The monkeypox virus (MPV) outbreak continues to grow nationally and in King County. This blog post provides updated information about local cases.  

Public Health continues to conduct case investigations, which are critical to help prevent spread. When we can connect with people who have MPV, we can offer vaccine to their close contacts including household and family members who might have been exposed, which can help prevent spread more broadly. If you suspect you have symptoms of monkeypox or that you have been exposed, contact your health care provider immediately for an evaluation. People with symptoms may also be seen at Public Health’s Sexual Health Clinic.

Current situation

MPV cases in the United States and locally here in King County have increased over the past several weeks. As of August 24, 2022, 310 King County residents have been diagnosed with MPV, an increase from 48 cases in mid-July.

Anyone who has been in close contact with someone who has MPV, including having direct contact with a rash or lesions of someone with MPV, is at risk of becoming infected. Locally, most of the cases have been reported in adult men* who reported close intimate contact, including sexual contact, with other men.  

*This includes people who may identify as non-binary, gender queer, or transgender.

A new case in a child

Recently, a case of MPV was identified in an infant in King County. The infant is currently hospitalized, stable, and receiving treatment. The infant was likely exposed to monkeypox through an infected family member. This child did not get the infection from school, childcare or other public setting.

To protect privacy, we are not providing any additional information about this case.

In addition, three people diagnosed with MPV identified as cis-gender females including an individual who may have been exposed to infection through sexual activity. Investigation of these cases is ongoing.

What does this latest information tell us about transmission?

The Centers for Disease Control and Prevention (CDC) reminds us that MPV is an emerging infection and there is still much to be learned about the virus in the context of this international outbreak. We do know that MPV spreads through close, prolonged and/or direct contact with someone who is symptomatic with the virus. This can include skin-to-skin contact with the lesions, contact with respiratory secretions, and shared items (like clothing, bedding, drinks). Examples of close, prolonged and/or direct contact may be different depending on the interactions between individuals. For example, close, direct contact between a caregiver and a young child might include hugging, cuddling, kissing, holding and feeding.

People with MPV who are isolating at home should take extra care to avoid contact with other household members and follow the CDC’s guidance for limiting transmission in the home. In cases where a child is infected with MPV, families are advised to minimize the number of caregivers for the child and limit the child’s interaction between siblings, including sharing toys, clothing, linens, and bedding. It is also important for the infected person to limit interactions with pets in the home as transmission of MPV to animals has been reported.

Are children at high risk for MPV infection?

No, the risk of MPV infection to the general public in King County including children is low. Cases among children nationally have been rare. However, as we reported above, children in a household with a person with confirmed MPV can become infected if there is close, prolonged and/or direct contact, such as what may occur during caregiving.  

While the risk is currently low, CDC advises that childcare centers and schools should continue to follow standard hygiene practices, including washing and sanitizing bedding and towels after each use (if used by more than one child), and always ensuring access to handwashing supplies (soap and water or hand sanitizer with at least 60% alcohol). 

If your child is ill and develops symptoms such as a rash, they should stay home and away from public settings including childcare or school and get checked out by a healthcare provider before returning to daycare or school. Parents and caregivers should notify a school or childcare immediately if a child receives a positive lab result for MPV.

The Center for Disease Control and Prevention (CDC) has provided guidance for schools and childcares.

What school or childcare administrators and parents can do to lower risk

If you or someone in your school, childcare, or household is diagnosed with MPV, it’s important to respond to Public Health calls in order to help identify potential contacts. There is a vaccine available for people who have had a recent known high-risk exposure, and this can prevent someone who has been exposed from getting ill and prevent further spread in the community.

Family members with MPV should follow these recommendations until MPV symptoms have resolved: 

• Stay at home (isolate) if MPV symptoms are present until you are evaluated by a healthcare provider; for those diagnosed with MPV, continue to stay at home until the rash has healed and a new layer of skin has formed.  
• Wash hands often with soap and water or use an alcohol-based hand sanitizer, especially after direct contact with the rash. 
• Engage with Public Health team members to better understand the source of infection; discuss questions and concerns with Public Health team to receive guidance to protect other family members and close contacts from infection. 
• Avoid close contact with others particularly with family members who are immunocompromised; avoid contact with pets in the home and other animals; use gauze or bandages to cover the rash to limit spread to others and to the environment; use separate bathrooms, if possible.
• Postpone visits from friends, family or others without an essential need at home. 
• Do not share potentially contaminated items (e.g. drinking glasses or eating utensils) or fabrics (e.g. bed linens, clothing, towels) and routinely clean and disinfect shared surfaces

More information about MPV available at: www.kingcounty.gov/monkeypox and http://www.kingcounty.gov/monkeypox/vaccine

Originally published 8.24.22