Probable case of monkeypox found in San Francisco resident

Probable case of monkeypox found in San Francisco resident

A probable case of monkeypox has been identified in a San Francisco resident amid a recent rise in cases in the United States and across the globe, public health officials announced on Friday evening.

Information about the San Francisco individual with the probable case could not be released for privacy reasons, but public health officials said that the person traveled to a “location with an outbreak in cases.” A California Department of Public Health laboratory in Richmond confirmed the probable case on Friday. The case will now be sent to the Centers for Disease Control & Prevention for final confirmation, public health officials said.

San Francisco health officials revealed the probable case Friday night after the U.S. Centers for Disease Control and Prevention said 20 cases of monkeypox have been identified in 11 states, including four in California. The San Francisco case was not counted among the 11.

Until the San Francisco case is confirmed by the CDC, it will be considered to be a probable case of monkeypox. The individual did not report any close contacts in San Francisco “during the time period where they could have spread the infection to others,” public health officials said.

“We were really pleased that this person remained aware and did seek medical attention,” said San Francisco health officer Dr. Susan Philip, who added that the person and their medical provider sought a prompt evaluation.

Philip said Friday that while most monkeypox cases resolve themselves, cases can be “serious in rare cases and we want to prevent further spread in the community.”

“San Francisco is prepared for this case and others, should more occur,” Philip said. “We want to emphasize that this is not a disease that spreads easily through the air like COVID-19, however we do want people who might have been exposed to watch out for symptoms and to see a medical provider immediately if they develop symptoms for an evaluation.”

None of the U.S. cases have resulted in deaths, and the “overwhelming majority” are among people who recently traveled internationally in a time frame that suggests their exposure happened there, said Capt. Jennifer McQuiston, incident manager for the CDC’s monkeypox response, during a media briefing Friday.

The other patients may have had contact with a known case or were identified through contact tracing. But at least one person did not travel and the source of infection is unknown — suggesting the virus may be spreading in the U.S., CDC officials said.

“Ongoing investigation suggests person-to-person community transmission, and CDC urges health departments, clinicians, and the public to remain vigilant, institute appropriate infection prevention and control measures, and notify public health authorities of suspected cases to reduce disease spread,” CDC scientists wrote in a report released Friday that analyzed U.S. monkeypox cases.

The risk to the public is still low, McQuiston said. Officials expect the number of cases to rise as more testing and contact tracing is done. In California, three confirmed cases have been detected in Sacramento County and one in Los Angeles County.

Monkeypox is a type of orthopoxvirus, the same family of viruses that includes smallpox, though monkeypox is less contagious and less severe. Monkeypox symptoms include rash and skin lesions that become raised and fill with fluid as they progress.

There are two federally approved vaccines for orthopoxvirus — Acam2000 and Jynneos — that are now being deployed for monkeypox, and one antiviral treatment.

Acam2000 is to be taken after exposure, and Jynneos can be taken before or after exposure. The antiviral — tecovirimat, also known as Tpoxx — was originally licensed for smallpox but can be administered for monkeypox under a federal protocol that allows some drugs to be used for purposes other than those tested in clinical trials when there are no better alternatives available.

Federal health agencies have sent 1,200 doses of vaccine and 100 courses of treatment to eight states, said Dr. Raj Panjabi, who is coordinating the White House’s monkeypox response. He did not specify which states have received them. The California Department of Public Health on Friday said the state has received 200 doses of the Jynneos vaccine to use as preventive treatment for people who have been exposed to monkeypox.

Federal officials on the call would not say how many doses of vaccine or treatments are currently in the national stockpile. But there is “more than enough vaccine available” and they have been “pre-positioned around the country,” said Dawn O’Connell, assistant secretary of emergency preparedness at the U.S. Department of Health and Human Services.

“The good news is we already have the vaccines and treatments needed to respond,” O’Connell said.

Monkeypox can spread from person to person from close physical contact, including sexual contact, through infected sores, body fluids or respiratory droplets.

Health officials in Europe, where several countries are reporting outbreaks, recently indicated that most or all cases have been in men, and many reported having multiple sex partners before contracting the virus.

The CDC report released Friday analyzed 17 U.S. patients with confirmed monkeypox infections as of May 31, and found that 14 of the 17 people had traveled internationally during the 21 days before symptom onset. Sixteen out of the 17 identified as men who have sex with men. In many cases, the rash began in the genital area.

“We’re focusing efforts to raise awareness within the LGBTQ-plus community,” McQuiston said.

Globally, there have more than 700 cases reported in at least 28 countries where monkeypox is not endemic. Monkeypox, a zoonotic disease that exists most commonly in rodents and can pass to humans, is endemic in several Central and West African countries.

The last outbreak U.S. outbreak was in 2003, when about 70 cases were detected. Investigators traced the outbreak to a shipment of pet prairie dogs imported from Ghana.

The CDC urged health care providers to be on the lookout for monkeypox symptoms and to test patients if they suspect it.

Catherine Ho (she/her) is a San Francisco Chronicle staff writer. Email: cho@sfchronicle.com Twitter: @Cat_Ho


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