What to Know About Monkeypox and Its Symptoms

Symptoms may not emerge until a week or two after exposure. 

Gay and bisexual men should monitor their symptoms closely — especially because it may take a few weeks after exposure for any to develop, said Perry Halkitis, dean and professor of public health and health equity at Rutgers School of Public Health.  

How does monkeypox spread?

The virus spreads through direct skin-to-skin contact of the rash, lesions, scabs, or body fluids — during sex or simply through kissing or cuddling — or by touching clothing, sex toys or sheets that also made contact with exposed skin rashes. Anyone can spread the virus. 

Health officials are still researching whether monkeypox can be spread directly through semen or vaginal fluids, or fecal matter. 

What precautions should people take?

“If you’re someone assigned male at birth who has sex with men, you want to make sure that people you’re intimate with don’t have any physical lesions,” said Sarah Henn, chief health officer for Whitman-Walker, a D.C.-based healthcare provider focused on serving LGBTQ+ people. Small bumps, which can be red or white, raised and firm, may appear on shoulders, fingers, hands, wrists, armpits, and many other places on the body. 

Having an open conversation with sexual partners about the partners they’ve had, plus how they met their partners, is also important, she said. Having multiple partners within the last two weeks or having anonymous sex — especially without such communication — are increased risk factors for infection. 

Individuals who know that a sexual partner was diagnosed with monkeypox in the last 14 days or who has had multiple sexual partners in the past 14 days in an area with known monkeypox spread are eligible for the JYNNEOS vaccine, if vaccination appointments and supplies are available. The vaccine comes in two doses, delivered 28 days apart. 

“If you are someone who has had multiple sex partners in the last several weeks, really working to access vaccination is important, because vaccination even after exposure is protective,” Henn said. 

While going to a concert or festival with other fully clothed attendees doesn’t pose much risk, going to a party with minimal clothing and frequent skin-to-skin contact does. Reducing skin-to-skin contact during sex and avoiding kissing can also minimize exposure. 

What should people do if they’ve been exposed to monkeypox?

It’s important to monitor symptoms for 21 days from the last exposure by taking one’s temperature twice a day. If symptoms develop, patients need to self-isolate and contact a doctor or the local health department. 

If only chills and swollen lymph nodes occur, with no other symptoms, patients can remain at home and self-isolate for 24 hours, according to the CDC. If a fever or a rash develops, or if the chills and swollen lymph nodes don’t go away, it’s important to contact a primary care physician or go to an urgent care clinic or emergency department — and try to reach out to the clinic ahead of time. 

Many early symptoms of monkeypox are similar to herpes, and doctors may test for that first. Additionally, the testing process in many areas may still be limited to local health departments, until the supply of commercial tests catches up with demand. 

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