Risk Low From New Kind Of Mpox Showing Up In U.S.

The first known U.S. case of an emerging Mpox strain was identified in California on Nov. 16, 2024. While the risk to the public remains very low, West Virginia Public Broadcasting’s Health Reporter, Emily Rice, spoke with Michael Kilkenny, the executive director of the Cabell/Huntington Health Department, about the new type of Mpox and how to avoid it.

The transcript below has been lightly edited for clarity.

Rice: All right, so we wanted to go ahead and talk about Mpox, and I wanted to go ahead and clarify. Is this the same virus that we were referring to as monkeypox, but we’re not calling it that anymore, right?

Kilkenny: Yes, Mpox is the new name for monkeypox. It was called monkeypox. But I don’t know who wants to have monkeypox. Mpox is a little bit less threatening to some people. It is the same disease, the same virus. This clade difference is the only distinction. There are two main clades of Mpox and a clade is –  it’s not like a variant, it’s like the ancestor chain of variants. So this is a group of Mpox viruses then that would all come from one common Mpox ancestor that’s different from the other one, and the Mpox that we dealt with, I believe it was in 2022, that was clade II. This is the first case of clade I that we’ve had in the United States.

Rice: We have this first case reported in the U.S. We’ve already talked about the differences between the two strains. But as far as protecting ourselves, is there a difference between the two strains and how we as citizens should react and protect ourselves?

Kilkenny: The advice for protection for the general public is essentially the same. As far as the same people are eligible for vaccination. The same discussion occurs regarding contact with people who are ill – contact with the bedding that they’ve used, or the clothes that they wore, and those kinds of things. That all remains the same, and the treatment of this will probably be the same also. So the recommendations are not really very much different. It’s just that we’re making people aware that this can spread. It does spread largely through travel.

Rice: So people who may have been vaccinated for the other strain, do they need to get another vaccine for this new strain?

Kilkenny: No, the vaccine for the previous strain is thought to be effective against this one also. So we’re still using that. We’re still advising people who are at risk of clade II, the more common one, that still has spread in the United States, although very low. We’re still advising those people at risk to get vaccinated. We’re not expanding that list of people in terms of the new clade.

Rice: Alright so if you’re up to date on your last Mpox vaccine, you should be good to go?

Kilkenny: Yep, should be good to go. We’re not, we’re still not recommending high-risk behaviors.

Rice: What are high-risk behaviors? Who is at more risk of contracting this?

Kilkenny: That can be anything that skin-to-skin contact, or the kind of household type contact that goes with bedding from people who sleep together. But high-risk contact also involves sexual contact, which we are advising you to be aware of. If you have sexual contact with somebody during your travels, or if you are symptomatic, you should avoid those things. 

Rice: And how do symptoms first show up? What should people look for? If they have participated, if they’ve gone, you know, overseas, they’ve interacted with someone, they’re coming back, what are the symptoms they should be looking out for?

Kilkenny: The symptoms start with a kind of flu-like fever, just feeling bad, and then frequently the people will get enlarged lymph nodes. It can be a sore throat. It can be other symptoms along those kinds like you would have with a respiratory illness. But Mpox then generally develops some type of skin lesions, or lesions on the lining of, say, inside the mouth, and they have a tendency to be quite painful.

Rice: So do people tend to kind of assume it’s a respiratory thing or a cold until the lesions start to show up?

Kilkenny: I think that people who are aware of the illness and the risk for that often will present to their health care provider with some concern that that might be actually the problem. We educate healthcare providers to raise their index of suspicion for this illness when they see the rash. We want them to know that this is a potential thing when you see somebody who’s sick, and to ask them whether they know of any contact that would put them at risk of Mpox.

Rice: All right, wonderful. Was there anything that you didn’t get to include that you wanted to?

Kilkenny: I think we covered it. I definitely wanted to give the CDC their props for the work that they’ve done, to make sure that even places that may never see a case of this are aware of it and just because you’ve never seen it doesn’t put you out of risk for it, and we’ve seen the things that we’ve never seen do show up and you can’t find it if you don’t know about it.