PORTLAND, Ore. — There's good news and bad news when it comes to monkeypox. The good news: It's not as communicable as COVID-19, which spreads through the air and is highly contagious. It's also not as severe — so far, there haven't been any deaths from monkeypox in the U.S.
The bad news: It's extremely painful, and it could lead to worse infections. Anyone can catch it, if only through very specific ways. At this point, doctors say they expect monkeypox is going to be in the community for months, maybe even years.
According to the CDC, monkeypox is part of the same family of viruses as smallpox, but it's much less severe and rarely fatal. It was first discovered in 1958. While it was originally identified in monkeys, some researchers believe it actually comes from rodents.
The first human case of monkeypox was recorded in 1970. Before 2022, monkeypox was reported in several countries in Africa. Earlier this year, it started spreading to other countries around the world, including the U.S.
Right now there are more than 31,000 monkeypox cases across the globe — the vast majority in places where it has not historically spread.
There are about 11,000 cases right now in the U.S. In Oregon, as of Friday afternoon, there were 95 confirmed cases. Of those cases, 57 were in Multnomah County. Washington state had 251 confirmed cases.
The vast majority of cases in Oregon are among men. Only three of the state's monkeypox cases are in women.
Doctors say monkeypox is spread primarily through prolonged skin-to-skin contact. Right now, they're seeing the most transmission through sexual activity, but it can be spread through any skin-to-skin contact.
Monkeypox is rarely fatal, but it's also not an infection to be taken lightly.
"Monkeypox may start with a fever, achiness or sore throat. But it may also start with a rash or sores. The rash often looks like pimples or blisters at the start," said Dr. Dean Sidelinger, state health officer and epidemiologist with the Oregon Health Authority.
"The rash will eventually get firmer, and may be very painful," Sidelinger continued. "If you're feeling sick and notice any new rashes, especially on the genitals or around the anus, avoid close skin-to-skin contact with others and talk to a health care provider. Or call 211 if you don't have one."
There's a lot of misinformation circulating about how monkeypox spreads. Doctors say that they're currently seeing the most cases between gay and bisexual men, both in Oregon and across the U.S. But not belonging to these categories does not at all exempt someone from risk.
"This means that anyone can be affected by monkeypox, and this is not a gay disease," Sidelinger said. "But as I shared earlier, this is not an easy disease to catch. The most common means of person-to-person transmission is from prolonged skin-to-skin contact, with a person with monkeypox, including direct contact with a rash, scabs, or body fluids. This is the type of contact that happens during sexual activity.
"Much less commonly, the virus can also be spread through touching objects, fabrics, and surfaces that have been used by a person with monkeypox and through contact with respiratory secretions of a person with monkeypox. These routes are much less common than skin-to-skin contact with someone who has monkeypox."
Advocates for the LGBTQ community say that there's been a lack of urgency from health officials in making available information, testing, vaccines and treatment for the people most affected. And they say that they're afraid it's soon going to become a bigger problem.
"The OHA and [community-based organizations] like the Equi Institute, Cascade AIDS Project, Pride Northwest and others have been sounding the alarm, and the lack of urgency from the federal government is concerning," said Katie Cox with the Equi Institute. "Would that urgency look any different if it wasn't impacting a historically marginalized community? Did we learn nothing from the AIDS epidemic?"
"I'm hearing straight people say they don't have to worry about it because it doesn't affect them," Cox continued. "At this point, it's not an if, but a when it'll start affecting other communities. Gay, bisexual, queer men and trans people are not the only people engaging in skin-to-skin contact, or having sex with multiple partners. Look at the World Naked Bike Ride that just happened."
Oregon Governor Kate Brown also weighed in on this, releasing the following statement:
"We have an ugly history in this country of ignoring diseases that primarily impact the LGBTQ+ community. I remember the early days of the HIV epidemic, when a generation of gay men was dying and the government did not seem to care. It took years before there was general recognition from the public that HIV, like all viruses, spreads indiscriminately."
Brown called on the federal government to speed up the delivery of vaccines and treatments — and for people to take steps to protect themselves.
There is a vaccine for monkeypox, but it's not easy to get. The supply is limited right now. Health officials say they're doing what they can to spread it out — including giving only one dose instead of the prescribed two — and they're prioritizing people who are in high-risk groups rather than vaccinating the general public.
Oregon has thus far received 6,800 vaccines and distributed a little over 2,000 of those.
If you think you've been exposed to monkeypox? As Sidelinger said, call your doctor, or call 211 if you don't have a primary care physician. You'll get tested, and the test involves swabbing the rash or sores. The tests take between one and three days to get results.
People with sores or a rash should cover them and not touch them. Doctors say that you should isolate until all the sores are scabbed and begin to go away.
There's one treatment for monkeypox — a drug called tecovirimat, sold under the brand name Tpoxx. But the drug, like the vaccine, is very difficult to get ahold of right now.
Oregon health officials say that right now there aren't any monkeypox cases among kids in the state. But as school starts up again soon, officials are having conversations about how to handle any cases that could arise. Regardless, the OHA said that schools are considered a low-risk setting.
"Younger children or any children who are cared for by a parent or caregiver in a household who has monkeypox, that transmission could occur," Sidelinger said. "And we worry especially about younger kids who require more close contact with their parent or caregiver and some parents who are sick don't have an alternative caregiver don't have someone else who can take over that duty for caring for the youngest child.
"So we are having discussions with our [Oregon Department of Education] colleagues but we don't anticipate that schools will be a location where monkeypox transmits commonly. But we do anticipate that whether it's a staff member or a student, schools will have to face issues where someone with monkeypox may have been on campus. what would put individuals at risk are things like close skin to skin contact. That happens in several situations in schools — for example, wrestling. So if a wrestler had lesions and were participating in practice or a tournament while they had those lesions, we could see transmission."
Sidelinger said that OHA is working with schools on how to support students and teachers who may need to isolate for several weeks — and how to reduce the stigma around infection.