CDC’s travel advisory on monkeypox: ‘Practice enhanced precautions’

By Forrest Brown, CNN

The US Centers for Disease Control and Prevention has an “Alert — Level 2” advisory for travelers to “practice enhanced precautions” because of the spread of monkeypox, a rare disease that’s a cousin of smallpox.

On its advisory, the CDC said that the “risk to the general public is low, but you should seek medical care immediately if you develop new, unexplained skin rash (lesions on any part of the body), with or without fever and chills.”

The CDC has three types of levels it might issue as cases have been reported in dozens of destinations. The levels are:

• Watch — Level 1: Practice usual precautions
• Alert — Level 2: Practice enhanced precautions
• Warning — Level 3: Avoid nonessential travel

On its website, the CDC has not applied levels to specific destinations, as it does with Covid-19.

Level 2 precautions

The CDC has the following recommendations for travelers as we’re in Level 2:

• Avoid close contact with sick people, including those with skin or genital lesions.

• Avoid contact with dead or live wild animals. This includes rodents such as rats and squirrels and nonhuman primates such as monkeys and apes.

• Avoid eating or preparing meat from wild game or using products derived from wild animals from Africa such as creams, lotions and powders.

• Avoid contact with contaminated materials used by sick people such as clothing, bedding or materials used in healthcare settings or with materials that came into contact with infected animals.

Where monkeypox has been reported

Usually associated with tropical Africa, confirmed cases of monkeypox are now global. The CDC says cases have been reported in Europe, North America, South America, North Africa, the Middle East and Australia.

Here is a CDC list of destinations with confirmed cases as of June 6:

• Argentina
• Australia
• Austria
• Belgium
• Canada
• Czech Republic
• Denmark
• England
• Finland
• France
• Germany
• Gibraltar
• Hungary
• Ireland
• Israel
• Italy
• Latvia
• Malta
• Mexico
• Morocco
• Netherlands
• Northern Ireland
• Norway
• Portugal
• Scotland
• Slovenia
• Spain
• Sweden
• Switzerland
• United Arab Emirates
• United States
• Wales

The United Kingdom (England, Wales, Scotland and Northern Ireland), Spain and Portugal have so far reported the most cases, each with more than 100 as of June 6. All other destinations reported fewer than 100 cases as of June 6. Click here to see a current CDC global outbreak map.

Symptoms of monkeypox

There is an incubation period of some seven to 14 days, the CDC said. Initial symptoms are typically flu-like, such as fever, chills, exhaustion, headache and muscle weakness, followed by swelling in the lymph nodes, which help the body fight infection and disease.

“A feature that distinguishes infection with monkeypox from that of smallpox is the development of swollen lymph nodes,” the CDC said.

Next comes a widespread rash on the face and body, including inside the mouth and on the palms of the hands and soles of the feet. It can also spread to genital areas.

The painful, raised pustules are pearly and fluid-filled, often surrounded by red circles. The lesions finally scab over and resolve over a period of two to three weeks, the CDC said.

What you should do if you get sick

The CDC says first avoid contact with others. Other advice:

“If possible, call ahead before going to a healthcare facility. If you are not able to call ahead, tell a staff member as soon as you arrive that you are concerned about monkeypox.”

The CDC says your should tell your doctor any of the following if true in the month before developing symptoms:

• You had contact with a person that might have had monkeypox.

• You are a man who has had intimate contact (including sex) with other men.

• You were in an area where monkeypox has been reported or in an area where monkeypox is more commonly found (Cameroon, Central African Republic, Côte d’Ivoire, the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, Sierra Leone and Sudan).

If you are sick and could have monkeypox, the CDC says delay travel by public transportation until you have been cleared by a healthcare professional or public health officials.

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CNN’s Sandee LaMotte contributed to this article from previous reporting.