Monkeypox can also be airborne

The Centers for Disease Control and Prevention last week updated its guidelines for travelers wishing to protect themselves from monkeypox. This was one of his recommendations: “Wear a mask. Wearing a mask can help protect you from many diseases, including monkeypox. ”

Late Monday night, that recommendation was removed.

“The CDC has removed the mask recommendation from the MonkeyPix Travel Health Notice because it has caused confusion,” the agency said in a statement on Tuesday.

However, the agency still says that in countries where monkeypox is spreading, wearing the mask of “household acquaintances and healthcare workers” should be considered. That guideline “also applies to other people who may be in close contact with a person infected with monkeypox.”

The turnaround indicates a slightly discussed aspect of the current monkeypox outbreak: the virus may be airborne, at least a short distance away. Although airborne infections are a small cause of the overall spread, experts said in an interview that there is no definitive estimate of how much it contributes.

Since May 13, when the first case of the outbreak was reported, more than a thousand people have been infected in 31 countries, and at least a thousand more are being investigated. As of Tuesday, the United States had recorded 31 cases in 12 states and the District of Columbia.

Outbreaks appear to be exacerbated during previous outbreaks of those who had close contact with infected patients or animals. But in some cases, airborne infections were the only explanation for the infection.

Elsewhere on its website, the CDC still urges monkeypox patients to wear a surgical mask, “especially those with symptoms of shortness of breath.” It also tells other family members to “consider wearing a surgical mask” when they are in the presence of a person infected with monkeypox.

Monkeypox is thought to be behaving like its viral cousin, smallpox. In a 2012 review of smallpox, University of Maryland virus specialist Dr. Donald Milton cites several examples of airborne infections.

This was the only plausible explanation for the smallpox outbreak in New York in 1947, he wrote, when a patient apparently infected another patient seven floors away from a hospital. Then, in 1970, a single patient on the third floor of a hospital in Meshed, Germany, infected several others with the help of air currents in the building.

And scientists studying the 2017 Monkeypox outbreak in Nigeria have observed incidence of infectious diseases in prisons and recorded the infections of two healthcare workers who did not have direct contact with patients.

At a scientific conference hosted by the World Health Organization last week, a number of researchers discussed many unknown things about monkeypox, including the primary mechanism of infection.

Nancy Sullivan, a researcher at the National Institute of Allergy and Infectious Diseases, told the conference that “what is the real or effective route of transmission is very unclear, and some of these can be addressed in animal models.” “Perhaps it should take the front seat for some laboratory research.”

However, in briefings with the press and with the general public, health officials did not explicitly mention the possibility of using masks for airborne infections or protection.

And in the interview, they emphasized the role of large respiratory droplets that are excreted from infected patients and flow to objects or humans. Monkeypox infection “really requires close, sustainable communication,” said Andrea McCullum, CDC’s leading expert on the virus.

“It’s not a virus that spreads within a few meters,” he said. “That’s why we have to be really careful about how we frame it.”

When asked if health officials need to be made more aware of the possibility of airborne infections, Ms. McCallum said, “This is a fair matter, and this is something we must consider going forward.”

For travelers concerned about the monkeypox, the CDC’s Swift Abbott-face coronavirus on the mask reminds her of her early denial that it was airborne. In September 2020, the company issued guidelines for airborne transmission of the virus and then abruptly withdrew it a few days later.

It wasn’t until May 2021 that the agency acknowledged that the coronavirus could “hang in the air for minutes to hours.”

Much of the information about the monkeypox virus has been gathered from research on smallpox. For the past two decades, scientists have been studying how smallpox spreads, with its presence in tiny droplets called aerosols to prepare it for possible use by bio-terrorists.

Mark Chalberg, a virologist at the National Institute of Allergy and Infectious Diseases, said, “Most people think that smallpox is usually transmitted by large droplets, but for whatever reason, it can sometimes be transmitted through small-particle aerosols.”

Dr Milton warned that planning a possible airborne transmission of monkeypox is particularly important in hospitals, as precautions to prevent the spread of the virus through aerosols are not universal.

As the outbreak of monkeypox continues, many patients are isolated at home because their symptoms are mild. Members of this family may need to consider the possibility of airborne infections, experts say.

There are many unanswered questions about monkeypox, why the current outbreak has only made the case relatively light. Scientists do not know whether people can transmit the virus even in the absence of symptoms, how long the virus has been circulating in the community, and whether it can be transmitted through semen or vaginal discharge.

There is evidence that a pregnant woman can transmit the monkeypox virus to her fetus. In an observational survey of 216 patients in the Democratic Republic of Congo, four of the five largest pregnant women of its kind had abortions. Researchers have found viruses and viral lesions in the fetus.

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