Monkeypox FAQs with DPH

On Wednesday, August 3, CAMP Rehoboth spoke with Camille Moreno-Gorrín, a senior epidemiologist with the Delaware Division of Public Health, for the latest updates on the monkeypox virus. We posed some of the most frequently asked questions from the community.

CAMP Rehoboth: How is monkeypox transmitted? Is it airborne at all?

Camille Moreno-Gorrín: Airborne transmission has not been documented. It is spread through direct contact with an infected person, especially contact with the lesions that appear during the rash period of the illness.

CR: Why is this being labeled a “men who have sex with men” (MSM) issue?

CMG: Some of the cases observed around the world and the US have been among MSM, but it is not restricted to these groups. Monkeypox is a disease that affects everyone. There was even a pediatric case reported by California. We don’t like to message that this is restricted to certain groups—it can affect anyone and is not restricted to certain sexual behaviors either.

CR: Can you expand on how the virus is transmitted through direct contact? 

CMG: Direct contact through any bodily fluids, including kissing, cuddling, and sharing drinks [could cause infection]. That’s what we’re observing in Delaware and the cases we’ve seen nationally. Primarily, it’s been sexual transmission, although we’ve seen persons become infected without any sort of sexual interaction. 

CR: What about surface contact?

CMG: It’s possible, but lower risk. It’s not highly transmissible through inanimate objects, but it’s still a risk. We take that into consideration when speaking with persons who’ve had close contact with an infection. We ask if they’ve had close contact with linens—a hotel room or something where the linens are soiled. We take that into consideration.

CR: What precautions should be made ahead of large-scale events? 

CMG: The most important thing to highlight is public awareness. It’s important to highlight: “if you feel sick, stay home.” There are some symptoms that come before the rash, so people should look at whether they’re feeling feverish, have a running nose, or feel fatigued. The rash can appear two to four days after those symptoms appear. So monitoring, knowing your body, and knowing if you were exposed to someone with a rash [are important preventative steps]. If your partner tells you that they think they have a rash, then try to get tested. Take the proper precautions before attending that event. 

CR: Where can people get tested? 

CMG: People should visit their primary care doctor as their first choice. There is the option to get tested via our public health clinics here in Delaware for people who are un- or under-insured. Commercial labs such as LabCorp and Quest are also conducting tests. That’s been a great help to us at the health department to expand testing opportunities.

CR: How exactly can uninsured persons get tested? 

CMG: The preferred route at this moment is to call our office at 1-888-295-5156. We can screen callers and can identify whether they have high risk factors—for example, if they have HIV or are on HIV PrEP. We can identify whether they have symptoms that are compatible with monkeypox, and then we’ll refer them to one of our clinics.

CR: Why doesn’t Delaware have a vaccine when other states do? Are we going to get a vaccine? 

CMG: The number of vaccine allocations that states get depends on the number of cases that they have and the concern of the disease in the community. We do not have a large number of cases. We have received three allocations of vaccine in Delaware [Ed. note: each allocation includes multiple doses of the vaccine], but it is being prioritized for persons who have been exposed to monkeypox (post-exposure prophylaxis; PEP) and to persons that belong to high-risk groups (they are HIV positive, or they have partners on HIV PrEP, or they reported having multiple sexual partners in the past 21 days). We take into consideration those high-risk factors, we screen them, and then we refer them. Unfortunately, it’s not something that’s widely available in the community, but we’re getting there. It depends on the allocation of cases. 

CR: Why are persons who are HIV positive and persons on HIV PrEP most likely to get infected with monkeypox?

CMG: It’s the commonality in risk factors and risk behaviors that are identified in this outbreak that has been spreading via sexual contact. HIV also is predominately spread through sexual contact. Due to those commonalities, we want to make sure we are addressing those groups. We can assume that someone on HIV PrEP is more susceptible to being exposed to HIV.

CR: Can you clarify the difference between PEP in reference to the monkeypox vaccine vs HIV PrEP?

CMG: HIV PrEP and HIV PEP are both different from PrEP and PEP for monkeypox. They are different treatments.