Public health officials reported the first presumptive case of monkeypox in Washington state on Monday.

Public Health – Seattle & King County is investigating the case in a King County man, who recently traveled to a country with confirmed monkeypox cases, though health officials declined to provide additional details about the patient and the country during a Monday news briefing.

The Centers for Disease Control and Prevention will confirm the presumptive monkeypox case, according to state and local health officials.

FILE – This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. A leading doctor who chairs a World Health Organization expert group described the unprecedented outbreak of the rare disease monkeypox in developed countries as “a random event” that might be explained by risky sexual behavior at two recent mass events in Europe. (Cynthia S. Goldsmith, Russell Regner/CDC via AP, File)

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Though monkeypox is rarely identified outside of Africa, as of Saturday, 92 confirmed cases and 28 suspected cases of monkeypox were under investigation in 12 countries, the World Health Organization reported.

King County public health officer Dr. Jeff Duchin on Monday said the public shouldn’t be concerned at this time, though they should be aware and monitor for symptoms and unexplained rashes.

Here’s what to know about the global outbreak and the presumptive case in Washington.

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What is monkeypox?

Monkeypox is a viral illness uncommon in the U.S, but as of Monday morning, the CDC had identified one confirmed and four other presumptive monkeypox cases in the U.S.

There are two strains of monkeypox, known as the Congo Basin and West African strains. The monkeypox outbreaks reported so far have been linked to the West African strain, which has a lesser mortality rate of the two strains, Duchin said Monday.

The disease belongs to the same virus family as smallpox, but its symptoms are milder. People usually recover within two to four weeks without hospitalization, but the disease can be deadly.

Monkeypox can affect anyone, and those who are most at risk are those who have had close physical contact with someone with monkeypox. In the recent surge, cases have been reported to be especially prevalent among men who have had close or intimate contact with other men, Duchin said, though the risk is not limited to men who have sex with men.

How is it spread?

While the virus has not easily spread from person to person in past outbreaks, transmission between people appears to be common in the latest confirmed cases, Duchin said.

Monkeypox can be transmitted through contact of bodily fluids from an infected person, sores, rashes or through infected items such as clothing or bedding.

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Prolonged face-to-face contact with an infected person could also lead to transmission through respiratory droplets entering the eyes or mouth, according to Duchin.

In parts of central and West Africa where monkeypox has been reported, people are usually exposed to the disease from bites or scratches from rodents and small mammals, preparing wild game, or contact with an infected animal or animal products, according to health department.

What are the symptoms?

The disease can be serious and present complications, especially for those who are immunocompromised, pregnant or very young.

Monkeypox cases reported so far in the latest outbreak have been generally mild or moderate and there have been no deaths linked to the disease, Duchin said.

The illness typically lasts for two to four weeks, according to the CDC. The time from infection to symptoms is usually seven to 17 days, but can range from five to 21 days.

Initial symptoms include:

  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Chills
  • Exhaustion

Within three days of the onset of a fever, people develop a rash on the face, body or groin area that then spreads. Similar to smallpox, lesions can scar.

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Is there treatment?

Currently, there is no proven, safe treatment for monkeypox, according to the CDC.

However, smallpox vaccine, antiviral drugs and and immunoglobulins used against smallpox have shown to be effective in this disease.

The smallpox vaccine is about 85% effective at preventing monkeypox, according to WHO.

When should I contact a health care provider?

People should seek medical evaluation if they notice new rashes characterized by sores, bumps or fluid-filled bumps.

People who have traveled to central or West African countries, European countries, or other regions with confirmed cases a month prior to the onset of symptoms should contact a health care provider, according to Public Health – Seattle & King County.

Additionally, individuals with symptoms who have had contact with someone with a confirmed or suspected case of monkeypox or should consult a health care provider.

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King County residents who suspect they may be infected are asked to contact Public Health – Seattle & King County at 206-296-4774.

Patients can be evaluated in the county’s sexual health clinic, housed at Harborview Medical Center, which is open Monday, Wednesday, Thursday and Friday from 7:30 a.m. to 6 p.m., and Tuesday from 9:30 a.m. to 6:00 p.m.

What are preventive measures?

The CDC recommends:

  • Avoiding contact with animals that could harbor the virus, including sick or dead animals in areas where monkeypox occurs.
  • Avoiding contact with any materials, such as bedding, that has been in contact with a sick animal.
  • Isolating infected persons from others who could be at risk for infection.
  • Practicing good hand hygiene after contact with infected animals or humans, like washing hands with soap and water or using an alcohol-based hand sanitizer.
  • Using personal protective equipment when caring for patients.

What do we know about presumptive case in Washington?

There is no suspected outbreak in the state and health officials do not believe there’s been a high risk exposure, Duchin said during the Monday news conference. As of Monday, less than a dozen people had close contact with the King County patient while he was infectious.

He has not been hospitalized and is recovering at home, where he is quarantining.

Local health officials alerted the CDC and other agencies and will continue to watch for additional cases or potential exposure.

Does this rise to the level of a pandemic?

While news of monkeypox cases might lead some to worry that the outbreak could herald another pandemic, confirmed cases reported in various countries have currently not been epidemiologically linked.

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While investigations are ongoing, as of May 13, there is currently no “established travel link” appearing between cases reported and the regions where monkeypox is prevalent, WHO said.

Public health officials are still gathering information and the CDC is also tracking multiple clusters of monkeypox that have been reported in early- to mid-May.  

On Sunday, President Joe Biden said the monkeypox threat, though concerning, doesn’t rise to the level of COVID-19.

While there may be a significant number of additional cases reported, it is unlikely that it will result in another global pandemic or “anything like we’re seeing with COVID-19.” Duchin said Monday, calling the timing an “unfortunate coincidence.”

Where have cases been reported?

Several cases of monkeypox in the U.S. were confirmed to WHO between May 13 and May 21, according to the agency.

A Massachusetts man who had recently traveled to Canada was the first case of the rare virus detected in the U.S. this year. The CDC confirmed his positive test Wednesday.

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On Thursday, the New York City Department of Health announced that it was investigating a possible monkeypox case after a patient tested positive for orthopoxvirus — the family of viruses to which monkeypox belongs.

Another presumptive case was also being investigated in Broward County in South Florida on Sunday, also believed to related to international travel.

The Salt Lake County Health Department in Utah said it was investigating two “probable cases” among two adults in the same household, who became infected after traveling internationally to an area currently experiencing monkeypox outbreaks earlier this month.

As of Saturday, the WHO had reported a total of 92 confirmed cases and 28 suspected cases across 12 different countries, including the U.S., Canada and Australia.

European countries with confirmed cases include Belgium, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden and the United Kingdom, according to the agency.

Between January and May, 1,238 cases and 57 deaths linked to monkeypox were reported in the Democratic Republic of the Congo, WHO said. Around the same time period, 46 cases were reported in Nigeria.

Between mid-December and late February, 25 cases and less than five deaths were reported in Cameroon, and between March and April, six cases and less than five deaths were reported in the Central African Republic.