By Amira Van Leeuwen
HAYS COUNTY — Monkeypox is believed to have been around for centuries but was first noticed in 1958 in rodents in Africa. The disease belongs to a family of viruses called poxviridae, and within the poxviridae family are different viruses. One of the viruses within the poxviridae family is called orthopox, which is where Monkeypox sits.
According to an Aug. 12 press release, the Hays County Local Health Department (HCLHD) identified two confirmed cases of Monkeypox. On Aug. 23, Texas State University announced that an individual in the university community had tested positive for Monkeypox.
Texas State students, faculty and staff were informed that the individual lives off campus and would remain isolated until the rash heals and is no longer contagious, as recommended by CDC guidelines.
Texas State University started preparations for Monkeypox before the semester began, according to Dr. Emilio Carranco, director of the Student Health Center. University medical staff was trained to identify signs and symptoms and test for Monkeypox – the university also communicated to all faculty, staff and students before the start of the semester to raise awareness about the infectious diseases that they should be aware of.
Texas State’s initial efforts are surrounded by educating students on these infectious diseases. So far, they’ve handed out informational flyers to students with written information about COVID-19, instructions on how to recognize Monkeypox, whom to contact for evaluation and testing, as well as emails with updates.
“I think one of the things that we're seeing in this country is that infectious diseases are becoming more common. I think part of the reason for that is because people are not vaccinating. People seem to have forgotten the history around vaccinations,” Dr. Carranco said.
“Before the 1960s, there were several diseases that were running rampant in our population and causing a lot of serious illness and death. Vaccines were developed and within a few years, what we saw was these diseases started to disappear. And in some cases, some of them completely disappeared. And that was absolute proof that vaccines work. Somehow, over time, through misinformation, perhaps, or just forgetting our history, people have begun to think that vaccines are not that important. And some people even think that they are dangerous,” Dr. Carranco said. “And so now we're starting to see diseases coming back on our campuses that we didn't use to see,” he said.
Carranco thinks it’s important for the Texas State community to be informed and look toward reliable resources for information. Carranco says that the university will continue to monitor COVID-19 and Monkeypox.
“I want everyone to be reassured that we’re looking at this and that we’re constantly evaluating the threat to our community,” Dr. Carranco said.
Vaccinations
Although smallpox vaccinations are believed to protect against Monkeypox, those vaccinations may experience waning after 20-40 years, which is when the vaccine's effectiveness diminishes. Dr. Rodney Rohde, a credentialed specialist in microbiology, virology and molecular diagnostics, says that if a person exposed to Monkeypox received their smallpox vaccine in the early 70s, it could be challenging to get protection.
Dr. Rohde says if the virus finds a rodent or domestic animal where it can maintain its ability to live without killing it, the disease could become endemic; however, Dr. Rhode hasn’t seen evidence showing that this particular Monkeypox strain in the United States has been mutating or growing virulent.
“It’s frustrating that people have turned this into something other than a disease,” Dr. Rohde said. “Diseases don’t care if you’re a Democrat, Republican or Independent or something else.”
The infectious disease expert says that we will continue to see the introduction of infectious agents like African swine fever.
“Regardless of where you stand, viruses and microbes and bacteria really don't care about who we are, how much money we make, where we live, how we vote. It's just not that way. They're not biased at all. All they exist for is to infect, cause problems and then jump to the next person. That's their goal and their lives,” Dr. Rohde said.
The HCLHD was one of the few health departments selected to receive a limited supply of vaccinations and is offering it to those who have had direct exposure to Monkeypox, including people who are engaging in group sex or are attending large events.
“We’re hopeful that we’ll be receiving more vaccines, hopefully in the coming months,” Ian Harris, HCLHD epidemiologist said.
The HCLHD is not releasing a specific number of vaccinations at this time because of the change in the way the Monkeypox vaccine is given.
According to Harris, the vaccine initially came out in one vial, which was equivalent to one dose; however, due to the new FDA Emergency Use Authorization, they are allowing five doses to come from one vial. The vaccine is also now authorized for children.
“The original way was a subcutaneous shot. The new method under the emergency use authorization is called an intradermal vaccination so it’s kind of similar to the way a TB screening test would be given just right under the skin,” Harris said.
Harris said the new method opens the United States up to using the limited doses on more people, as opposed to the one dose per vile.
“I think it’s important for the public, for Hays County, to know if anybody has a positive test, they can always contact us, and we’ll be in contact as well to do the investigation,” Harris said, “but we’re able to make a request to the Department of State Health Services to get the T-Pox antivirals, and that would be delivered to their healthcare provider so that they can prescribe that to their patient,”
Currently, Hays County’s vaccination distribution schedule is on a case-by-case basis based on whether or not someone calls and says that they have been or there is a chance they have been exposed to Monkeypox.
“Anybody, honestly, is welcome to contact us. We can go through their risk exposure and determine if they should receive a vaccine or not,” Harris said.
Demographics
Data the HCLHD has received from the Texas Department of State Health Services and epidemiological investigations show that men who have sex with men (gay, bisexual, transgender, nonbinary) are affected. Harris said that there is a strong link showing that members of the LGBTQ+ community are at a higher risk of contracting Monkeypox.
However, Harris also said that everyone is at risk of getting it. “There’s been a lot of people that have been saying that this is the only way you can get it, which is not true,” he said.
The epidemiologist explained that Monkeypox is primarily a direct-contact disease but can also be transmitted through respiratory secretions like sneezing, coughing or sharing a drink with someone. Harris said that it is not solely limited to the men who have sex with men community.
“Everybody is at risk,” Harris said.
Harris also said that he thought it was important for the public to know that a lot of people who have been investigated already have attended things like group sex parties or have had anonymous sex partners. It is not solely limited to the men who have sex with men community.
“It’s more of a behavior, rather than a certain group because it [Monkeypox] can really happen to anybody. And that’s kind of what we’re anticipating, is that eventually, this is going to continue to spread out into more of the general population,” Harris said.
Harris said the HCLHD is urging people to limit their number of sex partners and be more conscious about attending a sex party; if people do decide to participate in a sex party, it is a good idea to exchange contact information. Harris also said that people should also be conscious about attending large gatherings, especially in places where there is minimal clothing.
“But, I think what’s important to put out there is that a lot of the people that have been investigated already have attended things like group sex parties, or not, they have anonymous sex partners, things like that,” Harris said.
