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There are two identified cases of monkeypox in Oklahoma. Health experts think there are more

Oklahoma’s state health department announced a second probable case of monkeypox on Friday, but health experts across the country are concerned that case numbers are artificially low.

Compared to COVID-19, monkeypox has a low transmission rate. Nonetheless, a global outbreak has infected thousands of people. There are several symptoms, but the predominant are skin lesions and blisters.

“I think these cases are going unrecognized because the disease is presenting a little differently,” said Dr. David Holden, Oklahoma State Medical Association’s president.

Historically, patients had swollen lymph nodes, fever, and rashes on highly visible parts of the body. Those were the common symptoms during the last U.S. outbreak in 2003.

“Before, when the lesions, the blisters, the pustules would show up, (they would appear on the) hands, face, typically like that,” Holden said. “Now they're showing up around the rectum, genitalia and the mouth … It looks like an STD.”

Health officials on the local and federal levels are concerned that both patients and medical providers could see those symptoms and write them off as a common sexually transmitted disease. The Centers for Disease Control and Prevention issued a guidance on June 14, telling health providers to test patients for monkeypox if those patients have skin issues that look like syphilis or herpes symptoms.

Agency officials are concerned that there hasn’t been enough surveillance testing, according to reporting by NPR.

"There could be community level transmission that is happening, and that's why we want to really increase our surveillance efforts," Jennifer McQuiston, the deputy director of the CDC’s Division of High Consequence Pathogens and Pathology, said Friday. "I want to emphasize that this could be happening in other parts of the United States."

The virus can spread through physical contact. Like smallpox, monkeypox lesions can contaminate surfaces such as clothes and blankets, and then spread from there. It seems more common in this outbreak for the virus to spread through sexual contact.

Holden said the virus can spread through respiratory droplets, like COVID. One major difference, though, is COVID particles are so small, they travel in tiny aerosol droplets and linger in the air. Monkeypox particles are too large for that, so they can’t spread as far — again, requiring close contact for transmission. So it’s not likely monkeypox will spread in a setting such as a grocery store.

Holden says if these symptoms do appear, call your doctor or county health department. If you have to go to an ER or other urgent facility, call ahead so health workers can take precautions.

Catherine Sweeney reports for StateImpact Oklahoma, focusing on health.
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