Alaska’s health department confirms 2nd case of monkeypox in state, expands vaccine eligibility

A second case of monkeypox has been confirmed in Alaska about a week after the first case was reported.

Both cases have involved male residents of Anchorage who had recently had contact with someone who traveled outside the state, and neither case has been serious enough to require hospitalization, Dr. Joe McLaughlin, Alaska’s state epidemiologist, said Friday.

There also doesn’t appear to be an epidemiologic link between the two cases, McLaughlin said. In the most recent case, the man’s symptom began within the past week, and he tested positive late Wednesday afternoon. A total of 16 people have been tested for the virus in Alaska, and just two tests have come back positive.

This week, state health officials also announced they were expanding Jynneos monkeypox vaccine eligibility in Alaska to include men and transgender people who both have sex with men and have had multiple or anonymous sexual partners in the past two weeks. Anyone with a known exposure to someone with the virus is also eligible for a dose.

“If you believe you may be eligible for vaccination, please call your health care provider or local public health center,” Dr. Anne Zink, Alaska’s chief medical officer, tweeted Friday.

“It’s basically at this point first come, first serve,” said McLaughlin, who said it was particularly important for immunocompromised Alaskans who also fit the eligibility criteria to consider getting vaccinated, due to higher risk of severe illness if they were to contract the disease.

Examples of immunocompromising conditions include AIDS, atopic dermatitis or eczema, leukemia, lymphoma, organ transplantation, generalized malignancy, radiation therapy or receipt of high-dose corticosteroids, according to new monkeypox treatment guidelines for providers released by the health department this week.

“The big thing with the vaccination is it’s most effective if given within four days of the exposure. It can be given up to two weeks after the exposure, but the sooner the better. And so we want to make sure that the people who are at the very highest risk have very prompt access to vaccine,” McLaughlin said.

While monkeypox does not spread easily between people, transmission can occur when a person has skin-to-skin contact with body fluids or monkeypox sores; through contact with items that have been contaminated, like bedding and clothing; or through prolonged face-to-face contact.

According to a CDC report released this week, the vast majority of monkeypox cases U.S. since May — 99% — have involved men, and 84% of patients have reported male-to-male sexual contact.

Within this community, the risk of transmission is highest among people who have had multiple sexual partners or are having anonymous sex frequently, McLaughlin said.

That’s why the state decided to open up eligibility to include Alaskans who are at a higher risk of contracting the disease, McLaughlin said.

Monkeypox vaccine and treatments have been in short supply around the globe, but McLaughlin said the state has been allotted 480 doses of the vaccine in addition to the 130 it already had, including a shipment that arrived in the state Wednesday.

“Although the amount of vaccine that we’re receiving is not as much as we would like, we do want to use this vaccine and get it in the arms of people who are at highest risk for monkeypox disease,” he said. “The more people we have vaccinated, the the lower the probability of transmission in social networks.”

Alaska’s latest case is part of a global outbreak that has spread to thousands of people in dozens of countries in just a few weeks, prompting the World Health Organization to declare a global emergency last month and the Biden administration to declare a national health emergency this week.

By Friday, the CDC had reported more than 7,000 U.S. cases in 49 states.

Monkeypox is a disease caused by an infection with a pox virus that belongs to the same family of viruses that cause smallpox.

The illness typically begins with flu-like symptoms including a fever, headaches, muscle and backaches, chills and “just general exhaustion” within one to two weeks of exposure, according to McLaughlin.

Within one to three days, the patient will develop a rash that often begins on the face and spreads to other parts of the body, but not always. The illness typically lasts two to four weeks.

While the current strain has a very high survival rate of about 99%, the WHO has reported seven fatalities from the virus, McLaughlin said.

More severe cases of monkeypox infection can involve “extremely painful” lesions that can spread to multiple parts of the body, McLaughlin said.

“A lot of the people who are hospitalized for monkeypox are hospitalized for pain control, because the pain can be so severe with this rash,” he said.

While it was important for Alaskans with a higher risk of contracting the virus or getting very sick from it to consider getting vaccinated, he said he also didn’t want Alaskans with much lower risk to panic.

“We don’t want people who are really at a very, very low risk of monkeypox disease to be worried about it. Because this is a disease that is much more difficult to transmit than COVID,” he said.