SACRAMENTO, Calif. — Sacramento health officials are investigating a “likely” case of monkeypox virus related to travel in Europe and are awaiting confirmation Tuesday of tests by the Centers for Disease Control and Prevention.
If confirmed, it would be the first case of the virus in California and one of at least six cases in the U.S. this year.
“Based on symptoms and preliminary testing, monkeypox confirmation is likely,” Sacramento County Public Health officials said in a Tuesday morning announcement. The California Department of Public Health said the individual “tested preliminarily positive for an orthopox virus” and state and local officials were awaiting confirmation from the CDC.
Sacramento County Public Health Officer Dr. Olivia Kasirye said in a news conference that the risk to the public is “extremely low.”
“This case appears to be related to recent travel to Europe,” Kasirye said in announcing the case. “Public Health is working with CDPH to conduct contract tracing, and risk to the general public is extremely low.”
CDPH said health officials began investigating the case Saturday, though it was not disclosed when the person returned to the U.S. or if the traveler arrived at Sacramento International Airport. Kasirye said the tests were sent to CDC officials on Monday, and that a timeline for the confirmation was not known.
Kasirye said the individual is isolating at home and “doing well” as officials investigate others who may have come in contact with the person.
“We’re still determining the number of close contacts,” Kasirye told reporters during a briefing, saying health officials are still trying to define what close contacts are in this case. She shared no details about the infected person, including the person’s gender, age or health history, but said the case came to light after the individual’s health provider called county officials.
Kasirye sought to reassure that monkeypox “is a rare disease in the U.S.” and does not naturally occur in the United States.
“It’s important that if people are exhibiting symptoms that they contact their health care provider, so if they need to make a determination, they can do that right away,” Kasirye said.
The California Department of Public Health is working with the county and said its Richmond laboratory is prepared to perform more tests if needed.
“The California Department of Public Health is working quickly with local and federal health officials to ensure appropriate care and response, including contact tracing and post-exposure prevention for close contacts,” state epidemiologist Dr. Erica Pan said in a statement. “Because the disease is rare, health care providers may not be familiar with the presentation of monkeypox and the possibility of monkeypox transmission during intimate or sexual contact may not be well known.
“As such, CDPH is promoting awareness amongst health care providers and the public, including appropriate infection control for monkeypox cases in the health care setting.”
The name monkeypox comes from the first documented animal cases in 1958 when two outbreaks occurred in monkeys kept for research, according to Rodney E. Rohde, a microbiologist and the Regents’ Professor of Clinical Laboratory Science at Texas State University. “However, the virus did not jump from monkeys to humans, nor are monkeys major carriers of the disease,” he said.
Monkeypox symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. Within one to three days after the appearance of fever, the patient develops a rash. The rash often begins on the face before spreading to other parts of the body. The span from infection to symptoms can range from five to 21 days and the illness can last two to four weeks.
To date, the World Health Organization has recorded more than 90 cases of monkeypox in a dozen countries including Canada, Spain, Israel, France, Switzerland, the U.S. and Australia. U.S. health officials said Monday they knew of one confirmed case, in the state of Massachusetts, and four probable cases — two in Utah, one in Florida and one in New York City. All were men who had traveled outside the U.S.
According to CDPH, the CDC has “warned of a potential increased risk of exposure for those who self-identify as men who have sex with men.” A WHO adviser called the outbreak “a random event” that might be explained by sexual behavior at two recent raves in Europe.
Dr. David Heymann, who formerly headed WHO’s emergencies department, told the Associated Press on Monday that the leading theory to explain the spread of the disease was sexual transmission at raves held in Spain and Belgium.
“We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission,” said Heymann.
Health officials said, however, that anyone can be infected through close contact with a sick person, their clothing or bedsheets. Scientists say it would be difficult to disentangle whether the spread was being driven by sex or merely close contact.
A CDC official said Massachusetts health officials had identified 200 people who came in contact with a patient hospitalized with the virus in Boston, the “vast majority” of whom were health care workers, the Boston Globe reported. The virus is not considered easily transmissible and people are not contagious until after they have symptoms. The man, who had traveled to Canada, was being treated in isolation at the Boston facility.
The United States previously saw two cases of the “rare but potentially serious virus” in 2021, in Texas and Maryland. Both cases were from residents who had recently traveled to Nigeria.
Two types of vaccines are available to combat the virus, Kasirye said, one for smallpox, the other specific to monkeypox, but would only be deployed in an outbreak scenario, Kasirye said, adding that Sacramento County health officials would have to formally request the doses from the CDC in Atlanta.
“This is very different from COVID,” she said, but added, “We have yet to see where this is going to go or how many cases we’re going to get.”
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