Minnesota has reported a presumptive case of monkeypox, an infectious disease that has raised concerns because it emerged globally this spring and has been found in 26 U.S. states.
The infection announced Monday involves a Twin Cities man who is receiving outpatient treatment for an infection that likely occurred during travel to Europe. The state's public health laboratory identified the infection on Saturday night with a positive test result, which is being confirmed by the Centers for Disease Control and Prevention.
The man did not appear to have close contacts in Minnesota that present high risks of spreading the virus to others, said Dr. Ruth Lynfield, state epidemiologist and medical director of the Minnesota Department of Health.
The risk to the broader public is low because the monkeypox virus doesn't spread as easily as other infectious agents that cause measles, influenza or COVID-19. Transmission often involves prolonged face-to-face exposure or contact with infectious sores or bodily fluids, or with contaminated clothing or other items.
"It's important that everyone be aware of this disease, so that those at risk can seek medical care and get tested promptly if they believe they have symptoms," said Minnesota Health Commissioner Jan Malcolm.
The CDC has identified more than 200 monkeypox cases in 26 states. Common symptoms include fever, fatigue, headaches, muscle aches, swollen lymph nodes and a rash that can look like pimples or blisters. Some people in the outbreak have only reported rashes, which typically are found on the hands, feet, face or genitals.
Antiviral treatments and vaccines are available but are used on a case-by-case basis. The CDC recommends monkeypox vaccine in advance of exposure only to health care workers and researchers who work with the virus.
People with monkeypox are considered infectious until their rashes have healed. Typical illnesses last two to four weeks. Rare cases can cause pneumonia or be fatal.
The World Health Organization raised concerns this year because monkeypox is spreading from person to person and occurring outside Africa and in countries that typically don't have cases.
Clusters of the infection are common in tightly knit social groups, and have been identified globally in groups of men who have sex with other men. Close physical or sexual contact with an infected individual is a transmission risk, however monkeypox is not considered a sexually transmitted infection and there are other risks for exposure.
Health authorities in New York and England responded to case clusters by offering vaccine to gay and bisexual men who may have been exposed to the virus through recent sexual activity with multiple or anonymous partners.
"This being the first Minnesota case ... it seems perhaps a bit early" to consider that strategy locally, Malcolm said.
Another potential public health response is ring vaccination, providing shots to all of the close contacts of an infected person and then to the close contacts of those contacts, said Rick Kennedy, co-director of Mayo Clinic's vaccine research group. "If we get everyone around that person protected, then they are less likely to spread it to other individuals," he said.
Kennedy said this isn't likely to be Minnesota's last case, but that the risk remains low for now and largely related to travel outside the state rather than viral spread within the state.
Minnesota first issued a health alert in mid-May so that providers at emergency departments, dermatology clinics, sexual health clinics and other medical facilities would be on the lookout for symptoms.
Monkeypox is considered zoonotic — meaning it can spread across species from animals to people. It was first discovered in monkeys in the 1950s, and the name is somewhat of a misnomer as rodents were thought to be the primary means of spread before this year's person-to-person outbreak.