Monkeypox in Tarrant County: How to know if you’re at risk, and what to do if you are

In May, the first case of the previously rare monkeypox virus was diagnosed in the United States.

Since then, more than 13,000 people have been infected, including at least 78 Tarrant County residents as of Wednesday, according to Tarrant County Public Health.

Monkeypox is not usually fatal, but in some patients it can cause debilitating pain.

“The reality on the ground is that a lot of people with this infection are really suffering, and some actually may be at risk for permanent damage and scarring,” said Dr. Mary Foote, an infectious diseases expert during a panel with the Infectious Diseases Society of America.

Here are answers to some of the most urgent questions about the outbreak. If you have additional questions, you can email findout@star-telegram.com, or call or text health reporter Ciara McCarthy at ‪817-203-4391‬.

How does monkeypox spread?

The latest evidence shows that the outbreak of monkeypox in the U.S. and in Europe is spreading primarily via skin-to-skin contact during sex, said Dr. Susan McLellan, a professor of infectious diseases at the University of Texas Medical Branch. The virus usually spreads when an infected person’s lesions rub against another person’s skin, particularly if the lesions comes into contact with another person’s mucous membranes, like your mouth or your genitals.

It’s also possible for the virus to spread via other methods, like via respiratory droplets that come from an infected person’s mouth, McLellan said, but those other modes of transmission are “just not that efficient.”

Who is most at risk?

Almost all cases of monkeypox in the outbreak — 94% as of July 27 — have been in adult men who had sexual or close intimate contact with men in the three weeks before their symptoms began, according the U.S. Centers for Disease Control and Prevention. There are also a smaller number of cases in nonbinary and trans people, and racial and ethnic minority groups have so far been disproportionately affected.

But, like other illnesses that spread during sexual encounters, it is possible that more people outside of these networks will eventually become infected with monkeypox. Anyone who is sexually active is technically at risk, particularly if they have multiple partners or frequently have unknown partners.

“Anybody who is sexually active is at risk for monkey pox,” said DeeJay Johannessen, CEO of the HELP Center in Tarrant County. “You don’t know who does and doesn’t have it unless there are lesions present.”

But if you’re in a monogamous relationship with a partner, you’re probably OK.

The virus can also spread via soiled linens or fabrics. If someone in your household is infected with monkeypox, then you could be at risk if you don’t properly wash shared linens. But trying on clothes in a store is not likely to cause an infection.

Will we go back to sheltering at home or avoiding large crowds?

No, that’s not likely. SARS-CoV-2, the virus that causes COVID-19, spreads very differently than the virus that causes monkeypox. The virus that causes COVID-19 is airborne, and spreads primarily via respiratory droplets that can transmit easily from person-to-person and can float in indoor spaces for hours.

Monkeypox does not spread that way, and does not spread as easily as COVID-19 does.

“Worrying about it on the bus I think is silly,” McLellan said. “Worry more about being hit by the bus.”

Although it is possible for the monkeypox virus to survive on surfaces, that’s an unlikely way to get infected at this point in the outbreak, McLellan said.

Are kids at risk?

Schools are relatively low risk for spread of monkeypox, McLellan said.

In 2003, when a group of prairie dogs infected with monkeypox spread the virus to at least 78 people, including children, there was no evidence of that those people spread the virus, McLellan said.

It’s possible for children to become infected by someone else in their home, and there are some school activities that could allow for transmission of the virus. McLellan pointed to previous outbreaks of herpes among wrestling teams or at wrestling competitions, where student athletes wear minimal clothing and might share towels or other linens.

But right, now, kids are not at high risk.

How can we slow the spread of the virus?

The best tool to slow the spread is quickly vaccinating people who are highest risk.

What’s critical, McLellan said, is that people who are at risk can safely self-identify if they need the vaccine or if they need treatment for the disease. Discrimination already prevents LGBTQ people from accessing health care, according to surveys, and stigma can cause or exacerbate mental and physical illness among the gay community.

In addition to vaccination, the CDC recommends exchanging contact information with any new partners so you can reach out if you have symptoms of monkeypox. Men who have sex with men should consider reducing their sexual encounters if they want to limit their risk, and discuss any possible exposure to or symptoms of monkeypox before engaging in sex.