The Massachusetts Department of Public Health (DPH) confirmed a single case of monkeypox virus infection on May 18, in an adult male with recent travel to Canada.
DPH is working closely with the Centers for Disease Control and Prevention, relevant local boards of health, and the patient’s healthcare providers to identify individuals who may have been in contact with the patient while he was infectious. This contact tracing approach is the most appropriate given the nature and transmission of the virus. The case poses no risk to the public, and the individual is hospitalized and in good condition.
Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of central and west Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products. The virus does not spread easily between people; transmission can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact.
No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria. Since early May 2022, the United Kingdom has identified 9 cases of monkeypox; the first case had recently traveled to Nigeria. None of the other cases have reported recent travel. UK health officials report that the most recent cases in the UK are in men who have sex with men.
Based on findings of the Massachusetts case and the recent cases in the UK, clinicians should consider a diagnosis of monkeypox in people who present with an otherwise unexplained rash and 1) traveled, in the last 30 days, to a country that has recently had confirmed or suspected cases of monkeypox 2) report contact with a person or people with confirmed or suspected monkeypox, or 3) is a man who reports sexual contact with other men. This clinical guidance is consistent with recommendations from UK health officials and US federal health officials, based on identified cases.
Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts. Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus. The CDC plans to issue public information soon on poxvirus infections.
