Activities that are not safe, experts say

Monkeypox is everywhere now: it has spread to every state in the United States. And if you don’t want to catch it, you need to know what types of activities are safe and what to avoid until it’s gone.

The virus, which was declared a nationwide public health emergency earlier this month, has affected more than 14,000 Americans and continues to count, according to the Centers for Disease Control and Prevention (CDC). That might seem like a small number, especially compared to Covid. But monkeypox is not usually found in North America or Europe at all, making the current surge both noticeable and alarming.

Although not particularly deadly, monkeypox can be a very painful experience that in some cases leaves physical scars. And with rare vaccines and tests backed up in clinics, it’s at least temporarily up to you to protect yourself from infection.

Here’s what you need to know if you’re wondering how safe your plans to date, see friends or go to concerts are amid the monkeypox outbreak:

Close and prolonged contact

There is one key phrase to keep in mind when assessing the risk of monkeypox: close and prolonged contact.

“This virus is not very good at infecting us, unlike Covid, so we need more dose of virus,” says Dr. Katelyn Jetelina, epidemiologist at the University of Texas Health Sciences Center at Houston. “We can get more ‘dose’ through very close contact, or [if we are] exposed longer. »

The specific activity most closely associated with this level of physical contact is sexual intimacy, which Jetelina says helps explain the “clear social networks of transmission” of the virus. So far around 94% of cases have been in men who have sex with men, she says – but it’s not guaranteed that’s always the case.

“It could certainly spill over to other social networks that have close contacts,” says Jetelina. “We haven’t seen that yet, but that doesn’t mean we shouldn’t be prepared.”

Other more casual forms of physical contact do not appear to be major risk factors for the virus: a study published in the New England Journal of Medicine in July found that less than 1% of people infected with monkeypox worldwide had contracted the virus through “non-sexual contact”.

“Casual contact can mean shaking someone’s hand, touching a doorknob, putting on clothes [that someone else has worn]and these types of interactions are not necessarily high-risk,” says Dr. Syra Madad, pathogen epidemiologist at NYC Health + Hospitals.

That means places like restaurants, movie theaters, house parties, or concerts probably don’t pose much of a risk. If you’re still worried, keep this in mind: the chances of infection are always lower with more distance between people, less time spent together, and less skin-to-skin contact.

How to decide what feels safe

So far, only sex – between partners of any gender or sexuality – seems to pose a truly significant risk of monkeypox. Is abstinence the solution? Experts say no.

“We know that asking people to abstain from sex, asking people to abstain from drugs, is not possible,” says Dr. Eric Kutscher, a primary care provider and addiction medicine researcher at NYU Grossman School of Medicine.

Instead, Kutscher advises paying attention to any potential symptoms and taking them seriously if you notice them, either in yourself or in a sexual partner. Check yourself and your partner for any new rashes before getting intimate. Beware of any flu-like symptoms, from fever or chills to cough or headache.

Most importantly, you need to communicate any potential risk with your partner.

“You often have the ability to consent and gain consent from the other person you’re going to be with, as to what risk you’re comfortable with,” Kutscher says. “The most important thing is that everyone makes informed decisions, and for everyone, the calculation of the risk/benefit ratio may be different.”

Kutscher suggests asking yourself a few questions to help you determine your own personal risk calculation:

  • What would a monkeypox infection mean to me?
  • How would this infection affect my life or that of my partner?
  • How would completely avoiding infection affect my life?

Symptoms of most concern of monkeypox

The closest thing to a telltale sign of monkeypox is the rash, which appears as raised rubbery lesions on the skin. A single lesion could be a sign of monkeypox, although some patients experience thousands at a time.

So far, at least 95% of people with monkeypox have developed skin lesions, according to data from the New England Journal of Medicine and Centers for Disease Control and Prevention.

A classic monkeypox lesion develops a spot that may feel firm in the center, similar to a pimple. The resemblance to acne can be stressful, even for doctors. So how can you tell which is which?

“It’s not so much how [lesions] you have, but how different it is from your usual baseline,” says Kutscher. “If you typically have acne and you have a pimple that looks like a pimple in an area where you usually , it’s probably a button.

Most monkeypox lesions are not necessarily painful, with the exception of those in the genital area. These can be excruciating, and they’ve affected about 47% of those infected in the United States. If you develop unexpected new lesions – anywhere on your body – you should contact your doctor.

This is especially true if you also have other symptoms like fever, chills, swollen lymph nodes, or body aches. These flu-like symptoms often begin four or five days before the rash appears and up to 21 days after exposure, but some people don’t experience them until after the lesions appear. Others never have any at all.

The test usually involves swabbing at least one, and often two, lesions. If you haven’t developed one, but have other symptoms of monkeypox, Kutscher says you should refrain from jumping to conclusions: “In people with no known exposure and no general prodromal symptoms, it could be n anything.”

In this scenario, consider temporarily avoiding risky contact with others and waiting until you see lesions to head to an overwhelmed clinic for testing. If the lesions never show up and your other symptoms go away, you’re probably safe, the CDC says.

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