The alert level for travelers has been raised by the U.S. Centers for Disease Control and Prevention as monkeypox continues to spread. The number of confirmed cases of the virus has reached more than 1,000 worldwide, including two in Salt Lake County.

The CDC is warning that travelers should now “practice enhanced precautions,” against monkeypox, spelling out they should avoid:

  • Close contact with sick people, including those with the disease’s telltale rash or pustules on their skin or genitals
  • Contact with dead or live wild animals such as small mammals including rats, squirrels and other rodents, as well as monkeys, apes and other nonhuman primates.
  • Eating or preparing wild game or using products derived from wild animals in Africa
  • Contact with clothing, bedding or health care materials that have been used by people with the virus or that may have come into contact with infected animals

An earlier version of the CDC’s precautions included wearing a mask but that recommendation was deleted “because it caused confusion,” the agency said in a statement, according to a story posted Tuesday by The New York Times that warned the virus can be airborne.

There are three levels of travel advisories issued by the CDC: Level 1, where people are told to “practice usual precautions;” Level 2, where enhanced precautions like those above are recommended; and Level 3, where people should “avoid nonessential travel.”

Why monkeypox now a ‘moderate’ risk to the world’s health

The risk to the general public remains low, the CDC said. Monkeypox is a rare disease, fatal in up to 11% of cases according to the CDC, that had been largely confined to parts of Africa and transmitted through human contact with infected animals, but now appears to be spreading human to human.

Many of those infected are men who have had sex with men, but public health officials have stressed monkeypox can be can be spread through other types of prolonged, close contact, including with clothing, bedding or other materials contaminated by the virus.

As of Tuesday, the CDC is reporting 1,088 confirmed cases in 29 countries. The most, just over 300, have been in England and other parts of the United Kingdom, followed by Spain, Portugal, Canada, Germany, France and the United States, where at least 34 cases have been confirmed in more than a dozen states.

Two adults in the same Salt Lake County household who had traveled to a European country where monkeypox had been seen were announced as Utah’s first probable cases of the virus on May 23 by the Salt Lake County Health Department.

Nicolas Rupp, a county health department spokesman, said Wednesday the pair “are healed and ended their isolation last week” and currently, there are no suspected, probable or confirmed cases of monkeypox in Salt Lake County.

When the cases were confirmed, he’d said the infected individuals remained “in isolation and do not present a risk to the public; both individuals are expected to recover fully,” Previous contact tracing did not identify anyone at high risk from the local cases, the county health department has said.

The Utah cases were confirmed as monkeypox through additional testing by the CDC and the agency made it clear that all of the U.S. cases at that point involved men. That’s changed as the virus has spread, although little information on those with the disease is being made public due to privacy concerns.

The CDC says anyone with an unexplained rash or lesions on any part of the body should seek medical care immediately and avoid contact with others. Fever, headache, muscle aches, and swollen lymph nodes can also occur before a rash develops that turns into fluid-filled pustules, which eventually scab over and fall off.

Those who think they may have monkeypox should alert health care providers in advance by calling ahead if possible, the CDC says, and not use public transportation until they have been cleared to do so by a medical professional or public health officials.