The U.S. Department of Health and Human services declared monkeypox, a potentially serious viral illness that belongs to the orthopoxvirus family and spreads through skin-to-skin contact, a public health emergency on Aug. 4. As of Oct. 3, there have been 26,049 total confirmed monkeypox/orthopox virus cases in the United States, including 74 in Rhode Island, according to the CDC. There have been 68,900 cases globally, according to the WHO.
“We have never seen (monkeypox) spread like this before,” said Philip Chan, consultant medical director of the Rhode Island Department of Public Health and associate professor of medicine and behavioral and social sciences at the University. “What we’re … witnessing now is really a (public health emergency), as (has) been declared by the WHO.”
According to data reported by the CDC, the seven day average of daily monkeypox cases peaked around August 10 and has been declining since.
A vaccine is currently available to prevent monkeypox, recommended by RIDOH specifically for groups that are typically impacted by the disease. The vaccine consists of two doses administered 28 days apart. Brown will host a monkeypox vaccine clinic Oct. 15. RIDOH also provides a list of community vaccination clinics available on their monkeypox web page.
“With a significant number of folks being vaccinated, we are actually seeing decreasing trends in monkeypox, finally, across the world, across the U.S. and most states in the country,” Chan said.
The University will report cases to the community “only when there is a public health rationale for doing so, such as providing information that would help community members respond in ways that can help make them safer,” wrote Vanessa Britto MSc’96, associate vice president for health and wellness, in a Sept. 2 email to the University community.
Symptoms and science
Historically, monkeypox tended to cause sporadic outbreaks in central and west Africa, yet has recently spread “like never seen before,” Chan said. Monkeypox spreads through skin-to-skin contact, which occurs in many instances through sexual contact. Though anyone can contract the virus, gay, bisexual and other men who have sex with men are disproportionately affected.
If an individual believes they have contracted monkeypox, they should check in with a doctor or a clinic “immediately,” Chan said, adding that individuals should call their doctor or clinic prior to their visit so their doctor can be aware and take any necessary precautions.
According to Britto’s Sept. 2 email, students that believe they’ve contracted the virus should first reach out to Health Services to schedule an appointment with a provider. Those who test positive for the monkeypox virus are then required to isolate in accordance with CDC and RIDOH guidelines. The University will provide temporary isolation housing to students but “travel home will be an important consideration whenever possible.”
According to RIDOH’s website on Monkeypox information, “infection typically begins with flu-like symptoms and swelling of the lymph nodes and progresses to a rash on the face and body.” If they have reason to do so, an individual’s healthcare provider may swab the skin of the rash or lesion to be sent for monkeypox testing, Chan said.
The JYNNEOS vaccine used to prevent monkeypox was initially designed and used for the prevention of smallpox, which is also in the orthopoxvirus family. Immunity to one virus in the family also provides immunity against the other viruses in the family, Chan noted, but people are typically not vaccinated against smallpox because it has been “theoretically eradicated from the world.” But because of concern over smallpox in the military, there are “national stockpiles” of vaccines.
The vaccine is a two dose vaccine series, administered at least 28 days apart. According to RIDOH’s webpage on monkeypox, “vaccination within four days of exposure can prevent illness and if given within 14 days of exposure can significantly reduce severity of illness should the person develop illness.”
“There is some early emerging data that is showing that (the vaccine) appears to be quite effective,” Chan said.
“We do recommend that Brown community members who are eligible to receive the vaccine do so,” Britto wrote in an email to The Herald.
Lena Noya ’25 received the monkeypox vaccine at a clinic hosted by Open Door Health. After calling ahead to make sure there were appointments available, she went to the clinic with a few friends.
“It seems like the safe thing to do,” Noya said. “I think if it’s available, there’s no reason not to get it and to prevent the spread throughout the community.” She added that, especially given the party culture on college campuses, monkeypox may be more transmissible.
“Certainly for groups that are impacted by monkeypox, (RIDOH) definitely recommends that those groups get vaccinated,” Chan said. “Really for gay and queer (men) of the Brown community … I would make a strong public health push for them to really consider getting a JYNNEOS vaccine because we are still seeing transmission.”
Noya noted it “would be good” for the monkeypox vaccine to be more readily available to Brown students in the future.
Stigma and support
Monkeypox is not considered a sexually transmitted inflection, rather it is “sexually associated,” Chan said. It is not clear if the virus can be transmitted through genital fluids, but it is associated with intimate skin to skin contact and rashes around the genitalia, rectum and mouth.
There is current debate around classifying monkeypox as a sexually transmitted infection, according to Anthony Faccenda, director of the AIDS Project Rhode Island. Part of the hesitancy in doing so centers around “not wanting to give people a false sense of security,” Faccenda wrote in an email to the Herald. While monkeypox is often contracted through sex, it can also be spread through kissing and, in rarer cases, touching objects used by someone who has monkeypox.
“Labeling something as an STI can lead to stigma and inhibit someone from seeking treatment,” Faccenda continued. “Recently, dozens of (APRI’s) clients have expressed concerns that the climate surrounding monkeypox mirrors that of the HIV/AIDS epidemic of the 1980s.”
“It is crucial not to single out any one group when talking about monkeypox prevention,” Faccenda wrote. “At APRI, we educate all clients on monkeypox, regardless of gender or sexual orientation.”
APRI has worked closely with RIDOH since the start of the outbreak in May to educate Rhode Islanders about the monkeypox virus, Faccenda wrote. In June, the organization started including monkeypox educational materials in their at-home HIV testing program, mailing test kits throughout Rhode Island. The organization has also helped vaccinate 100 individuals during six clinics from August through October.
Correction: A previous version of this story stated that APRI distributed monkeypox tests, when in fact it distributed monkeypox educational materials. The Herald regrets the error.