Mpox Resurfaces: Unexplained Cases in US Spark Concern Over Local Transmission

New alarms are ringing in the United States as health authorities report two new mpox cases in individuals with no recent international travel history. These isolated incidents, one in Michigan and another in New York, are raising significant concerns about the potential for local transmission within communities, a development that health officials are closely monitoring.

Previously known as monkeypox, mpox is a viral zoonotic disease, meaning it can spread from animals to humans, and then between humans.

While typically associated with travel to regions where the virus is endemic, the absence of a travel link in these latest cases suggests a critical shift. This situation underscores the importance of public awareness and vigilance, as health agencies like the CDC intensify their investigations to identify the source of infection and prevent further spread.

Understanding Mpox: A Refresher

Mpox is caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes the variola virus (cause of smallpox).

Although related, mpox is generally less severe than smallpox. The disease typically presents with a distinctive set of symptoms:

• Fever: Often the initial symptom, sometimes accompanied by chills.
• Headache and Muscle Aches: General malaise and body aches are common.
• Lymphadenopathy: Swollen lymph nodes (in the neck, armpits, or groin) are a hallmark symptom, often distinguishing mpox from other rash-causing illnesses like chickenpox.
• Rash: This is the most recognizable symptom.

  It often appears 1-4 days after the onset of fever. The rash progresses through several stages: flat spots (macules), raised bumps (papules), small fluid-filled blisters (vesicles), pus-filled blisters (pustules), and finally crusts (scabs) that fall off. The rash can appear anywhere on the body, including the face, hands, feet, mouth, and genitals.

Symptoms typically last 2-4 weeks.

While most cases are mild and resolve on their own, severe cases can occur, especially in young children, immunocompromised individuals, or those with underlying health conditions.

How Does Mpox Spread?

Mpox is not considered a sexually transmitted infection in the traditional sense, but it can spread through close, personal, often skin-to-skin contact.

The primary modes of transmission include:

• Direct Contact: Touching the mpox rash, scabs, or body fluids of an infected person. This includes intimate physical contact, such as sexual activity, hugging, massage, and kissing.
• Respiratory Secretions: Prolonged face-to-face contact, where respiratory droplets can be exchanged.
• Contaminated Objects: Contact with contaminated objects, such as clothing, bedding, or towels used by an infected person.
• Maternal-Fetal Transmission: A pregnant person can spread the virus to their fetus.
• Animal-to-Human: The virus can also spread from infected animals (e.g., rodents, primates) to humans through bites, scratches, or direct contact with body fluids or lesions.

It's crucial to understand that transmission typically requires close, sustained contact, not fleeting interactions.

Prevention and Public Health Measures

In light of these new cases, public health efforts are focused on:

• Vigilance and Reporting: Healthcare providers are urged to consider mpox as a diagnosis for patients presenting with characteristic rashes, especially if accompanied by other symptoms, even without a travel history.
• Contact Tracing: Thorough contact tracing is essential to identify individuals who may have been exposed and offer post-exposure prophylaxis.
• Vaccination: The JYNNEOS vaccine is approved for preventing mpox and is recommended for individuals at high risk of exposure, including those who have been exposed to someone with mpox or those whose work puts them at risk.
• Personal Hygiene: Practicing good hand hygiene, avoiding close contact with people who have symptoms, and refraining from sharing personal items can help reduce the risk of transmission.
• Isolation: Infected individuals should isolate themselves until their rash has healed and new skin has formed to prevent further spread.

The recent cases serve as a critical reminder that while the global mpox outbreak has largely subsided, the virus remains a threat.

Continued awareness, prompt reporting, and adherence to public health guidelines are vital to contain any potential resurgence and protect community health.