Michigan health officials, who on Wednesday announced the state's first presumed case of monkeypox, told the Free Press Thursday that Michigan doesn't have any doses of Jynneos, the smallpox and monkeypox vaccine used to prevent disease or limit severity of symptoms.
The vaccine has been held in the Strategic National Stockpile, and so far has only been distributed to states with outbreaks of the virus, said Lynn Sutfin, a spokesperson for the Michigan Department of Health and Human Services.
"States have not been allocated vaccine prior to identification of a case," Sutfin said, adding, however, that the national strategy on Jynneos distribution is starting to change. "MDHHS is working with the local health department to identify any high-risk contacts and will order Jynneos vaccine as appropriate."
Jynneos can be used after exposure to monkeypox to prevent illness or make it less severe in people ages 18 and older. It is given in two injections spaced four weeks apart.
However, the sooner the vaccine is given after exposure, the better. Ideally, a person who was exposed to monkeypox should get vaccinated within four days of exposure to prevent disease, or four to 14 days after exposure to limit the severity of disease, according to the U.S. Centers for Disease Control and Prevention.
While the CDC does not advise widespread monkeypox vaccination, it suggests the vaccine may be recommended for people who:
Have had confirmed close physical contact with someone diagnosed with monkeypox.
Have a sexual partner who was diagnosed with the virus.
May have been exposed.
Are men who have sex with men who have recently had multiple sex partners in an area where monkeypox was confirmed or where the virus was spreading.
Perform laboratory testing to diagnose monkeypox and may be at risk of exposure.
More vaccine doses are now being distributed to states from the federal stockpile to help combat the outbreak, which has spread to at least 27 states and 51 countries outside of its endemic areas as of June 29, according to the CDC.
As of Tuesday, the U.S. Department of Health and Human Services had allocated 9,000 doses of vaccine and 300 courses of antiviral smallpox treatments from the Strategic National Stockpile to 32 states and U.S. territories. The goal is to distribute 1.6 million doses over the next several months.
Federal officials also are ramping up testing capacity — providing orthopoxvirus tests to 78 sites in 48 states, allowing the U.S. to conduct 10,000 tests per week.
The CDC recommends that anyone with a rash that is consistent with monkeypox seek medical care. The agency also is urging health care providers to be on the lookout for possible cases, regardless of a patient's risk factors, travel history, gender or sexual orientation.
Michigan's first presumed positive case was diagnosed in an Oakland County resident by a swab sample, said Calandra Green, Oakland County health officer. The sample was collected Monday and sent to the State Bureau of Laboratories. The presumed positive test result was announced two days later.
"The confirmatory test was sent to the CDC," Green said. "It is a presumed positive result. So it's highly likely that the confirmatory tests will be positive."
Sutfin said the CDC should have a definitive answer within a few days, but noted that because monkeypox is the only orthopoxvirus circulating in the U.S. at this time, the testing completed at the State Bureau of Laboratories "is sufficient for determining the diagnosis."
"To protect patient privacy, no further case details will be provided," she said.
Sutfin did not say whether the Michigan person with the virus is hospitalized but told the Free Press: "So far in the U.S., hospitalization is not common and generally has occurred for pain management and not necessarily due to severe, disseminated infection."
Green said it's important for people to understand that monkeypox is not as transmissible as COVID-19, and risk is very low.
"This case is currently isolating and poses no risk to the public," she said. "Monkeypox is very vastly different than what we've seen over the last two years with COVID-19 being highly contagious and infectious."
It can take up to 21 days for symptoms to develop after a person is infected, according to the CDC. But when symptoms first appear, they are typically flulike and include the swelling of lymph nodes. Common are:
Swollen lymph nodes
From one to three days after the flulike symptoms begin, people typically develop a rash and lesions that may start in one place on the body and spread to other parts.
Lesions progress through stages and scab before falling off.
The illness typically lasts two to four weeks, and could initially be confused with a sexually transmitted disease such as syphilis or herpes.
Monkeypox is contagious when a rash is present and up until the scabs have fallen off, Green said. It can be contracted person-to-person through direct contact with infectious rash, scabs or bodily fluids, through respiratory secretions during prolonged or face-to-face contact or intimate physical contact.
"It's usually associated with a rash that can look like pimples or blisters that appear on the face, the inside of the mouth, and other parts of the body like the hands and feet, the chest, the genital area," Green said.
"It's very hard to dismiss it."
Contact tracing is underway now with people who have been in close contact with the Oakland County resident who is believed to have the virus.
"When there is a communicable disease like monkeypox, we work with the case to do an investigation, try to determine where the case has been, where have they traveled to, any behaviors associated with tracking monkeypox and then identifying those close contacts," Green said.
"Those close contacts are monitored in the same or a similar fashion to what we do with COVID in that we monitor for any signs and symptoms of the infection during the contact-tracing period.
"If and when any signs and symptoms of monkeypox are exhibited in those close contacts, then we would then refer them to a health care provider who could quickly identify, test those individuals and then notify the state."
Contact Kristen Shamus: firstname.lastname@example.org. Follow her on Twitter @kristenshamus.
This article originally appeared on Detroit Free Press: Michigan doesn't have any doses of vaccine used to prevent monkeypox