Monkeypox Update and FAQs
Updated guidance and information about the monkeypox outbreak
An update on the current monkeypox outbreak
There is an ongoing outbreak of monkeypox (MPX) in several countries that do not normally report monkeypox, including in the United States. While there is reason for concern regarding this current MPX outbreak, panic is not warranted.
Currently, cases of MPX are primarily reported among social networks of men who have sex with men (MSM). At this time, the overall risk of MPX to the general population appears to be low as it is primarily spread through direct, often intimate contact, and is not known to spread easily through casual contact. However, it is likely that others beyond the MSM community will get infected.
In the context of this outbreak, there is a risk of stigma and discrimination against persons with MPX or those groups at risk for it. Every effort must be taken to reject stigmatization and discrimination.
The University is closely monitoring the situation based on data reported by the New York City Department of Health and the CDC and will continue to communicate with the community as the outbreak evolves.
Frequently Asked Questions (FAQs)
Monkeypox is a rare condition caused by infection with the monkeypox virus. Monkeypox virus belongs to the same family of viruses—known as orthopoxviruses—as the smallpox virus. However, while monkeypox symptoms are similar to those of smallpox, they tend to be milder, with very rare fatalities. This virus has been circulating in some regions of the African continent for several decades, however, most prior outbreaks outside these regions have been small in size. The current outbreak is notable for the relatively large number of cases and breadth of countries from which cases have been reported.
Symptoms of monkeypox can include the following:
- Fever
- Headache
- Muscle aches and backache
- Swollen lymph nodes
- Chills
- Exhaustion
- Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)
- A rash that can look like pimples or blisters that appears on the face, inside the mouth, and on other parts of the body, like the hands, feet, chest, genitals, or anus.
The rash goes through different stages before healing completely. It is important to note that in the current outbreak, people have reported getting a rash first, followed by other symptoms. Others only experience a rash.
The illness typically lasts 2-4 weeks and recovery is determined when symptoms and rash have completely resolved.
The monkeypox virus is most often spread through direct contact with a rash or sores of someone who has the virus. It can also spread through contact with clothing, bedding and other items used by a person with MPX, or from respiratory droplets that can be passed through prolonged face-to-face contact.
The following steps can prevent one from getting monkeypox:
- Avoid close, direct skin-to-skin contact with people who have a rash that looks like monkeypox or those diagnosed with MPX. Do not touch rash or scabs and avoid kissing, hugging or other intimate contact with a person with MPX.
- Do not handle or touch the bedding, towels, or clothing of a person with MPX.
- Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
Resource: CDC: Social Gatherings, Safer Sex and Monkeypox
Vaccination
Monkeypox vaccination with the JYNNEOS vaccine is currently recommended for people who have had contact with someone with MPX and those who are at higher risk of being exposed to MPX.
The vaccine is recommended as two doses, at least four weeks apart.
Resource: JYNNEOS Vaccine for Monkeypox: Frequently Asked Questions
Vaccine eligibility
Eligibility for MPX vaccination may change as the outbreak evolves and based on vaccine supply. Currently, in New York City, adults 18 years of age or older who meet any of the following criteria are eligible for vaccination:
- People who have had multiple or anonymous sex partners in the last 14 days, and identify as one of the following:
- Gay, bisexual, or other man (cisgender or transgender) who has sex with men (cisgender or transgender) or transgender women
- Transgender, gender non-conforming or gender non-binary
- Sex workers and anyone engaging in survival sex or any other types of transactional sex (including sex in exchange for money, food, shelter or other goods) of any sexual orientation or gender identity
- People who have been informed by the Health Department that they are a close contact of someone with monkeypox.
How to get vaccinated
Eligible persons can schedule an appointment through the city’s online vaccine finder. NYC currently has a limited number of doses of the vaccine, thus, appointments may be difficult to secure. However, more vaccine doses are anticipated to be available in NYC over the next several weeks.
For those who have been informed by the Health Department that they are a close contact of someone diagnosed with MPX, the department will provide instructions about where to get vaccinated.
Most people with MPX have self-limited illness and require only supportive care. However, for some, antivirals such as tecovirimat (TPOXX) are recommended. These include people with more severe illness and those who are more likely to get severely ill with MPX, such as individuals with weakened immune systems.
Persons with MPX are encouraged to talk to their provider to find out if they are eligible for antiviral treatment. They may also be able to obtain medications to alleviate the symptoms of MPX.
If a person starts experiencing symptoms, they must isolate (see Monkeypox Isolation Protocols below) immediately and talk to their health care provider. If a person does not have a health care provider, it is recommended to call 311 or search the NYC Health Map. A provider will conduct an evaluation and may order testing and referral for further management.
Columbia University students can also access evaluation, testing, and guidance at Columbia Health (for Morningside students) and Student Health on Haven (for CUIMC students).
A person with MPX is contagious until all symptoms have resolved and all sores have healed and a new layer of skin has formed on all sores, which can take 2-4 weeks.
A MPX diagnosis is considered private health information and affiliates who are diagnosed with MPX are not required to disclose their diagnosis to course instructors or supervisors when requesting accommodations during their isolation period.
Monkeypox Isolation Protocols
Isolation for cases with monkeypox infection is required. Columbia University has updated its isolation guidance for its affiliates based on recent changes in the isolation protocols as per the CDC and New York City Department of Health. The University guidance aims to be consistent with these new protocols while acknowledging the importance of minimizing academic disruption for students diagnosed with Monkeypox infection.
- All students who are symptomatic with a fever or any respiratory symptoms, including sore throat, nasal congestion, or cough, must remain in isolation at all times and away from others, unless it is necessary to see a healthcare provider or for an emergency.
- Students with no fever or respiratory symptoms, but in whom rash persists, may break isolation only to attend classroom-based courses and labs that do NOT involve performances or patient-facing clinical activities. Clarification regarding which classes/labs would be permissible to attend can be sought from the contact tracing team. While attending such classes or labs, students must:
- Cover all parts of the rash with clothing, gloves, and/or bandages.
- Wear a well-fitting mask to prevent the wearer from spreading oral and respiratory secretions when interacting with others until the rash and all other symptoms have resolved.
- Return immediately to isolation after class or lab is completed
- Students should isolate, with the exception of attendance of classroom-based courses and labs as noted above, until all signs and symptoms of monkeypox illness have fully resolved. This includes:
- Refraining from participating in extra-curricular or athletic activities
- Not sharing items that have been worn or handled with other people or animals. Launder or disinfect items that have been worn or handled and surfaces that have been touched by a lesion.
- Avoiding close physical contact, including sexual and/or close intimate contact, with other people.
- Avoiding sharing utensils or cups. Items should be cleaned and disinfected before use by others.
- Avoiding crowds and congregate settings.
- Washing hands often with soap and water or using an alcohol-based hand sanitizer, especially after direct contact with the rash.
Faculty and staff:
Faculty and staff must isolate at home and follow all isolation requirements until all signs and symptoms of monkeypox illness have fully resolved, unless it is necessary to see a healthcare provider or for an emergency.
All contacts should do the following:
- Seek vaccination as soon as possible, ideally within five days of contact
- Monitor closely their health and if develop symptoms, promptly seek consultation with provider or through student health services.
Sources: CDC and New York City Department of Health and Mental Hygiene