As Illinois monkeypox cases continue to rise, with Chicago reporting five new cases this week, health experts are urging added precautions in the lead-up to major summer events, but what should you be watching for and how does the illness spread?
Here's the latest on the outbreak and what you need to know.
What is monkeypox?
Monkeypox is a rare, but potentially serious viral illness, which often begins with flu-like symptoms and swelling of the lymph nodes, and progresses to a rash on the face and body, health experts said. It was first observed in Africa in 1970, and is usually found in western and central portions of the continent.
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The virus comes from the same family as smallpox.
"It does not come from monkeys. That's just what it was initially detected in and it's a virus that is not related to the COVID virus," Chicago Department of Public Health Commissioner Dr. Allison Arwady said. "It's a completely different family. One of the reasons why there's attention to it is it's in the same family that the smallpox virus. We don't have smallpox anymore. We eradicated but it's in that family."
How is it spread?
Local
CDPH said person-to-person transmission is possible through "close physical contact with monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact."
“It’s not just your casual handshake,” Hafiz said. “(Contact must be) longer, more pronounced. It is not technically a sexually transmitted disease, but it involves close contact.”
“It takes prolonged (contact), not minutes,” NBC News Medical Contributor Dr. Kavita Patel added. “(It can also involve) body fluids or lesions.”
Where have cases been confirmed?
The Centers for Disease Control and Prevention is on alert after cases of the virus were reported in several countries that typically do not report monkeypox cases, including the U.S.
As of Tuesday, the CDC has reported 65 confirmed cases across multiple states:
| StateSort by state in no order | Number of CasesSort by number of cases in no order |
|---|---|
| Arizona | 1 |
| California | 15 |
| Colorado | 4 |
| District Of Columbia | 2 |
| Florida | 5 |
| Georgia | 2 |
| Hawaii | 5 |
| Illinois | 8 |
| Massachusetts | 3 |
| New York | 11 |
| Ohio | 1 |
| Oklahoma | 1 |
| Pennsylvania | 1 |
| Rhode Island | 1 |
| Texas | 1 |
| Utah | 2 |
| Virginia | 1 |
| Washington | 1 |
Illinois reported its first probable case in a Chicago resident earlier this month.
The CDC last week raised its alert level for monkeypox and stepped up its guidance as global cases of the virus surpassed 1,000.
Globally, 1,678 cases have been reported across 35 countries, according to the CDC. The majority of cases were reported in the UK, Spain and Portugal.
What do we know about the Chicago-area cases?
In a news release Monday, CDPH confirmed at least seven cases have been identified in Chicago, a significant increase from the two cases that were reported in the previous weeks. Seven of the cases involve individuals who recently traveled to Europe, and the first two cases appeared to be related to each other, health officials said.
One Chicago resident was diagnosed with monkeypox after attending the International Mr. Leather conference, which took place from May 26-30 in the city, and other cases connected to the event have been reported.
Another case was reported over the weekend in DuPage County.
The case was found in a man who had traveled internationally in the past month to a country which has also reported monkeypox infections recently, the DuPage County Health Department said.
According to Northwestern Medicine infectious diseases expert Dr. Robert L. Murphy, over 95% of cases in Europe, Canada and the U.S. are in LGBTQ individuals, specifically hitting the community of men having sex with men. Health experts warned, however, that the virus is not limited to that community and "not all Chicago cases have been among men."
What symptoms should you watch for?
Virus symptoms range from fever, aches and rashes all over the body.
"Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts," CDPH stated.
Dr. Irfan Hafiz, an infectious disease specialist with Northwestern Medicine’s McHenry and Huntley Hospitals, said the virus causes symptoms that are similar to several maladies, including chickenpox or smallpox.
“It can, to the layperson, look like chickenpox or warts,” he said. “But these (sores) tend to be in exposed areas.”
Health experts also said the illness can be confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus.
Federal health officials are urging doctors in the U.S. to "consider a diagnosis of monkeypox in people who present with a consistent rash, especially if they meet any of the following criteria:
- Had contact with someone who had a rash that looks like monkeypox or someone who was diagnosed with confirmed or probable monkeypox
- Had skin-to-skin-contact with someone in a social network experiencing monkeypox activity; this includes men who have sex with men who meet partners through an online website, digital application (app), or social event (e.g., a bar or party)
- Traveled outside the US to a country with confirmed cases of monkeypox or where monkeypox activity has been ongoing
- Had contact with a dead or live wild animal or exotic pet that exists only in Africa or used a product derived from such animals (e.g., game meat, creams, lotions, powders, etc.)
Infections typically last between two and four weeks, CDPH said.
Health officials said anyone with a "new or unexplained rash, sores, or symptoms, or have a confirmed exposure" should visit their healthcare provider and "avoid sex or being intimate with anyone until they have been seen."
How does monkeypox spread?
According to CDPH, "Individuals can become infected with the monkeypox virus when they come in contact with lesions, bodily fluids, or respiratory secretions of anyone infected with the virus, as well as with objects that may have been in contact with lesion crusts or bodily fluids (e.g., contaminated linens, bandages, dishes)."
The CDC also notes that the virus "can be spread by respiratory secretions during prolonged, face-to-face contact" as well as during intimate contact contact between people, though "at this time, it is not known if monkeypox can spread through semen or vaginal fluids."
Murphy said the illness is not a sexually transmitted disease "in the classic sense."
"It is spread by close physical contact with lesions," Murphy said. "I go back to the example with meningitis. It’s not a gay disease — there have been outbreaks on many college campuses."
What makes the recent cases unique?
“What makes this a little different is the number of cases, and the countries that are affected by this,” Hafiz said.
Chicago's top doctor echoed that sentiment.
"Usually, in a normal year, we will see a few cases mostly in Western Africa that are related to animals," Arwady said. "There are animals that can carry it and we'll see, you know, a few dozen cases that people can get infected just from just from being in contact with animals. The reason there's been more attention is that at this point, there's been somewhere between 100 cases that have been identified that are not connected to the typical way that we see monkeypox."
The CDC said that “cases include people who self-identify as men who have had sex with men,” but emphasized that anyone can contract the illness through prolonged contact.
How worried should you be?
The virus is rarely lethal, experts said.
Most individuals diagnosed so far have experienced mild symptoms, and no one has died.
"We want to make sure we understand it so it's rare, but it is potentially serious," Arwady said.
Still, Chicago officials urged residents to take added precautions ahead of big upcoming summer events.
“While the risk in Chicago remains low, CDPH wants the public to be able to make informed choices about gathering in spaces or participating in events where monkeypox could be spread through close or intimate contact,” Arwady said.
Health officials said they have been in contact with organizers of summer events and said anyone attending festivals or other such events "should consider how much close, personal, skin-to-skin contact is likely to occur at the events they plan to attend."
"If someone feels sick or has rashes or sores, CDPH recommends not attending a gathering, and visiting a healthcare provider as soon as possible," the health department stated.
According to Murphy, the U.S. recently purchased thousands of vaccine doses, "which implies the CDC is really concerned."
"That being said, infectious disease people like myself are calling it an outbreak; it’s not an epidemic, and it’s very unlikely to become one," Murphy said. "It’s a DNA virus, they don’t mutate like these RNA viruses, so you’re not expecting this to turn into something like HIV or COVID-19."
