Recently, the Maine Center for Disease Control and Prevention (CDC) announced that Maine had its first confirmed case of monkeypox (MPX). As you are probably already aware cases are appearing all over the world, mostly among gay/bi men or men who have sex with men (MSM). The US has identified about 2,600 cases as of late July with Maine being one of the few last states with a confirmed case.
As summer activities continue you may have questions about symptoms, transmission, and prevention. We hope to answer some basic questions about MPX, offers some tips and suggestions about harm reduction/safety, and give you some resources to learn more.
Vaccine Sites
Here are a few of the clinics offering vaccines, but supplies are still limited. We'll keep this updated as more sites open.
Maine CDC has a list of vaccine sites here. Feel free to contact Ren at Frannie Peabody Center with questions, however.
Pop-Up/Walk-In Clinics
No appointment needed. First come, first serve. Call or text Ren at Frannie Peabody Center 207-749-6818 with questions.
Every Tuesday/Thursday from 1-6pm and Saturdays 10:30am-1pm the York County Vaccination Clinic will be offering Monkeypox vaccines. 1364 Main St., Suite 7, Sanford, ME 04073
Saturday September 24th at the East End School 9am-12pm 195 North St. Portland
Friday October 7th at Twin Ponds Lodge in Albion, Maine. Clinic starts at 7pm!
What Is Monkeypox?
Monkeypox is a viral disease spread by close, personal contact with infected individuals. Monkeypox is related to the smallpox virus, but with milder symptoms. Until the recent global epidemic in 2022, MPX was most commonly seen in Central and Western Africa. Cases outside of Africa were largely a result of international travel to areas where MPX is common or contact with rodents or non-human primates from those areas.
Who can get monkeypox?
The recent outbreak has largely been among men who have sex with men (MSM), and rightfully, there is concern that public health messaging may create stigma similar to that of HIV/AIDS. While it is important to raise awareness of spread among MSM communities, anyone can get monkeypox. Risk to the public at large is still very low, however.
Transmission
You might be wondering how you can get monkeypox? The virus can spread from person-to-person through:
Direct contact with infectious rash, scabs, or body fluids
Respiratory droplets during a prolonged face to face conversation or intimate physical contact
Touching items/clothing/bedding etc. that previously touched the infectious rash or body fluid
Monkeypox can spread from the time symptoms start until the rash has fully healed.
There is some evidence of asymptomatic transmission, but the extent of which or whether or not this is even possible is still unknown.
Signs and symptoms
The incubation period is usually around 7-8 days.
Monkeypox can cause a rash that can look like pimples or blisters. The rash can appear anywhere on the body including the genitals, but also inside the body such as mouth or anus. Flu-like symptoms may include:
Fever
Headache
Muscle aches and backache
Chills
Fatigue
Swollen lymph nodes
Something to keep in mind is that symptoms can be very mild, or start off mild only to get worse. Flu-like illness may begin from the start or appear after the rash has begun so be mindful! The rash goes through different stages before healing completely. The illness typically lasts 2-4 weeks, and is rarely fatal. The rash can be very painful, particularly internal lesions. See the resources section below for tips on rash care and healing.
Testing
Testing must be performed by your healthcare provider, and can only be performed in the presence of lesions. There is currently no precautionary tests such as blood or saliva testing for monkeypox.
Testing is performed by swabbing lesions. This can be a little painful as lesions can be tender.
2 swabs are taken from five 5 separate specimen sites for a total of ten 10 swabs
Swabs are stored in dry specimen containers
Time for test results to come back depends on the lab used to process specimens. Your healthcare provider can give you an estimate on wait time for results.
Prevention
Take the following steps to prevent getting monkeypox:
Avoid close, skin-to-skin contact with people who have a rash that looks like monkeypox
Do not handle or touch the bedding, towels, or clothing of a person with monkeypox
Wash your hands often with soap and water or use an alcohol-based hand sanitizer.
Vaccination
The vaccine being used is the JYNNEOS (also known as Imvamune or Imvanex)
2 doses via injection 4 weeks apart
While both doses are required for a complete immune response that is long lasting, a single dose is believed to offer a high enough level of protection to prevent illness. It can take at least 2 weeks for the vaccine to start taking effect, and up to 4 weeks for maximum benefit for the single dose!
The second dose takes full effect 14 days after the injection.
If there is a gap longer than 4 weeks between your first and second dose don't worry. That single dose can should last you until the second dose becomes available, even if it is weeks or months later.
The vaccine can cause redness and swelling at the injection site. This is expected, but make sure to ask your provider about it.
Safer-Sex
Get vaccinated! We'll have vaccine locations listed as soon as we can. Stay tuned!
Consider your risk. How many cases are in your area? Are you traveling to a place where there are a lot of monkeypox cases?
Stick to trusted partners or form exclusive sex pods with your partners, and avoid outside contacts until everyone is vaccinated.
Talk to your partners! Ask if they are feeling ok, are having any symptoms, or have been in contact with anyone who may have monkeypox? Have they recently returned from an place where there are a lot of cases? This can help you gauge risk.
Consider taking a break until you can get vaccinated. This won't last forever, and if you are concerned about getting monkeypox then waiting till the outbreak cools off might be a good choice.
Desirée Guerrero covers some other tips for safer sex/hook-ups to consider here
Vaccine Sites
Here are a few of the clinics offering vaccines, but supplies are still limited. We'll keep this updated as more sites open.
Maine CDC has a list of vaccine sites here. Feel free to contact Ren at Frannie Peabody Center with questions, however.
Treatment
Severe cases of monkeypox may require treatment. Providers use a drugs called TPoxx (Tecovirimat) and is which is a typically used to treat smallpox, but has proven highly effective against monkeypox. TPoxx requires a prescription, and currently only available at certain clinics in Maine. Because TPoxx is part of the federal stockpile of emergency medicine the prescribing process can be somewhat complicated. If your provider wants to prescribe TPoxx, but is unsure how to go about it have them contact State Epidemiologist Isaac Benowitz.
Resources
Here are some articles and resources that will hopefully help
Keren Landman's piece for Vox covers the World Health Organization's declaration of an international health emergency and what that means.
Dr. Carlton Thomas is a gay doctor who's been using his community and clinical skills to help folks find monkyepox resources. Looking for tips on recovering from MPX? Check out his Instagram or TickTock accounts.
Science Magazine had an article explaining why MPX is mostly affecting MSM.
Infectious disease scholar Jim Downs argues that we speak frankly with MSM about monkey pox.
Monkeypox FAQ
The following are commonly asked questions about monkeypox. We'll be updating these are they come up.
Q: If I had the smallpox vaccine does that offer any protection from monkeypox?
A: The jury is still out on this one. The evidence suggests a smallpox vaccine offers some protection, but experts don't know for how long.
Q: If I had monkeypox can I be reinfected?
A: Experts aren't sure. The general belief at this point is that infection with monkeypox provides immunity, but how long that immunity lasts is not well known.
Q: If I had monkeypox do I need a vaccine?
A: Current guidance is no, but ask your healthcare provider about what is right for you.
Q: Is monkeypox a sexually transmitted disease?
A: Not technically, no, but the majority of infections have been passed through sex.
Q: Is monkeypox a gay disease?
A: No. The current outbreak is almost exclusively among men who have sex wiht men (MSM), and is spreading through sexual contact. There is nothing implicitly different about MSM that makes them more vulnerable to this disease. It's simply that MPX got into the sexual networks of this community and that is where it is spreading. Anyone can get monkey pox from contact with an infected individual, sexually or otherwise, but the risk to the general public is very low.
Q: Am I more at risk for monkeypox if I have HIV?
A: The CDC has an FAQ that answers questions about HIV and MPX.
Q: When does the vaccine start to take effect, and how long before it is safe to play again?
A: The vaccine needs time to build up your immunity before it starts offering protection. Current thinking is that it takes about two weeks, but immunity continues to grow after that (see the image below).
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