DAVIDSON COUNTY, N.C. (WGHP) — North Carolina is ramping up the fight against monkeypox as cases begin to appear all across the country.
We sat down with David Priest, Novant Health’s chief safety, quality and epidemiology officer, to talk about the virus, how it spreads, how to get tested and how to get vaccinated.
What is monkeypox?
Before you start drawing comparisons to COVID-19, Priest says these viruses are not the same.
“Monkeypox is not COVID,” he said. “We’ve known about it for many decades. There’s not a lot of mystery to it. There’s a lot of tools that we already have at our disposal to deal with monkeypox, so we don’t anticipate certainly the same kind of pandemic situation we’ve seen with COVID.”
Monkeypox is described as a “rare, but potentially serious, viral illness that typically involves flu-like symptoms.” Symptoms can include fever, headache, muscle and back aches, swollen lymph nodes, chills, exhaustion and a rash that looks like pimples or blisters. Most infections last two to four weeks.
“The good news is that most of the patients that have had monkeypox around the world have had mild disease,” Priest said. “They have not required hospitalization.”
The CDC says anyone with “a rash that looks like monkeypox” should speak with their healthcare provider, and those providers can order tests.
How do people get monkeypox?
Monkeypox is primarily spread through skin-to-skin contact, but can also spread through droplets.
“We know there’s been some local transmission, and it’s been primarily intimate sexual partners and in particular social networks, but as we know from HIV and other infectious diseases, these are not infections that stay within particular sexual networks or social groups for very long,” Priest said. “They generally end up in the population, and so should not be considered a disease associated with a particular group like men who have sex with men. That’s where primarily seeing it now, but as we know, very quickly, that will end up in the general population.”
Priest said that while condoms could, theoretically, help to prevent the transfer of monkeypox, “the problem is sometimes the skin-to-skin contact involves areas of the body that a condom does not cover, and so usually a condom is not enough to say, ‘I’m going to guarantee I wouldn’t get monkeypox.'”
How do I get tested for monkeypox in North Carolina?
At this point, testing is primarily going through the North Carolina state epidemiologist and the state health department via local health departments.
If you think you have monkeypox, let your physician know. Your physician will work with the state epidemiologist or local health department to discuss the likelihood that you have monkeypox and whether or not you should be tested.
Priest added that commercially-available testing will be arriving this week.
“Actually, as we speak, literally today and tomorrow is when it’s rolling out, so what you’re going to see is increasing availability of testing for people, which is good timing because I think we will see more causes at this point moving forward,” he said.
Health and Human Services announced on June 22 that five commercial laboratory companies would soon be able to process monkeypox tests.
LabCorp, the commercial laboratory network based in Burlington, North Carolina, started processing tests last week. Labcorp will be using CDC tests for orthopoxvirus, the genus of viruses that includes pathogens like smallpox, cowpox and monkeypox.
How do I get the monkeypox vaccine in North Carolina?
When COVID-19 struck, the world was scrambling to develop a vaccine, but we’ve been working on the monkeypox vaccine for centuries.
Monkeypox is an orthopox virus, which puts it in the same category as smallpox. The smallpox vaccine is regarded as the first vaccine ever developed to combat a contagious disease, and the two vaccines that have been approved to combat monkeypox — JYNNEOS (also known as Imvamune or Imvanex) and ACAM2000 — are also used to combat smallpox.
The smallpox vaccine played a significant role in helping to eradicate smallpox in 1980, and no cases of naturally occurring smallpox have happened since 1977.
“We didn’t see a lot of it (monkeypox) decades ago when everyone got smallpox vaccine because they were protected from it,” Priest said. “And if you’re 50 years of age and younger, in all likelihood, you did not get smallpox vaccine.”
The U.S. stopped giving the smallpox vaccine in the 70s, so anyone born after that point likely never received the vaccine, meaning there’s less group immunity.
For now, you are only likely to see a vaccine if doctors believe you have monkeypox or believe you were exposed.
“There is a small amount of vaccine in the state of North Carolina that’s being distributed by the federal government, a few hundred doses, and right now its primary role is to be given to individuals who are thought to have monkeypox and their very close contacts,” Priest said.
The vaccine is not available for the general population and likely won’t be for some time. Priest said that he expects production of particularly the JYNNEOS vaccine will increase, and once it is more readily available, healthcare workers will get new guidance on how to distribute it.
Right now, the vaccine is at seven health departments in North Carolina, spread out geographically to make it more accessible.
With the JYNNEOS vaccine, you must wait four weeks between your first and second shots. You are fully vaccinated two weeks after your second shot.
With the ACAM2000 vaccine, you are fully vaccinated four weeks after getting your one and only dose.
How many cases are there in N.C. and the U.S.?
North Carolina reported its first case on June 23. On July 6, the state reported its third case, and by July 12, the state was up to 10 cases.
DCHD officials say the person is currently isolating, and close contacts have been notified. To protect patient privacy, no additional information about the person will be shared.
“The Davidson County Health Department is poised and ready to respond to cases of monkeypox in our community,” said Davidson County Health Director Lillian Koontz. “With over two years of extensive, daily work in communicable disease case investigation and contact tracing, our team is well-practiced in all aspects of communicable disease work. Upon notification of the positive result, our skilled nurses were able to communicate isolation procedures to the sick individual and connect with their known close contacts to offer vaccinations.”
North Carolina's 10 cases leave the state tied for the 14th most cases in the country, as of July 12. 27 states, as well as Puerto Rico and Washington D.C., are reporting at least three, and 13 states have as few as one or two cases. Some states are seeing numbers in the triple digits.
New York has reported 158 cases and California is not far behind with 150. Rounding out the top 10 states and territories with the most cases are Illinois with 121, Florida with 72, D.C. with 69, Georgia with 48, Massachusetts with 44, Texas with 39, Pennsylvania with 29 and Virginia with 25. In total, the U.S. is reporting just over 929 cases nationwide.
No cases have yet been reported in Alabama, Alaska, Kansas, Maine, Mississippi, Montana, North Dakota, South Dakota, Vermont and Wyoming.
Those numbers could continue to change as testing becomes more widely available.