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Virginia reports case of monkeypox, state’s first in recent uptick

An electron microscopic image depicting a monkeypox virion, obtained from a clinical sample associated with the 2003 prairie dog outbreak. (Cynthia S. Goldsmith/Centers for Disease Control and Prevention/AFP)
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Virginia public health officials on Thursday reported the state’s first presumed case of monkeypox, in a Northern Virginia woman who had recently traveled to an African country.

The case is among nine recently identified in seven states, officials at the Centers for Disease Control and Prevention told reporters Thursday morning. The state lab identified the case, and as of Thursday afternoon, the Virginia Department of Health was awaiting CDC confirmation.

The patient was not symptomatic and therefore not infectious during travel, state officials said. She did not require hospitalization and is isolating at home. The health department identified her close contacts, who are primarily health-care providers, and is monitoring them.

State Health Commissioner Colin M. Greene stressed that, despite the national uptick, monkeypox is a very rare disease in the United States and that the Virginia patient does not pose a public health risk.

“Transmission requires close contact with someone with symptomatic monkeypox, and this virus has not shown the ability to spread rapidly in the general population," he said.

What is monkeypox, the rare virus now confirmed in the U.S. and Europe?

Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like symptoms and swelling of the lymph nodes and progresses to a rash on the face and body, the state said in a news release. Symptoms generally appear seven to 14 days after exposure and usually clear up within two to four weeks.

The first case in the United States this year was identified last week in Massachusetts, in a resident who had recently traveled to Canada, where cases are also rising. Since then, cases have been identified in Florida, Utah, New York, Washington state and California.

“We need to presume that there is some community spread, but there is active contact-tracing that is happening right now to understand whether and how these cases might have been in contact with each other or with others in other countries," CDC Director Rochelle Walensky said Thursday.

As monkeypox cases rise in Europe and other parts of the globe, health authorities are expressing concern about the unusual uptick. (Video: Alexa Juliana Ard, Meryl Kornfield/The Washington Post)

U.S. public health officials say the cases appear to be concentrated among men who have sex with men, a trend also seen in European countries where the recent increase originated.

Brandy Darby, a veterinary epidemiologist at the Virginia Department of Health, said it is too early to say whether the Virginia case is part of an international cluster or an isolated case.

“It’s a really good reminder that it doesn’t matter what your age or gender or sexual orientation is: Anyone could potentially be exposed to monkeypox if they’ve been in close prolonged contact with an infected person or items associated with that person,” said Darby, an expert on monkeypox because it is an illness that has jumped from animals to humans.

The state health department, she said, will monitor the patient’s close contacts for 21 days after their last exposure and gave them general information about the illness, how it is transmitted and symptoms.

The health department last week advised medical providers in Virginia to watch for cases of monkeypox and report them to local health authorities right away.

CDC monkeypox warning urges ‘enhanced precautions’ for travel

With the global increase in cases, Darby said, patients tend to present with a rash first, without the fever and illness. She said anyone who develops the discrete rash associated with monkeypox and notices a distinct progression from flat red spots to fluid-filled and raised sacks, and who recently traveled internationally or had close contact with a potentially infected person, should contact their health-care provider.

Darby also advised caution. Unlike coronavirus, she noted, monkeypox spreads through direct prolonged contact and people are contagious when symptomatic.

“There are obviously similarities, which gives everyone a little bit of post-traumatic stress," Darby said. "This is somewhat different. … You really need to be touching or in very intimate contact with a person for that transmission to occur. It’s not going to be transferred person to person as readily as covid-19.”

Fenit Nirappil contributed to this report.

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