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"Low" risk to public from Michigan's first monkeypox case

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CDC
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The monkeypox virus.

The first probable monkeypox case in Michigan was identified Wednesday in an Oakland County resident, according to the Michigan Department of Health and Human Services, and confirmatory testing is underway at the Centers for Disease Control.

“The individual is currently isolating and does not pose a risk to the public,” a state health department statement said. “MDHHS is working with local health departments to notify any close contacts. To protect patient privacy, no further case details will be provided.”

As of Tuesday, 351 monkeypox cases have been confirmed in the US since May 18, none of which have been fatal. The virus, which is part of the same genus of viruses that cause smallpox, “is much less transmissible than fast-spreading respiratory diseases like COVID-19,” the White House said Tuesday. It typically causes symptoms including fever, headache, muscle aches, swollen lymph nodes, chills, exhaustion and a pimple-like rash that appears on “the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus,” according to the CDC. 

“Monkeypox is a viral illness that spreads primarily through direct contact with the infectious rash, scabs, bodily fluids or prolonged face-to-face contact,” said Dr. Natasha Bagdasarian, MDHHS chief medical executive, in a statement released Wednesday. “It is important to remember that the risk to the general public is low. However, Michiganders with concerns about monkeypox should see their provider to be evaluated for testing.”

Risk factors include travel to a country where the disease is present, contact with an infected animal, or exposure to someone who has the virus. Also, “early data from this outbreak suggest that men who have sex with men make up a high number of initial cases,” according to the MDHHS.

“The symptoms of monkeypox start out as sort of generic fatigue, muscle aches, swollen lymph nodes,” said Dr. Matthew Sims, medical director of Infectious Disease Research for Beaumont Health. “The real key feature of monkeypox is the rash. It's sort of a blistering pustular rash, usually over the entire body, really. And you would get really large swollen lymph nodes in the neck and whatnot.

“This version of monkeypox seems to be presenting a little differently in some patients, where the rash is really frequently localized to the area of contact. In this case, the anus…because it's been spreading in men who have sex with men. So you may not see the rash the same way. So doctors have to be very aware when they're speaking to a patient who might have it and know that it doesn't present in the classic way always.”

While the vast majority of people likely won’t need to get vaccinated for monkeypox, those with higher risk levels - including healthcare professionals, who may come into contact with infected patients - may want to consider it, Sims said. Currently, HHS has delivered “over 9,000 doses of vaccine and 300 courses of antiviral smallpox treatments” in the U.S., with plans to expand that to nearly 300,000 vaccine doses in the coming weeks. “Over the coming months a combined 1.6 million additional doses will become available,” according to a White House press release sent out Tuesday.

Distribution of testing supplies will also ramp up in the coming weeks, according to the Biden administration, which will be helpful in getting a more accurate picture of the spread of the virus.

“Because testing has been fairly limited, there's potentially people out there who have the symptoms and have not been tested, because it's difficult to get the testing,” said Sims. “Because doctors aren't used to this, and don't immediately think of testing for monkeypox. [But] I think that will change over the next [few] months.”