CONWAY — Memorial Hospital in North Conway is preparing to respond to the monkeypox outbreak that has spread worldwide over the past few months.
So far, 13 cases have been reported in New Hampshire, with the state Department of Health and Human Services announcing the first one on June 29.
Memorial's chief medical officer, Dr. Matt Dunn, said Tuesday he wants people to know the hospital is "watching this, we are preparing, we’ve worked out a way to test if we need to, and we’re working to get the information out there."
None of the New Hampshire cases has come through Memorial, and while Dunn said he has not seen a lot of concern locally about the disease, he's fielded the occasional question.
“Will it make it’s way here? It’s likely,” he said.
"It’s slowly going up. I think we will continue to see it spread,” Dunn said.
But he said he doubts monkeypox will prove to be as significant a threat as COVID-19 since it is generally less severe.
Cases have so far been concentrated primarily among gay and bisexual communities, and the World Health Organization recommended gay and bisexual men limit their number of sexual partners to protect themselves
But on July 25, WHO said there is no guarantee it will continue to spread only within specific communities and detection in gay communities could be a harbinger of a wider outbreak.
Dunn said monkeypox does not target gay men.
"It is hitting all populations," he said. "It is not isolated to any single group.”
Monkeypox is in the same family as the smallpox virus, which was eradicated worldwide in the 1970s, and causes a similar but milder illness.
According to DHHS, the first symptoms of monkeypox are similar to those of the flu: fever, headache, exhaustion, muscle aches, sore throat, cough and swollen lymph nodes.
That is followed a few days later by a skin rash or spots that develop into raised bumps. These can break open or become crusty before scabbing over. The rash can be itchy and painful.
While usually mild, a monkeypox case can last for up to four weeks and can cause severe illness and death in rare cases, Dunn said, particularly in the very young, the very old or the immune-compromised. The rash can also leave scars, and in rare cases the illness can affect vision.
Anyone who suspects they have monkeypox should contact their primary care provider, Dunn said.
Also, according to DHHS, “anybody diagnosed with monkeypox is required to isolate at home, and a public health investigation identifies other people who may have been exposed so their health can be monitored and to prevent further spread. A person with monkeypox is not considered contagious and is not considered able to spread monkeypox until they develop symptoms."
To prevent spread, people should avoid close contact with others who are sick or who have new skin rashes, cover coughs and sneezes, and practice good and frequent hand hygiene.
The treatment for those who are ill, Dunn said, “by and large is going to be like any other virus,” which includes a recommendation of isolation and precautions such as not sharing clothing, bedding, food or other items.
Dunn said monkeypox spreads most easily by direct contact but can be spread by respiratory droplets.
It is shared mostly through skin-to-skin contact or through contact with things they have touched.
Unlike with COVID, Dunn said, the monkeypox virus can live for a long time outside of the body, and clothing, bedding and other items should be washed to help stop the spread.
Dunn said people working at Memorial Hospital are well protected because they are using full personal protective equipment, including gowns, gloves and respirators, whenever they encounter a patient who is sick with an unknown cause.
In addition to preventative vaccines, antiviral medicines can be used to treat monkeypox, Dunn said, but are generally reserved for people at high risk for severe illness.
Monkeypox isn’t new. It was first discovered in laboratory monkeys in 1958 and the first reported case in humans was in 1970. It has been found in rodents and primates in western and central Africa.
There have been limited outbreaks outside of Africa over the years. The World Health Organization reported the current outbreak started this year in early May.
According to the Centers for Disease Control and Prevention, as of Tuesday, there have been more than 25,000 recent cases of monkeypox worldwide, and WHO has declared it a global health emergency.
Nearly a quarter of the cases (6,326) have been in the United States, including one in Vermont, one in Maine, 134 in Massachusetts, 1,617 in New York and 13 in the Granite State.
Statistics are updated daily on the CDC website at tinyurl.com/2mh8vvwm. Although the CDC reported only one case in Maine as of Aug. 2, Maine Centers for Disease Control Director Dr. Nirav Shah confirmed a second case on Monday.
Dunn expressed frustration about the difficulty in tracking the disease as there is no standard mechanism for reporting to the CDC.
“It sounds very much like what we were hearing three years ago about COVID,” he said, adding, “Didn’t we fix this?”
Two vaccines are available, Dunn said, but the amount of vaccine is currently limited and being used only in areas where the risk is highest.
The World Health Organization reports that a smallpox vaccination used during the smallpox eradication program (which ended in 1980) has provided some protection against monkeypox.
Dunn noted current numbers in the United States are highest in large cities, including New York, Chicago, Atlanta and Miami and some cities in California. In some places where the case numbers are highest, clinics have been set up to vaccinate people. The case count is not currently high in Boston.
Dunn does not expect the disease to overwhelm U.S. health-care resources the way COVID surges did. It could, however, affect the economy, he said, because people could be out of work for weeks if they get sick.