12.12.2024

Penn State University student tests positive for monkeypox

A student at Penn State University has tested positive for monkeypox as experts fear the coming fall semester will spark outbreaks of the virus.

Health officials at the university said the unnamed student is now in isolation and that their close contacts were being traced.

The individual attends the University Park campus in central Pennsylvania, the college’s largest with some 46,000 undergraduates, but they reside off-campus.

The student received the positive result on August 13, about a week before the start of the fall term on August 22.

There are mounting concerns the return of colleges and universities could help drive the viral outbreak, with the latest case marking the second at a college this month. On Thursday, the University of Maryland said a staff member had a presumptive case and that more infections will likely be detected in the coming weeks.

America has spotted more than 14,115 monkeypox cases so far with the vast majority among gay or bisexual men, although it is feared the virus — which is spread via physical contact — will spread to other groups.

A student has tested positive for monkeypox at Penn State University. They attend the University Park campus (pictured) – the largest at the college – but do not live on site

A student has tested positive for monkeypox at Penn State University. They attend the University Park campus (pictured) - the largest at the college - but do not live on site

The above map shows the number of monkeypox cases detected by state. The outbreak is largest in New York, California and Florida

Monkeypox is primarily spread by skin-to-skin contact with lesions on an infected individual — mostly via sex in the current outbreak — but it can also be transmitted through touching scabs left by patients on clothing and bedsheets.

Penn State University revealed the monkeypox case this week, advising any students experiencing symptoms to contact their health provider.

They did not reveal the age of the student, whether they had visited the campus, or how many people were being contact traced, citing privacy concerns.

The college is one of America’s largest, with more than 73,000 undergraduates spread across 20 campuses.

The case only adds to concerns that the return of colleges this month could spark an uptick in monkeypox infections, amid close contact between students.

Announcing its first monkeypox case yesterday, the University of Maryland’s health director Spyridon Marinopoulos said: ‘As this disease continues to be present across the country and the world, it is likely we will experience monkeypox cases on campus.’

He also urged anyone suffering symptoms — including a rash — to contact university health services or their healthcare provider.

The above shows the number of monkeypox cases detected by day (yellow bars) and the seven-day average (white line)

This map highlights states with the largest uptick in monkeypox cases compared to a week ago, and the hotspot (New York in red)

This map highlights states with the largest uptick in monkeypox cases compared to a week ago, and the hotspot (New York in red)

Several universities already have monkeypox tests on site for students, while others have prepared accommodation to help those who catch it isolate if necessary.

But there is mounting fear in the academic and scientific community that the return of academic institutions could spark an uptick in cases.

Dr Rachel Cox, an assistant professor in at the MGH Institute of Health Professions, told CNN earlier this month: ‘As we head into the fall, I’m concerned about outbreaks on college campuses as they are often a place where individuals engage in higher risk sexual activity and are in close contact with many different people.

‘We need to make sure we’re prepared to allocate resources like tests, vaccines, and antivirals to places that may become hotspots.’

Andrea Conner, the head of student affairs at Lake Forest College in Illinois, says there is a ‘lot of fear’ the start of the new academic year could lead to more cases in universities.

She told NPR that the same team that handled Covid is already putting together guidance for students to avoid monkeypox, and plans are being put in place to help those who may contract the virus.

Monkeypox infections tend to begin with flu-like symptoms about three days after infection before a rash appears and then spreads across the body. Patients are required to isolate for around four weeks, until the rash has scabbed over and the scabs have fallen off.

In the current outbreak, however, many patients are experiencing rashes in the genital area as a first symptoms before these spread across the body.

The main treatment available at present is TPOXX — an antiviral which stops the virus spreading to other cells slowing down an infection.

Some patients may also be offered the monkeypox vaccine to treat their infection.

Penn State warned today that students could catch monkeypox through direct contact with rash, scabs, bodily fluids or droplets from an infected person. They also said touching fabrics previously touched by the rash of a patient or being scratched or bitten by an infected animal puts them at risk.

To avoid catching the disease, they said students should not have close, skin-to-skin contact with anyone who looks like they may have monkeypox.

This includes not kissing, hugging, cuddling or having sex with a suspected patient, not sharing eating utensils or cups, and not handling their bedding.

More than nine in ten infections are currently being detected among gay or bisexual men, with an average age around 35 years old. Sixty percent of cases are in people of color.

But there are mounting concerns that the virus will start to spill over into other groups — including the student population which was also a hotbed of COVID-19 transmission during the pandemic.

New York is the national hotspot with 2,744 infections detected, followed by California with 2,663 and Florida with 1,372.

At the other end of the scale, Wyoming is now the only state not to have spotted a case of the disease. Alaska, Montana, South Dakota and Vermont have each detected two cases.

How DO you catch monkeypox and what are the symptoms? Everything you need to know about the virus

Nurses and doctors are being advised to stay 'alert' to patients who present with a new rash or scabby lesions (like above)

How do you catch monkeypox?

Until this worldwide outbreak, monkeypox was usually spread by infected rodents — including rats, mice and even squirrels — in west and central Africa.

Humans can catch the illness — which comes from the same family as smallpox — if they’re bitten by infected animals, touch their blood, bodily fluids, or scabs, or eat wild game or bush meat.

The orthopoxvirus, which causes monkeypox, can enter the body through broken skin — even if it’s not visible, as well as the eyes, nose and mouth.

Despite being mainly spread by wild animals, it was known that monkeypox could be passed on between people. However, health chiefs insist it was very rare until the current outbreak.

Human-to-human spread can occur if someone touches clothing or bedding used by an infected person, or through direct contact with the virus’ tell-tale scabs. The virus can also spread through coughs and sneezes.

In the ongoing surge in cases, experts think the virus is passing through skin-to-skin contact during sex — even though this exact mechanism has never been seen until now.

How deadly is it?

Monkeypox is usually mild, with most patients recovering within a few weeks without treatment.

Yet, the disease kills up to 10 per cent of cases. But this high rate is thought to be in part due to a historic lack of testing meaning that a tenth of known cases have died rather than a tenth of all infections.

However, with milder strains the fatality rate is closer to one in 100 — similar to when Covid first hit.

The west African version of the virus, which is mild compared to the Central African strain, is behind the current spread. No deaths have been reported as part of the ongoing outbreak.

How is it tested for?

It can be difficult to diagnose monkeypox as it is often confused with other infections such as chickenpox.

But when a case is suspected doctors send samples to their local health authorities to be tested for orthopox viruses — the family of viruses that includes monkeypox and smallpox. If the result is positive, the sample is then sent to the Centers for Disease Control and Prevention (CDC) or a private laboratory for confirmatory testing.

The test involves taking samples from skin lesions, such as part of the scab, fluid leaking from them or pieces of dry crusts.

What are the symptoms?

It can take up to three weeks for monkeypox-infected patients to develop any of its tell-tale symptoms.

Early signs of the virus include a fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion — meaning it could, theoretically, be mistaken for other common illnesses.

But its most unusual feature is a rash that often begins on the face, then spreads to other parts of the body, commonly the hands and feet.

The rash changes and goes through different stages before finally forming a scab, which later falls off.

How long is someone contagious?

An individual is contagious from the point their rash appears until all the scabs have fallen off and there is intact skin underneath.

The scabs may also contain infectious virus material.

The infectious period is thought to last for three weeks but may vary between individuals.

What do I do if I have symptoms?

The CDC advises anyone with an unexplained rash or another warning sign to contact their healthcare provider for a medical assessment and monkeypox test. Anyone who does not have insurance should visit a public health clinic.

Suspected patients should also avoid close contact — including sex or being intimate — with others, they add.

When they visit a clinic it is also advised to wear a mask, and remind the healthcare provider that the virus is circulating in the area. Gay and bisexual men have been asked to be especially alert to the symptoms as most of the cases have been detected in men who have sex with men.

What even is monkeypox?

Monkeypox was first discovered when an outbreak of a pox-like disease occurred in monkeys kept for research in 1958.

The first human case was recorded in 1970 in the Democratic Republic of Congo and the infection has been reported in a number of central and western African countries since then.

Only a handful of cases have been reported outside of Africa and they were confined to people with travel links to the continent.

The UK, U.S., Israel and Singapore are the only countries which had detected the virus before May 2022.

But as testing was ramped up globally cases were quickly detected in other countries — including the first case in the U.S. in May in a man who had recently returned from Canada by car.

Monkeypox is a rare viral infection which kills up to one in ten of those infected but does not spread easily between people. The tropical disease is endemic in parts of Africa and is known for its rare and unusual rashes, bumps and lesions (file photo)

Nurses and doctors are being advised to stay ‘alert’ to patients who present with a new rash or scabby lesions (like above)

Is it related to chickenpox?

Despite causing a similar rash, chickenpox is not related to monkeypox.

The infection, which usually strikes children, is caused by the varicella-zoster virus.

For comparison, monkeypox — like smallpox — is an orthopoxvirus. Because of this link, smallpox vaccines also provide protection against monkeypox.

Are young people more vulnerable?

Americans aged under 50 may be more susceptible to monkeypox, according to the World Health Organization.

This is because children in America were routinely offered the smallpox jab, which protects against monkeypox, until 1972. The programme was halted once smallpox had been eradicated.

The WHO also warns that the fatality rate has been higher among young children.

Does it spread as easily as Covid?

Leading experts insist we won’t be seeing Covid-style levels of transmission in the monkeypox outbreak.

A World Health Organization report last year suggested the natural R rate of the virus – the number of people each patient would infect if they lived normally while sick – is two.

This is lower than the original Wuhan variant of Covid and about a third of the R rate of the Indian ‘Delta’ strain.

But the real rate is likely much lower because ‘distinctive symptoms greatly aid in its early detection and containment,’ the team said, meaning it’s easy to spot cases and isolate them.

Covid is mainly spread through droplets an infected person releases whenever they breathe, speak, cough or sneeze.

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox, including the drug tecovirimat or TPOXX, which was approved for monkeypox in the U.S. in August

Is there a vaccine for it?

The smallpox vaccine, called Imvanex in the UK and Jynneos in the U.S., can protect against monkeypox because the viruses behind the illnesses are closely related.

Data shows it prevents around 85 per cent of cases, and has been used in the U.S. since 2019.

The jab, estimated to cost $24.16 per dose, contains a modified live vaccinia virus, which is similar to both smallpox and monkeypox, but does not cause disease in people.

Because of its similarity to the pox viruses, antibodies produced against this virus offer cross protection.

Are there any drugs to treat it?

There are a handful of antivirals and therapies for smallpox that appear to work on monkeypox.

This includes the drug tecovirimat — also known as TPOXX —, which was approved for use against monkeypox in the U.S. in August.

Tecovirimat prevents the virus from leaving an infected cell, hindering the spread of the virus within the body.

An injectable antiviral used to treat AIDS called cidofovir can be used to manage the infection, according to the US Centers for Disease Control and Prevention (CDC).

It also works by stopping the growth of the virus.

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