eating utensils and cups. Do not share bedding, towels, or personal grooming devices.
  • Wash your hands with soap and water or use an alcohol-based hand sanitizer (if water and soap are not available) after contact with people or animals who have monkeypox.
  • Wear a mask in situations where you may have lengthy face to face contact with other people who may be infected.
  • Consider the events you attend and your behavior at those events. If there is close, prolonged skin-to-skin contact with others, the risk of spreading monkeypox is higher.

Prevention tips to lower risk during sex:

  • Talk to your partner about any recent illness or the appearance of new and unexplained sores or rashes. Do not have sex if either of you are feeling sick or have a new rash or sores. You should contact your healthcare provider for care if you are ill.
  • If you or a partner has monkeypox, the best way to protect yourself and others is to not have sex of any kind (oral, anal, vaginal) and not kiss or touch each other’s bodies while you are sick, especially with any rash or sores. Do not share things like towels, fetish gear, sex toys, and toothbrushes.
  • If you do decide to have sex: 
    • Limit the number of sexual partners. 
    • Consider virtual sex that is not in-person, or if in person, consider ways to limit physical contact. 
    • Avoid kissing.
      • Consider sex with clothing on, or with clothing covering any rashes or sores to limit skin- to-skin contact. 
      • Wash hands, objects, and linens used during sex. 
    • Because the disease can be spread through any skin-to-skin contact, using condoms does not guarantee protection. 

For additional recommendations, see CDC: Social Gatherings, Safer Sex and Monkeypox (PDF) (2 pp, 119KB)

Do you think you were exposed?

If you have symptoms of monkeypox, contact your healthcare provider immediately for testing, especially if it is possible you were in a setting or situation within the last month where monkeypox is known to spread.

High Risk: Unprotected contact with the skin, lesions, or bodily fluids from a person infected with monkeypox, including any kissing or sexual contact, as well as contact with contaminated materials (e.g.,  linens, clothing).

Recommendation: Post-exposure vaccination- VDH will work with you to monitor any symptom changes for 21 days after an exposure.

Intermediate Risk: Being within six feet of a person with monkeypox for three hours or more without masks.

Recommendation: VDH will work with you to determine if vaccination is needed, and to monitor for any symptom changes for 21 days after an exposure.

Low Risk: Being within six feet of someone with monkeypox without a mask for less than 3 hours.

Recommendation: VDH will work with you to monitor for any symptom changes for 21 days after an exposure. Vaccination not recommended at this time.

Learn more about the VDH response to monkeypox here.

 If you have been named a contact to a known positive case, you will be contacted by VDH. VDH will provide you with resources and will ask about your other contacts to help reduce overall transmission. Your information will still remain protected health information and not released to any other person.

While it is important to educate yourself about monkeypox, this virus does not pose a significant threat to the public’s health at this time. We urge people to know what risk level they have and to take the appropriate precautions to protect their health. 

What to do if you think you have it?

If you have symptoms consistent with monkeypox, you should physically separate yourself from other people and pets (if you cannot completely separate yourself from others, wear a well-fitting face mask when around others), cover your lesions, and contact your healthcare professional for further advice about possible testing.  If you do not have a primary care provider, contact your local public health clinic, New Horizons Health Care, or any urgent care center. Please call ahead before going to a healthcare facility and let them know that you are concerned about monkeypox.

You can use these resources to find treatment options:

VDH Health Department Locator Tool https://www.vdh.virginia.gov/health-department-locator/

Federally Qualified Health Center (FQHC) Locator Tool https://findahealthcenter.hrsa.gov/

STI Resource Connections https://vadoh.myresourcedirectory.com/

The Centers for Disease Control and Prevention (CDC)  has other recommendations for people who have monkeypox and are isolating at home.

https://www.cdc.gov/poxvirus/monkeypox/clinicians/infection-control-home.html

Treatment Information

There are no specific treatments for monkeypox virus infections. However, monkeypox and smallpox viruses are similar. This means that treatments developed to protect against smallpox may be used to treat monkeypox virus infections.

Certain antivirals, such as tecovirimat (TPOXX), may be recommended for people who are more likely to get severely ill if they become infected, for example, patients with weakened immune systems. VDH is working with healthcare providers who request the medication for their patients.

If you have symptoms of monkeypox, you should talk to your healthcare provider immediately, even if you don’t think you have had contact with someone who has monkeypox. VDH is working with healthcare providers to make sure they have information about monkeypox treatment.

As of November 16, 2022