Amid Monkeypox Outbreaks, College Health Officials Outline Initial Guidance

The disease is spreading as most schools are still finalizing their COVID-19 protocols for the fall semester.
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Updated on September 29, 2023
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  • Monkeypox is a disease in the smallpox family spread primarily through prolonged intimate contact.
  • Through Aug. 3, the U.S. has reported more than 6,600 cases of monkeypox across 48 states; Washington, D.C.; and Puerto Rico.
  • New York, Illinois, and California have declared states of emergency over the rapidly spreading disease.
  • Colleges in those states are mobilizing to inform their students — and their larger communities — about monkeypox.

California Gov. Gavin Newsom declared a state of emergency over the monkeypox outbreak Monday — the third U.S. state to do so in less than a week.

"California is working urgently across all levels of government to slow the spread of monkeypox, leveraging our robust testing, contact tracing and community partnerships strengthened during the pandemic to ensure that those most at risk are our focus for vaccines, treatment and outreach," Newsom said in a statement.

Illinois also declared a public health emergency Monday. New York declared a state disaster emergency Friday in response to the monkeypox outbreak.

The U.S. has confirmed more than 6,600 cases of monkeypox across 48 states; Washington, D.C.; and Puerto Rico through Aug. 3, according to the Centers for Disease Control and Prevention.

The respective declarations of a health emergency raise awareness of monkeypox prevention and accelerate government action for distribution of vaccines in those states, which are home to the country's three largest cities: New York City, Los Angeles, and Chicago.

As a result, even as they finalize COVID-19 protocols, colleges in California, Illinois, and New York are also now mobilizing their health officials, medical schools, and epidemiologists to inform their students — and their larger communities — about monkeypox, its symptoms, and how to prevent the spread of the disease.

Here's what they are saying about the disease and its spread.

What Is Monkeypox?

Monkeypox is a disease in the smallpox family. It is caused by a virus that was first found in laboratory monkeys in the 1950s according to Dr. Stephen Morse, a professor of epidemiology at Columbia University. The name, however, is a misnomer, he says, since the disease is common to rodents rather than monkeys.

The first human case was reported in the 1970s in Africa, Morse said.

Monkeypox is classified as a zoonosis virus, a virus transmitted from animals to humans, according to Dr. Anne Rimoin, the Gordon-Levin professor of infectious diseases and public health at the University of California, Los Angeles Fielding School of Public Health.

There are two distinct types (clades) of monkeypox: the Central African clade, which is more transmissible and more severe, and a West African clade.

How Does Monkeypox Spread? What Are the Symptoms?

Monkeypox is spread primarily through prolonged contact.

Common ways of contracting monkeypox are from face-to-face contact and touching infectious rashes, scabs, or bodily fluids or from clothing/linens exposed to infectious rash or bodily fluids, according to Dr. Ramon Lorenzo-Redondo, director of the Center for Pathogen Genomics and Microbial Evolution at Northwestern University's Feinberg School of Medicine.

The illness lasts around 2-4 weeks, according to Dr. Robert Murphy, executive director of the Robert. J. Havey, MD, Institute for Global Health and a professor of medicine in infectious diseases at Northwestern University's Feinberg School of Medicine.

"Unlike the virus that causes COVID-19, the monkeypox virus is not known to be transmitted over a distance by small aerosol particles, although it is possible that it may spread through respiratory secretions when people have close face-to-face contact," according to Dr. Stanley Deresinski, clinical professor of infectious disease at Stanford Medicine.

Anyone can get monkeypox, but it's much harder to get than COVID-19 since it requires prolonged exposure in close contact with someone infected or contaminated objects, said Deresinski.

Monkeypox also has a low death rate. The current outbreak has had five confirmed deaths, all reported from Africa, where the disease is regularly found, said Murphy of Northwestern University.

He said those most at risk for complications are children, pregnant women, and people who are immunocompromised.

Is There a Vaccine for Monkeypox?

Yes. There are two vaccines for monkeypox — Jynneos and ACAM2000.

Each uses live strains of vaccinia virus to treat both smallpox and monkeypox in the United States, Dr. Danielle Ompad, a professor of epidemiology at New York University (NYU), said in a live-streamed question-and-answer session on monkeypox.

There are also antiviral treatments for monkeypox and other orthopoxviruses called cidofovir, brincidofovir, and tecovirimat, clinically reviewed in the Oxford Academic.

The availability of those vaccines and treatments to college students remains a question, however.

The Washington Post on July 30 reported that there are only enough vials of the two-dose Jynneos vaccine to cover about a third of the estimated 1.6 million gay and bisexual men who officials consider at highest risk and who are being urged to get the shots.

That shortfall is already being felt in San Francisco, Mayor London Breed said in a Medium post. The city requested 35,000 vaccines a few weeks ago, she said, but has not received more than one-third of the doses requested.

WHO Recommends Gay and Bisexual Men Limit Sexual Partners

World Health Organization (WHO) Director-General Tedros Ghebreyesus last week released a video on Twitter in which he said that while 98% of cases of monkeypox involve men who have sex with men, anybody can get the disease.

He recommended that gay and bisexual men limit their number of sexual partners to protect themselves from monkeypox and help slow transmission of the rapidly spreading virus.

Identifying those who have the disease or are more at risk for contracting monkeypox is vital to contact tracing and reducing its spread, NYU professor of epidemiology Dr. Don Des Jarlais said in the university's live-streamed question-and-answer session on monkeypox.

However, doing so also risks stigmatizing those populations. And that stigma can cause at-risk or infected people to refrain from being identified and getting the care they need.

"Stigma is one of the critical issues in trying to control monkeypox," Des Jarlais said.

That sentiment was echoed in a statement by Dr. Wafaa M. El-Sadr, founder and director of ICAP, a Columbia University global public-health initiative.

"As with any infectious disease, it is critical to avoid stigmatizing those diagnosed with monkeypox or at risk for this infection," El-Sadr said. "We have learned again and again that viruses do not discriminate and that stigma and discrimination can drive people to delay diagnosis and shun needed services."