Monkeypox, a viral disease that causes skin lesions and flu-like symptoms, has seen an alarming rise in America—and particularly among men who have sex with men. But it is not a “gay” disease, according to the Houston Health Department (HHD).
“Monkeypox can and does infect everyone, regardless of sex or age,” says Kirstin Short, HHD’s chief of epidemiology who saw Houston’s first case in early June. There are currently eight known people with monkeypox in Houston, HHD reports. “In the current outbreak we are seeing a preponderance of cases in men—some who have traveled overseas recently, but also some who haven’t.”
The World Health Organization reported in January that the outbreak of US monkeypox continued to primarily affect men who have sex with men who had reported recent sex with new or multiple partners. The US outbreak may be linked to certain super-spreader events overseas. Similarly, a Dallas outbreak prompted health officials to warn those who visited Club Dallas from June 22 to June 25 to watch for symptoms. An out-of-state visitor with confirmed monkeypox reported having multiple sexual encounters at the club during those dates. A similar warning went out to attendees of the annual Daddyland Festival over the July Fourth weekend, which featured gay dance parties and pool parties.
Nathan Maxey, MPA, an HHD senior health planner, spearheaded a community town hall on monkeypox on July 7. “As a Black gay man, it’s important to dispel all myths and rumors about monkeypox,” he says. “We don’t want to stigmatize any community.”
“I think, overall, the risk is low,” Short adds. “But I would want everyone to be aware of your partner, or if you have a new rash. This is an evolving response, like in the early days of COVID. We are sending out education teams to community events and we have a monkeypox page on our website. We’re doing extensive education with our HIV and epidemiology teams.”
Monkeypox, unlike COVID, requires close, personal (often skin-to-skin) contact including sex, kissing, or mutual masturbation with someone infected with monkeypox sores.
“What we are seeing here is the West African variant,” Short notes. “The majority are isolating and recovering at home.”
Unlike COVID, monkeypox is not contagious until symptoms appear. But once they do, you should be tested and follow a doctor’s orders, Short advises. “The patients that do need hospitalization are doing so for pain management.” Most patients present with sores on their hands and face, but for those who contract the disease through sex, genital and anal sores can be very painful.
Once a positive test is confirmed, the patient needs to avoid sex or intimacy with anyone until all sores have healed and a fresh layer of skin has formed. Again, most patients will recover at home by staying hydrated and taking over-the-counter medications.
The antiviral Tecovirimat (TPOXX), used to treat smallpox, was confirmed by the World Health Organization in May to be effective against severe cases of monkeypox. But, Short says, it is only available through the Centers for Disease Control and Prevention (CDC). Likewise, vaccines against monkeypox are currently available only through the CDC.
There are two vaccines licensed by the US Food and Drug Administration (FDA) available for preventing monkeypox infection: JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000. In the United States, there is currently a limited supply of JYNNEOS, although more is expected in coming weeks and months. There is an ample supply of ACAM2000. However, this vaccine should not be used by people who have a weakened immune system, skin conditions like atopic dermatitis/eczema, who are pregnant, or who have certain other conditions.
“Right now, because of the limited supply, it’s only advised for those who have been exposed through direct contact. As supplies increase, we can expand on that,” Short says.
She reiterates that most cases can be treated at home with over-the-counter drugs, but stresses that if you have a rash and develop sores, you need to see a healthcare provider and remind them that there are cases of monkeypox in our community.
“One thing I do want people to know: this is not like COVID where businesses shut down and people were isolating at home for weeks and months,” Short says. “With monkeypox, there is no need to isolate at home until symptoms appear.”
For more information on local monkeypox cases, visit houstonhealth.org.