The monkeypox virus has spread to at least six men in Oregon in the past three weeks.
Oregon labs confirmed one case in Lane County and two cases in Washington County on Wednesday, according to the Oregon Health Authority. Two others were confirmed July 1 in Lane County, and the first man infected, confirmed in mid-June, lives in Multnomah County.
All of the cases involved men who have sex with men, said Dr. Tim Menza, a senior health adviser for the health authority.
“I point this out not to say that men who have sex with men are the only people at risk for (the virus), but that right now our priority should be empowering men who have sex with men and the larger LGBTQIA+ and queer community and their health care providers with information, testing, prevention and treatment strategies,” Menza said in a statement.
The health authority said it released a community letter before Pride events last month with Multnomah County Health Department and providers. The letter, addressed to the LGBTQ+ community, included information about the outbreak. It stressed the virus is not easily transmissible like the virus that causes Covid and recommended to watch for symptoms. If they emerge, it advised people to isolate at home until seeing a health care provider.
The letter was sent to officials at Pride Northwest and others, including the Q Center, Equi Institute, Quest Center for Integrated Health that have LGBTQ outreach lists or email links, according to Kate Yeiser, a spokeswoman for the Multnomah County Health Department. The county staffed a booth during Pride events, directing people to the federal Centers for Disease Control and Prevention for information.
“The reach is not adequate or systematic overall,” Yeiser said. “We are working to set up a liaison list that community based organizations, service providers, LGBTQ businesses, and community members can join for updates when we do have increases in current health conditions or new emerging conditions.”
About 4% of men in Oregon have sex with men, said Jonathan Modie, a spokesman for the health department. He said that translates to almost 90,000 men.
The health authority is also trying to raise awareness in other ways, including through social media, it said.
“An OHA team also has begun working with community-based organizations to develop culturally tailored awareness and prevention messaging,” the agency said.
The virus is transmitted through skin-to-skin contact with an infected person. It can also be transmitted through contact with towels, bedding or other objects used by an infected person. And it can be transmitted through respiratory droplets or oral fluids through prolonged face-to-face contact.
Transmission typically involves sex, cuddling, massage, kissing or being close to an infected person.
The disease usually starts with a fever or headache and can include muscle aches, swollen lymph nodes, chills and exhaustion. It is also associated with severe symptoms, including a rash over large areas of the skin, excessive bleeding, an infection of the central nervous system, eye infections or sepsis, a blood infection. An infected person can spread the virus when symptoms start and can remain infectious until the sores have healed.
Testing can take up to three days through a private lab. The health authority is working on expanding testing, it said. Providers can send test samples directly to the Oregon State Public Health Laboratory and no longer need prior approval from OHA.
The first case in Oregon involved a man who traveled to a country where the disease has emerged. But the more recent cases have involved local transmission, the health authority said.
They are part of a global outbreak of more than 7,200 cases, mostly in Europe, though many other areas have been affected as well, according to the Centers for Disease Control and Prevention. The CDC reported more than 600 cases in North America as of Wednesday.
On the West Coast, the virus has infected at least 10 people in Washington and 136 in California. Only one case has emerged in Idaho along with four in Nevada, according to the CDC.
The disease has typically affected Africans, and has been associated with handling bush meat.
Menza advised people planning to attend a gathering, including a party or festival, to be wary of a potential risk.
“We can think about risk on a spectrum,” Menza said. “For example, events like sporting events or concerts, where people are more likely to be fully clothed and unlikely to have skin-to-skin contact, are safer, compared to clubs and parties where people are wearing minimal clothing and there is often skin-to-skin contact or spaces like saunas, bathhouses or sex clubs, where there is minimal to no clothing and often sexual contact.”
He advised new sexual partners to be transparent about any rashes, especially on the genitals or around the anus.
“If you or your partner have been sick recently, are currently sick, or have any new rashes, avoid close, personal and skin-to-skin contact, and talk to a health care provider,” he said.
A vaccine to prevent the disease is given in two doses, starting within 14 days of exposure. Oregon has a limited supply, but new doses have started to arrive from the federal government, the health authority said.
For the moment, doses in Oregon are limited to those who’ve been exposed.
“When more vaccine becomes available, our goal is to offer vaccination to those at increased risk of exposure to (the virus), including cisgender and transgender men who have sex with men and transgender women who have sex with men with more than one sex partner in the prior two weeks,” Menza said.
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