People coming in close contact with monkeypox are being advised to quarantine for three weeks, according to health officials in Belgium and the United Kingdom.

Belgium made it a requirement, issuing the first compulsory three-week quarantine for confirmed cases of monkeypox, CNBC reported.

The Centers for Disease Control and Prevention says people with monkeypox should isolate themselves until the crusts from the rash are gone. But it still calls the risk to the general public low.

Those high-risk contacts being urged or ordered to isolate include sexual partners, household members, or anyone exposed to the body fluids of an infected person, including by way of a cough or sneeze.

“As well as isolating for 21 days, people who have had this level of exposure to monkeypox are being told to avoid contact with immunosuppressed people, pregnant women and children under 12 where possible,” Fortune reported.

As of May 21, 12 countries, including the United States, have reported a total of 92 confirmed and 28 suspected cases to the World Health Organization. Portugal, Spain and the United Kingdom have the most cases. But cases have also been found in Australia, Belgium, Canada, France, Germany, Italy, Netherlands and Sweden.

Utah public health experts are investigating two possible cases. But they said there’s no risk to the public, although they are doing some contact tracing while they await lab confirmation.

Monkeypox is most often seen in parts of central and western Africa, but none of the cases in the outbreak were linked to recent travel there, the World Health Organization said in a statement posted on its website Saturday.

About monkeypox

Monkeypox starts as a rash that turns into pus-filled blisters that eventually harden and scab, then fall off. It is spread by respiratory and other secretions, including coming in contact with contaminated clothing and linens. The virus can enter through the eyes, nose, mouth or broken skin. Sexual transmission is believed possible, too. Animal to human transmission is typically through a bite or scratch. The incubation period, according to the World Health Organization, is between 5 and 21 days.

Should you be worried about monkeypox?
What is monkeypox and where is it spreading?

Monkeypox feels like the flu at first, including chills, exhaustion and weakness. Symptoms also include fever, headache, muscle or back pain and swollen glands.

Then it turns into a rash that can start on the face and in the mouth, and spread to the body, including the palms of the hands and soles of the feet.

Cases typically resolve on their own within two or three weeks. But some people have died because of complications from monkeypox.

There is no specific treatment for monkeypox, though the CDC has called the smallpox vaccine “at least” 85% effective against monkeypox. The Washington Post reported that two vaccines have been licensed in the United States to prevent smallpox, “with one authorized specifically for monkeypox.” Antivirals for it are also being developed.

President Joe Biden on Monday said the United States has enough smallpox vaccine on hand “to deal with the likelihood of a problem.” During a news conference in Tokyo cited by USA Today, he added, “I just don’t think it rises to the level of the kind of concern that existed with COVID-19.”

Still, he warned people to be careful.

CNN reported that the CDC is monitoring six people in the United States after they sat near an infected fellow passenger on a flight from Nigeria earlier this month. An earlier confirmed case likely is related to travel to Canada. “And in New York City, one patient has tested positive for orthopoxvirus, the family of viruses to which monkeypox belongs, NYC health officials have reported,” the article said.

Linked to raves?

Since monkeypox has not previously triggered widespread outbreaks outside of Africa, where it typically comes from contact with infected animals, officials have been looking for a common link.

At least one expert believes that the link could be sexual activity at two raves in Europe, according to The Associated Press. “Dr. David Heymann, who formerly headed WHO’s emergencies department, told The Associated Press that the leading theory to explain the spread of the disease was sexual transmission among men at raves held in Spain and Belgium. Monkeypox has not previously triggered widespread outbreaks beyond Africa, where it is endemic in animals.”

But while The Associated Press said sexual activity might have helped spread the illness, “scientists say it will be difficult to disentangle whether the spread is being driven by sex itself or merely close contact, Anyone can be infected through close contact with a sick person — or their clothing or bedsheets.”

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Belgium said its three confirmed cases are linked to the Darklands fetish festival in early May in Antwerp.

CNBC reported that the CDC and The Health Security Agency in the United Kingdom “said they have noted a particular concentration of cases among men who have sex with men, and urged gay and bisexual men in particular to be aware of any unusual rashes or lesions.”

But Heymann, who last week chaired a World Health Order advisory group meeting on infectious disease threats, said there’s no evidence monkeypox has mutated to become more infectious. According to AP, he doesn’t expect widespread transmission.

“This is not COVID,” he said. “We need to slow it down, but it does not spread in the air and we have vaccines to protect against it.”

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