What to Know About Monkeypox

Yale Health is closely monitoring the global monkeypox outbreak. Monkeypox information is continually being updated by the Centers for Disease Control and Prevention (CDC) and the Connecticut State Department of Health.

  

What is monkeypox and how is it spread?

Monkeypox is a viral infection caused by the monkeypox virus, which is related to smallpox though much less severe. Most states in the US are reporting cases and a Connecticut dashboard is updated weekly on Tuesdays.

Monkeypox spreads primarily through sex and other close skin-to-skin contact with the infectious rash or lesions. Other less common ways the virus is spread is through contact with an infected persons respiratory secretions or touching objects or fabrics that have come in contact with infectious lesions. Most cases to date have been related to sexual activity in the prior 1-3 weeks. At this time, monkeypox is not known to spread by the airborne route or by people who do not have symptoms.

 

What are the symptoms? 

Symptoms of monkeypox include:

  • Rash that can look like pimples, bumps, or blisters. Lesions may appear on the face, inside the mouth, or other parts of the body including hands, feet, genitals, or anus and rectum. The lesions may be itchy or painful and may be associated with rectal pain or bleeding. The CDC provides images of the rash.
  • Mouth, genital, or anal pain. 
  • Body aches, swollen glands, sore throat, fatigue and headache.

What should I do if I have symptoms?

Isolate and contact your healthcare provider as soon as possible to be tested. Specimens for testing must be obtained by a healthcare provider, who will swab a lesion and submit the sample to either a commercial lab or the state of Connecticut for testing. Results may take several days to process.

Yale Health is prepared to provide clinical evaluation, testing, and vaccination guidance for members. Please call your primary care provider if you develop symptoms of monkeypox or have been exposed. Those with other insurance should seek care through their own healthcare provider.

 

Who is at risk for infection?

Anyone can get monkeypox if they have been exposed. Currently, monkeypox is disproportionately affecting some gay and bisexual men, transgender, and non-binary people. Infection is not limited by gender or sexuality and can spread to anyone where there may be close, personal, and often skin-to-skin contact. Behaviors linked to higher risk of monkeypox transmission include multiple sex partners and anonymous sexual encounters in the previous 1-3 weeks.

 

What if I test positive?

Yale Health (for students or members) or your healthcare provider will work with you on an appropriate treatment plan including mental health support if needed.

You are infectious until your lesions are fully resolved, which can take 2- 4 weeks. You will also need to isolate until your lesions have healed, scabs have fallen off, and a fresh layer of skin has formed. Wear a well-fitting mask, cover lesions when around others, and avoid skin or mucosal contact with household members and pets, especially mammals. The CDC provides guidance for preventing the spread to others.

If you are a student living on campus and test positive, you may go home, or an appropriate location will be provided on campus. Students living off campus will be provided with guidance for safe isolation practices.

Your healthcare provider is required by law to report cases of monkeypox to the Department of Public Health (DPH). The DPH or local health department will reach out to you to conduct contact tracing so that anyone at risk can be notified and vaccinated as soon as possible. You will be asked where you have been since your symptoms started. The health department will contact the university if you have been on campus (including for work) so that any spaces you have occupied, including a dorm room, can be specially cleaned by university staff.

How is it treated?

In most cases, monkeypox infection is mild and resolves without treatment. However, medications developed to treat smallpox (tecovirimat or TPOXX) are available for patients who are at risk for more severe disease from monkeypox. Standard treatments are available for symptoms of pain and itching from lesions and can be prescribed by a healthcare provider. 

 

Is there a vaccine that can help prevent infection?

Vaccines developed for use against smallpox are being used to prevent monkeypox following exposure, or to reduce the likelihood of infection in those at increased risk of exposure. There is currently a limited supply of JYNNEOS vaccine and vaccination is prioritized for individuals at the highest risk of exposure. The vaccine is administered as 2 doses 28 days apart, with full protection effective by 14 days after the second dose.

Vaccine is currently available in Connecticut for two groups: 

  1. Individuals exposed to a known or likely monkeypox case while that person was symptomatic.
  2. Individuals with no identified exposure but are at increased risk.  Individuals must meet the following criteria:
    • People who are aware that a sexual partner in the past 14 days was diagnosed with monkeypox OR
    • Had multiple sexual partners in the past 14 days in a jurisdiction (e.g. city/state/county) with known monkeypox AND
    • Connecticut resident OR student studying in CT

Eligible individuals may request appointments for vaccinations by calling the state-designated community partner clinics (see below) directly.

At present, the vaccine is available only through a network of community partner clinics around the state. Note that Yale Health will not be administering the vaccine at this time. Vaccine supplies are limited so it is possible that individuals will be placed on a waiting list.

*Please Note: Fair Haven Clinic is charging a $25 administration fee which will be reimbursed by Yale Health on request). 

Are there other preventive measures?

Other health and safety measures can reduce the likelihood of either infection or transmission, including:

  • Avoiding close physical contact with anyone who has been diagnosed with monkeypox or has a suspicious rash. 
  • Taking steps to reduce your risk of exposure during activities where there is likely to be skin-to-skin contact, such as sex and certain social gatherings.
    • Temporarily reduce your number of sexual partners.
    • Talk with your partner about any rash or other symptoms.
    • Notify close contacts if you test positive.
  • Avoiding handling bedding, towels, or clothing of someone who has or may have monkeypox 
  • Washing hands frequently 

How does this impact Campus Health and Safety, and Data Sharing?

Yale University has an obligation to protect not only workforce health and safety, but also to provide as safe an environment as possible for those living and studying on campus.  Recent emergent diseases and public health emergencies have necessitated balancing employee and student health data privacy expectations and requirements with the need to share health information to mitigate the spread of contagious disease amongst the Yale community.  This document intends to clarify data sharing practices at Yale in response to monkeypox which was declared a public health emergency on August 8, 2022.

Updated 9/14/22