Explainer: Monkeypox has arrived in Long Beach. Who’s at risk and who can get vaccinated?

It took about two and a half months for the global monkeypox outbreak to reach Long Beach, which reported its first case of the disease Saturday. But now that the rare illness is here, what does that mean and how worried should residents be about protecting themselves?

So far, there’s been only 120 cases in Los Angeles County, just under 2,000 confirmed cases nationwide and a little more than 13,000 cases around the world, but the fact that most of those cases are occurring in areas where there’s no history of monkeypox is alarming public health specialists.

“It is not new, but this is by far the largest outbreak of monkeypox outside of Africa ever,” said Andrew Noymer, an associate professor of public health at UC Irvine. “It may be the largest human outbreak ever.”

Though monkeypox is very similar to smallpox, health officials consider it far milder. Symptoms, which can be painful, typically last two to four weeks, according to the California Department of Health.

Monkeypox symptoms include fever, muscle aches, chills, exhaustion and painful lesions that can appear on the face, inside the mouth or on other parts of the body like the hands, feet, chest, genitals and anus. The infected person in Long Beach is recovering at home, according to health officials, who said the patient has no recent travel history, which could indicate the disease was already spreading locally.

While monkeypox can cause death, its fatality rate is very low. None of the patients in LA County have died or even been hospitalized, according to Dr. Rita Singhal, director of the disease control bureau at the LA County Department of Public Health.

In fact, the World Health Organization has recorded just three deaths worldwide since the start of the year, according to Reuters. All three deaths were in Africa, according to the WHO.

Unlike COVID-19, which is a novel variant of coronavirus, much is already known about monkeypox. Nevertheless, there are significant public health challenges when dealing with monkeypox.

Here’s what we know.

How easily does it spread?

Monkeypox is not nearly as contagious as a disease like COVID-19. It is spread through direct contact with an infected person’s body fluids or lesions, or contaminated materials such as clothing or linens, and through respiratory droplets through prolonged face-to-face contact with an infected person, according to Long Beach health officials.

Only symptomatic patients can spread monkeypox, according to the CDC.

Who can get monkeypox?

Though health officials say the risk of contracting monkeypox is very low, anyone can get it, according to public health officials.

While monkeypox is not a sexually transmitted disease, many of those affected in the current global outbreaks are gay, bisexual, or other men who have sex with men, according to the CDC.

Is there a vaccine against monkeypox?

Yes. It’s called JYNNEOS and was originally designed to vaccinate against smallpox. Like the vaccines used against COVID-19, it’s a two-dose regimen, with the second dose given four weeks after the first, though anyone who was previously vaccinated against smallpox may only need one dose, according to the CDC.

Smallpox was eradicated in the U.S. in 1972, ending routine vaccination against it, according to the CDC. Vaccine boosters are recommended between two and 10 years after the initial vaccination for people at continued risk of exposure to smallpox, monkeypox or other related viruses, according to the CDC.

Who should get vaccinated against monkeypox?

Ideally, everyone should get vaccinated, according to Noymer, the public health professor.

“It can spread by skin-to-skin contact, so handshakes can spread this in theory,” Noymer said. “I’m not saying anyone has gotten it this way, but it is possible.”

Noymer also noted that the JYNNEOS vaccine has very few side effects, while the original smallpox vaccine had far harsher side effects, which included possible death.

But because the U.S. has so little of the JYNNEOS vaccine stockpiled, there are strict eligibility requirements as to who can get vaccinated now.

Currently, Long Beach health officials are limiting vaccination to the following categories:

  • people who have been exposed to a person confirmed to have been infected with monkeypox
  • people with established care at specialty clinics where there was high risk of exposure to monkeypox
  • gay and bisexual men and transgender people with a diagnosis of rectal gonorrhea or early syphilis within the past 12 months who have a doctor’s referral or proof of a positive result
  • gay or bisexual men and transgender people who are on HIV pre-exposure prophylaxis (PrEP)
  • gay or bisexual men and transgender people who attended saunas, bathhouses, sex clubs, circuit parties, or sex parties where they had anonymous sex or sex with multiple partners

LA County public health officials have similar criteria.

Those eligible for the vaccine should call their health provider. If they don’t have a health provider, they can call the city’s public health hotline (562-570-7907) for assistance in getting tested and vaccinated.

It is unclear whether vaccine eligibility will expand to include the general population, according to Long Beach health officials.

What if I’ve been exposed to monkeypox. Can I still get vaccinated?

Yes. If a vaccine is administered within four days of exposure to monkeypox, it can prevent infection entirely, according to Dr. Dawn Terashita, associate director of LA County’s acute communicable disease control program.

Vaccinations administered within 14 days of exposure can also help limit symptoms, according to Terashita.

But ideally, vaccination is best when administered before exposure.

What is the procedure for people to get tested for monkeypox?

Currently, the only approved way to test for monkeypox is to swab infected lesions, but it can take weeks for these to develop in an infected person, according to the Food and Drug Administration. Results should be available one to two days after testing, according to health officials.

Because confirmed cases are overwhelmingly male, Noymer believes women are underrepresented in the data showing who is contracting monkeypox.

“We need better testing,” said Noymer. “Anything that is a painful rash needs to be tested for monkeypox. Most will be shingles or whatever, but we need to test.”

In Long Beach, anyone who feels they should get tested should go to their health care provider, according to city health officials. Those without insurance should go to the nearest emergency department or urgent care clinic for testing and treatment, health officials said.

Are there antivirals that can treat monkeypox?

While monkeypox typically resolves on its own, there is an “investigational new drug” called TPOXX that can alleviate some of the pain and discomfort it causes, according to health officials.

Because the drug was not designed for use against monkeypox and hasn’t been approved for such use, those wishing to take it must ask their health provider, who in turn will consult with public health officials, said Terashita.

Editor’s note: After this story was published, the city of Long Beach announced new categories of people eligible for the monkeypox vaccine. The article has been updated with that information.

Long Beach reports first presumptive case of monkeypox

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Anthony Pignataro is an investigative reporter and editor for the Long Beach Post. He has close to three decades of experience in journalism leading numerous investigations and long-form journalism projects for the OC Weekly and other publications. He joined the Post in May 2021.
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