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CDC Raises Monkeypox Travel Alert to Level 2, Revises Guidance

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The Centers for Disease Control and Prevention (CDC) has issued a new travel alert for monkeypox. On Monday, the CDC ramped up its monkeypox alert to level 2, and encouraged people to practice “enhanced precautions” to lower their risk of contracting the virus.

The next level of travel alerts—level 3—would encourage people to avoid nonessential travel. “Cases of monkeypox have been reported in Europe, North America, South America, Africa, Asia, and Australia,” the alert says. “Some cases were reported among men who have sex with men. Some cases were also reported in people who live in the same household as an infected person.” The alert also notes that “many of these people have not recently been in central or west African countries where monkeypox usually occurs, including the Democratic Republic of the Congo and Nigeria.”

The CDC briefly included advice in the alert to wear a mask, writing, “wearing a mask can help protect you from many diseases, including monkeypox.” However, that advice has since been removed.

Public health experts stress that the risk of contracting monkeypox is low to the general public, but cases continue to crop up across the country—and the world. A “situation summary” from the CDC says that there have been 31 confirmed monkeypox cases in the U.S. as of Monday.

Here’s what you need to know about the new travel alert, plus how to protect yourself.

Why was the travel alert raised?

The CDC suggests online that the increase in cases across the world led to the new travel alert. “There are ongoing cases of monkeypox in communities around the world,” says Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. “It is important for people to be cognizant of the fact as they travel.”

Public health officials have also “faced challenges” in tracing where these cases of monkeypox have come from, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “A lot of this transmission is sexual,” he points out. “It’s usually intimate contact that is fueling this transmission.”

The reason the alert has been issued, Dr. Schaffner says, is that “people are traveling to various countries where they may engage in intimacies.”

How monkeypox spreads

How does monkeypox spread? Monkeypox virus can spread when a person comes into contact with the virus from an infected animal, person, or materials that have been contaminated with the virus, the CDC says.

Monkeypox spreads between people mostly through direct contact with infectious sores, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact and during intimate contact between people—including during sex—as well as activities like kissing, cuddling, or touching parts of the body with monkeypox sores, per the CDC.

The virus may also spread from animals to people through the bite or scratch of an infected animal, by handling wild game, or through the use of products made from infected animals, the CDC says. You can get monkeypox from having direct contact with body fluids or sores on an infected person or with materials that have touched body fluids or sores, like clothes or linens.

How to stay safe from monkeypox while you travel

The CDC shared the following advice in the alert on how to stay safe from monkeypox:

  • Avoid close contact with sick people, including those with skin lesions or genital lesions.
  • Avoid contact with dead or live wild animals, including rats, squirrels, monkeys, and apes.
  • Avoid eating or preparing meat from wild game.
  • Don’t use products derived from wild animals from Africa, like creams, lotions, and powders.
  • Avoid contact with contaminated materials used by sick people , like clothing, bedding, or materials used in healthcare settings, or that came into contact with infected animals.

    While the warning is technically a travel warning, experts say the risk of contracting monkeypox on a plane is low. “It is not the travel or the mode of conveyance that confers the risk, it is what activities people engage in at other destinations that confers the risk,” Dr. Adalja says. “There have been cases linked to raves, ‘saunas,’ and other activities that individuals travel to amplify transmission.”

    Dr. Schaffner agrees. “It doesn’t spread the way COVID does,” he says.

    Dr. Russo says it’s possible you could pick up monkeypox on a plane, but unlikely. “It really requires close contact with sick people, particularly those that have skin lesions,” he says. “It can be transmitted through respiratory droplets. If someone was infected in close proximity, it’s possible there could be transmission.” That, Dr. Russo says, is likely why there was some brief guidance on masking while you travel. “But the risk of acquisition while you actually travel is low,” he adds.

    Dr. Adalja agrees. “Although respiratory transmission is possible with monkeypox, it is not an efficient means of transmission—especially in this outbreak where direct contact is the primary mechanism of spread,” he says.

    Still, experts stress the importance of masking up while you travel anyway. “If you’re going on a plane, I continue to recommend wearing a mask to protect against COVID,” Dr. Schaffner says. Dr. Russo agrees. “At this time, the risk of acquiring COVID-19 [like BA.2.12.1] during travel is more likely than monkeypox,” he says.

    This article is accurate as of press time. However, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC and WHO to stay informed on the latest news. Always talk to your doctor for professional medical advice.

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